Frequently Asked Questions

SPERM DONATION

Where do sperm donors come from? How are they chosen?
Sperm donors are recruited by our coordinators through the voluntary offers we receive on our web site CRYOBANK. To be chosen, they must meet a series of pre-established medical, psychological and physical requirements. Dr. Osés is the founder and medical director of the bank and is responsible for evaluating and accepting potential donors.

Can we meet the donor or see photos?
The sperm donation program is anonymous, for both the donor and the recipient. Specific physical data about the donor can be provided, but no identifying information. In some instances, we can share photographs of the donors as children. Dr. Osés has been in charge of accepting them in the program and can assist you with matching. 

What types of donors are there?
The anonymous donor (the most common), the known donor (provided by the patient) and the DIA donor, who agrees to have his identity revealed to the person conceived with his sperm, if requested, upon reaching adulthood. 

Can a single woman undergo artificial insemination and/or IVF with donor sperm?
Yes, Dr. Osés performs artificial inseminations and IVF with donor sperm in single women and/or in couples (with male or female partner).

EGG DONATION

What are the reasons for using donor eggs?
Most women use donor eggs because their ovaries do not produce sufficient amount or good quality eggs. The main reasons for this are: advanced age, diminished ovarian reserve, being a carrier of a genetic condition or having a significant family history for a genetic condition, and repeated failures of assisted reproductive techniques. 

What are the requirements in order to become an egg donor recipient?
Up to 50 years of age and completion of a series of pre-conception studies.  

What is the pregnancy rate in egg donation?
The pregnancy rate is approximately 50%.

What medications are needed to undergo an egg donation cycle?
Oral medications (tablets) to prepare the endometrium (where the embryo will nest). 

Does pregnancy rate decrease with egg donation in women over 40?
No, pregnancy rate depends on the age of the eggs (donor) and not on the age of the uterus (recipient). Several studies have shown that pregnancy rate is similar in recipients between 25 and 50 years of age.

What is the age limit to be accepted as a recipient at ARGENTINA FERTILITY SERVICES?
Recipients must not be over 50 years old. 

What happens during a fresh cycle if the donor is cancelled or enough mature eggs are not retrieved?
A minimum of 9 (nine) mature eggs are guaranteed for each recipient in a fresh cycle. If the donor's cycle is cancelled, or less eggs are retrieved, another donor will be assigned to the recipien. There are no extra costs in these cases. Transfer of one blastocyst (Day 5 embryo) is guaranteed. 

Can I meet the donor chosen for me when undergoing a fresh cycle?
No, the program is anonymous for both the donor and the recipient. No identifying information will be provided; only physical features such as height, weight, hair color, eye color and ancestry.

What are the advantages of using vitrified donor eggs?
The advantages are that the eggs are already available (no waiting list) and the information on the donor can be chosen from a database.

Moreover, at OVOGENETIC we run a personalized donor search program for patients with special or specific needs. This includes finding the right donor, running tests (routine, infectious and genetic), sharing personal details and providing pictures (as a child, as an adolescent and current).

How old are the donors and how are they selected?
Donors are between 21 and 32 years of age. This decreases the chances of poor-quality eggs and aneuploidy (chromosomal abnormalities); less chances of Down syndrome.  

How many embryos are transferred?
Usually one embryo (occasionally two) at the blastocyst stage is transferred into the recipient's uterus. The objective is to have a good chance of pregnancy, avoiding the risk of triplets. 

What happens with exceeding embryos?
In the event more embryos are obtained they are frozen and can be used for another transfer (at a later date) if either pregnancy is achieved or if transfer is not successful.

What are the obstetric risks for a recipient who becomes pregnant with donor eggs?
The obstetric risks in egg donation are related to the age of the recipient. The obstetric risks in women well above forty are: hypertension, diabetes, premature delivery, low birth weight and bleeding during the second half of pregnancy. These complications are generally well managed with good prenatal care. 

How long before a donor is assigned to me?
The waiting time for donor assignment goes from two to three months, from the moment you decide to participate in our program, or sometimes longer if you are looking for specific characteristics. The possibility of using vitrified donor eggs means that there is no waiting time and specific requirements can be met.  

Can donor sperm be used to fertilize donated eggs?
Yes, our sperm bank has a wide selection of donors with European ancestry CRYOBANK.

IN VITRO FERTILIZATION

What is the pregnancy rate with in vitro fertilization using a woman's own eggs?
The pregnancy rate depends on the age of the woman. It is approximately 50% in women under 38 years of age, 35% in women between 38 and 40 years of age, and 20% in women over 40 years of age. 

Are miscarriages more frequent in older women?
Miscarriages and chromosomal abnormalities increase as the woman's age increases. In case of egg donation, they are related to the age of the donor and not to that of the recipient.

Is it possible to diagnose genetic diseases in the embryo?
Yes, preimplantation genetic screening (PGT-A) or preimplantation genetic diagnosis for monogenic disorders (PGT-M) can be used to detect some chromosomal abnormalities or genetic mutations. The main reasons for requesting this study include family history for a genetic disease that can be transmitted to the offspring, multiple IVF failures, and recurrent miscarriages.

SPERM RETRIEVAL IN AZOOSPERMIA 

Is it convenient to perform sperm testicular aspiration before ovarian stimulation for egg retrieval and fertilization?

In general, it is preferable to perform sperm aspiration before ovarian stimulation, since sperm may not be found; and, sometimes, a simultaneous testicular biopsy with anatomopathological analysis is necessary to arrive at an accurate diagnosis. It is important to emphasize that there are no differences between the results obtained from ICSI with fresh spermatozoa than with cryopreserved spermatozoa. If sperm were not recovered with the sperm aspiration procedure, the couple could opt for artificial insemination with donor sperm, for which it is not generally necessary to resort to in vitro fertilization, which is more costly and more laborious.

Nevertheless, when patients come from abroad we prefer simultaneous treatment (testicular aspiration and ovarian stimulation) for two main reasons: 1) in certain cases the quantity of sperm obtained is scarce and it is preferable to undergo ICSI instead of freezing it; and 2) patients are prepared to receive sperm donation if retrieval is not successful. 

Are genetic studies necessary before performing ICSI with sperm obtained from sperm aspiration?
Some genetic studies are essential and others are optional. Azoospermia is frequently associated with a genetic disorder. In patients with bilateral vas deferens agenesis, a cystic fibrosis gene mutation is found in more than 60% of cases. The woman should also be tested to evaluate her carrier status. If both partners have any cystic fibrosis gene mutation, the chance of fathering a child with cystic fibrosis is 50%. Approximately 15% of AZNO patients have a genetic abnormality detectable through sophisticated studies of the Y chromosome (so-called microdeletions). If the patient has a microdeletion and fathered a male child, he would inherit the problem. In addition, other chromosomal abnormalities are frequently found in men with AZNO through karyotyping, and these abnormalities can be inherited by children born with ICSI. When genetic abnormalities are found, the couple should be referred to a geneticist for counseling before being offered a sperm aspiration and ICSI procedure. Since sperm retrieval attempts are sometimes unsuccessful, the couple should consider using donor sperm. In many cases there is ambivalence about this issue, so psychological counseling with a specialist on the subject should be advised to discuss the implications of having a child who is not genetically linked to the father.

Can you predict if a patient has intratesticular sperm before undergoing sperm aspiration?
There is no way to know with certainty if a patient will have sperm in the testicle before undergoing sperm aspiration. If the diagnosis is AO the recovery rate is very close to 100%; however, if the diagnosis is AZNO, we are successful up to 60% of the time only. It has been established that there are no biochemical or physical parameters that can indicate which patients will have sperm in the testicle. Recently, inhibin B has been described as a test that would help predict the presence or absence of intratesticular spermatozoa in patients with AZNO, but this study is not absolute. Likewise, the type of microdeletion in the patient with AZNO would also contribute to the selection of patients with more possibilities of harboring sperm in the testicles (AZFa, AZFb or AZFc), although it should be remembered that only 15% of azoospermic patients have a microdeletion ever detected.

What are my chances of having sperm in the testicle if a biopsy done a few years ago was "negative"?

In a study carried out at the Institute of Gynecology and Fertility we have shown that intratesticular spermatozoa can be found in 20% of patients with abnormal anatomopathological studies! In other words, it is still possible to try to achieve biological paternity. Sperm aspiration (using the appropriate technique) is very successful in the cases selected by our group; it is a minimally invasive procedure, and allows men with very few sperm in the testicle to achieve biological paternity. Our goal is to provide the most effective and least invasive method to obtain the highest quantity of good quality spermatozoa to avoid multiple future interventions. Multiple sperm aspiration procedures (especially TESE) can cause alterations in testicular function, including testicular atrophy and decreased testosterone levels, sometimes transiently and sometimes permanently; therefore, these procedures should be performed by professionals with extensive experience in this area.