Premature ovarian insufficiency and fertility

We understand that you must be extremely distressed with the news that you have attained premature menopause and that you may not be able to start your own family. Your own eggs have indeed been exhausted, but there are now ways around this. While adoption is one approach, more and more women like you are resorting to egg-donation IVF.

There are several options which you should be aware of which may enable you to start a family.

Unlike women with regular periods, women with premature ovarian insufficiency do not ovulate (release an egg) every month. However, studies have shown that women with unexplained premature ovarian insufficiency do sometimes ovulate and approximately 5–10% will become pregnant over their lifetime. Unfortunately, there is no way of predicting which group of women this will happen to.
Women who resume menstruation and ovulation following recovery from chemotherapy are fertile and may be able to conceive naturally.
The combined oral contraceptive pill is not a suitable treatment for you if you want to become pregnant because it prevents ovulation.
HRT does not affect your chances of becoming pregnant.
You can have fertility treatment using eggs donated by an egg donor and fertilised in a test tube (in vitro fertilisation [IVF]) with your partner’s sperm. You will need to take HRT to prepare the womb and thicken the womb lining before an embryo is placed inside. HRT is continued for the first few weeks of pregnancy.
Many couples decide that remaining childless is a positive option. Adoption is a rewarding way of building a family, but it is not always easy. Adoption agencies would expect you to have ended any fertility treatment before you apply.

At the Premature Menopause Clinic London, we can provide you with all the necessary support and guidance that you will throughout your journey of fertility treatment. We can help you get in touch with some of the leading fertility clinics in UK and abroad which offer egg donation IVF treatment. We can also help complete baseline investigations and preparations (including optimising HRT) that you will need to embark on egg donation IVF treatment.

Egg-donation IVF could be the solution

Egg and embryo donation are ways to help you conceive, using donors. Egg donation is when eggs from another woman are fertilised with your partner’s sperm in a laboratory. The resulting embryos are then transferred to your womb (uterus).
Embryo donation is when another couple’s embryo is implanted in your womb during IVF. This is an option if you and your partner need both egg and sperm donation, or if you’re a single woman who cannot use your own eggs.
The process starts with finding a donor. Egg donations can be from egg donors or egg sharers:

Egg donors are women who are not receiving fertility treatment themselves, but who choose to donate their eggs to help other women, or a particular woman they know.
Egg sharers are women undergoing fertility treatment, who donate some of their eggs as part of their IVF cycle.

Embryos are usually donated by couples or women who have successfully had their baby or babies from IVF and who want to help other parents-to-be.

In the UK, donors aren't paid, apart from basic expenses, so they give their eggs or embryos voluntarily. However, clinics may offer benefits for egg sharers or embryo donors by giving discounts on their treatment, reduced storage charges or quicker access to treatment.
It’s recommended that egg donors are under 36 years of age, because fertility treatment is more successful with younger eggs. But there can be exceptions to this, such as when a woman is donating eggs to friends or family. All egg donors are screened for infectious diseases such as HIV, hepatitis B, hepatitis C, and some genetic conditions such as cystic fibrosis, before their eggs are used. Where possible, egg donors may be matched as closely as possible with the recipient couple for characteristics such as hair colour, eye colour, occupation, and even interests.
Where possible, egg donors may be matched as closely as possible with the recipient couple for characteristics such as hair colour, eye colour, occupation, and even interests.

No information that could identify an egg donor is allowed to be given to a child until he or she is 18. However, if a child born as a result of donation is in a sexual relationship when he is 16, he can find out about the donor. In cases of both egg and embryo donation, the woman giving birth to the child is the legal mother. Your partner will be the other legal parent if you’re married or in a civil partnership. If not, you’ll need to sign legal parenthood consent forms before the treatment takes place.

There may be differences between countries in terms of the legal framework regulating all aspects related to fertility treatments, for instance the anonymity or the age of the donor, among others. Consequently, if you are planning to undergo a treatment outside of the United Kingdom, we recommend that you ask for information on the legal specificities of that particular country.

Egg-donation IVF – take me through the process

You and your partner will need to have some baseline tests before starting treatment. These include –

For female partner

Pelvic ultrasound scan
Detailed reports of any previous treatments
Recent full blood count
Blood group
Serology tests for infectious diseases (no older than six months): HIV 1 and 2, hepatitis B antigen (HBsAg), VHC (hepatitis C) and syphilis (RPR)
TSH and free T4

For male partner

Semen analysis
Karyotype
Recent full blood count
Blood group
Serology for infectious diseases (no older than six months): HIV 1 and 2, hepatitis B antigen (HBsAg), VHC (hepatitis C) and syphilis (RPR)

Consultation with Premature Menopause Clinic, London

Optimisation of HRT

Baseline investigations

2 weeks

Initial consultation with Fertility clinic (UK or Spain)

Treatment plan provided by the clinic

6 - 8 weeks

Treatment completed by Fertility clinic

Follow-up and monitoring at Premature Menopause Clinic, London

The process of IVF needs to be coordinated so that you and the egg donor have synchronised fertility cycles. You will both be given hormones to make sure this happens. So, at around the time that your womb lining is able to support an embryo, your donor needs to be ovulating.

Your egg donor will also be given fertility drugs to help her to develop several mature eggs for fertilisation. When the eggs are ready, a doctor will remove them using a fine, hollow needle.

On the same day as the eggs are collected from your donor, your partner needs to provide a semen sample. The eggs will then be mixed with his sperm in a laboratory if you’re having standard IVF. Or if you’re having ICSI, one sperm is injected into each egg. Two days later, any fertilised eggs become a ball of cells called an embryo.

The embryo is then transferred into your womb through your cervix with a thin catheter (tube). This happens between two days and six days after fertilisation. It’s recommended that only one embryo is transferred in order to avoid a multiple pregnancy.

In some cases, the fertilised donor eggs and the resulting embryos are frozen to allow for embryo transfer to take place on another day. This means your menstrual cycle doesn't need to be synchronised with the donor. This may make your treatment cycle less stressful. If all goes well, at least one of the embryos will stick to your uterine wall and continue to grow. You can take a pregnancy test in about two weeks.

Improvements in freezing technology means it’s also possible for donor eggs to be frozen until selected for treatment. The thawed eggs are then fertilised with the sperm and the resulting embryos are transferred to your womb. This approach doesn’t require synchronisation with your menstrual cycle either.

Egg-donation IVF: costs, success rates, where, when, how?

Each IVF treatment cycle using donated eggs has a success rate of about 35 to 50 per cent. It can depend on your age and whether the sperm used is your partner’s or donated. Bear in mind that it may take several attempts before it’s successful. There are several factors which can influence the success rates, and a healthy lifestyle including cessation of cigarette smoking, healthy diet and regular exercise can go a long way in helping you through the process.

The cost of egg donation IVF treatment usually ranges from a minimum of about £4000 up to £9000 all in.

How can we help?

Where can I get more information?

Human Fertility and Embryology Association – Information about IVF and list of clinics

Donor Conception Network - www.dcnetwork.org click here www.dcnetwork.org

BarcelonaIVF

Instituto Bernabeu

The Daisy Network

National Gamete Donation Trust – Information about donor eggs

British Menopause Society

International Menopause Society