Donor eggs and pregnancy loss – risks, recovery and next steps in treatment
Got questions about donor eggs and pregnancy loss?
If you’re on a donor egg fertility journey, navigating the nuances of donor eggs and pregnancy loss, as well as risks, recovery, and finding the right support can feel like a difficult prospect.
We chat with expert Dr. Natalia Pylypenko, Оbstetrician-gynecologist from the International Fertility Group (IVF) who guides us through pregnancy loss when using donated eggs. We’ll unravel insights on the likelihood of miscarriage with donor eggs, and discuss the essential aspects of recuperation, including the right time to return to work.
Looking for more support, or specific guidance for next steps for treatment? Connect with their expert team today who can help you with a personalised plan.
Transcript
Eloise Edington
Hello, good evening. Hi to those who are joining, welcome back. We had a few tech issues, but all should be resolved now.
I am about to go live with Dr. Natalia from IFG, the International Fertility Group, to talk about donor eggs and pregnancy loss, which is obviously a very difficult topic. I have questions to ask her today, and I welcome you to ask questions too.
So, hopefully, here we are. We’re live. Hello, welcome. Good evening, Doctor, how are you?
Dr. Natalia Pylypenko
Hello everyone, I’m fine, thank you. Thank you for inviting me to this wonderful meeting.
Eloise Edington
Absolutely. Sorry for this disconnection; we are here now, so that’s what matters.
Before we start, could you briefly introduce yourself and your role at IFG, and tell us a little bit more about the International Fertility Group?
Dr. Natalia Pylypenko
Thank you very much. I am Dr. Natalia Pylypenko. I am an international gynecologist with a specialization in fertility, and my goal is your positive beta-hCG result.
Our International Fertility Group has a lot of facilities all over the world. Our main facilities are in Levice, Slovakia; Tirana, Albania; and Manila in the Philippines, and we are ready to give you the best services we can.
Eloise Edington
Fantastic, thank you for that introduction. We do have a lot of followers and readers who are looking for fertility support abroad, so this is very useful to hear about.
Today’s topic is around donor eggs and pregnancy loss, which is obviously a very difficult topic to discuss and to experience.
People want to know what’s next, how it might occur, and what options might be available, so they can get help dealing with it from an expert like yourself.
Could you start by explaining what can cause a miscarriage and what can cause a miscarriage with donor eggs, given that pregnancy success rates are normally much higher with donor eggs?
Dr. Natalia Pylypenko
Thank you for the question. I can provide more details on the factors that can contribute to miscarriage with donor eggs.
It can be due to uterine issues; the health of the uterus is crucial for a successful pregnancy. Structural abnormalities, such as fibroids or polyps, may interfere with implantation or fetal development, increasing the risk of miscarriage. Hormonal imbalance of the recipient’s body, such as an insufficient level of progesterone, can also affect implantation and pregnancy maintenance.
There can also be autoimmune disorders; some autoimmune conditions can increase the risk of miscarriage as the body’s immune response may recognize the donor embryo as a foreign invader and attack it.
We also encounter blood clotting disorders, like antiphospholipid syndrome, which can lead to improper blood flow to the uterus, affecting the embryo’s development and potentially increasing the risk of miscarriage.
Other factors include infections, illness, environmental factors, and advanced maternal age. While donor eggs are typically from younger, healthy donors, the age and health of the recipient can still play a role. Advanced maternal age is generally associated with a higher risk of miscarriage.
Eloise Edington
What is the difference between a miscarriage with your own eggs and a miscarriage with donor eggs?
Dr. Natalia Pylypenko
We don’t make much of a distinction. We also have patients of advanced maternal age who undergo a mitochondrial donation program and have an embryo transfer with their own embryos by their own DNA, but donor eggs are typically obtained from young, healthy donors, and the screening process aims to minimize the risk of genetic abnormalities and reproductive health issues.
When we undergo a frozen egg donation program, we also perform PGT-A testing, which increases successful implantation rates to 80%.
Eloise Edington
Are there any ways to reduce the chance of miscarriage?
Dr. Natalia Pylypenko
Our first recommendation is to go through PGT-A testing. Without PGT-A testing, as I mentioned, we have a lower implantation rate.
To increase implantation rates, we ask patients to undergo this testing. We also recommend taking time for physical recovery, provide psychological counseling, and offer medical support 24/7, so our team is ready to provide all necessary support to achieve a positive pregnancy outcome.
Eloise Edington
Thank you, and for anyone who would like to find out more about IFG and Dr. Natalia and the team, please don’t hesitate to reach out.
If you go to our link in bio, you’ll be able to contact the team.
After a miscarriage, people often want to know how long they should take for their body and emotions to recover before considering next steps.
Dr. Natalia Pylypenko
After an unsuccessful outcome, we meet with our embryologist, our genetic counselor, our IVF specialist, and the patient to discuss all next steps.
We check the number of embryos, the number of PGT-A-tested embryos, and discuss any additional lab tests, like checking the implantation window or performing immune system tests.
Based on the results, we determine the best time to perform the next embryo transfer.
If there are no issues that could impact the success of the next transfer, it’s possible to consider it in the next cycle after the miscarriage.
However, each case is individual, and only after counseling can we determine when and how we’ll proceed. Sometimes we may need to change the protocol for preparing the endometrium.
Eloise Edington
Would you do any testing after pregnancy loss, especially after donor egg pregnancy loss, to try and determine what may have been the reason?
Dr. Natalia Pylypenko
Yes, of course. We perform endometrial testing, such as EMMA, ERA, ALICE, and checking the implantation window. We may need to check for chronic endometritis or immunological factors.
However, it’s not necessary to perform all these tests after just one miscarriage. This type of testing is usually advised after a second or third unsuccessful attempt.
Eloise Edington
You mentioned PGT-A testing, which I think is important, especially with donor eggs. Would you normally recommend PGT-A on embryos made from donor eggs?
Dr. Natalia Pylypenko
Yes, we do recommend this test because we want to ensure that we’re transferring a healthy, euploid embryo. That’s why we ask our patients to undergo PGT-A testing.
I think what can be hard for people is the fact that if PGT-A shows a chromosomally normal embryo, it’s very difficult to hear that it still hasn’t worked or that it worked but didn’t continue.
Yes, this does happen. If we have a miscarriage after PGT-A testing, we meet to discuss what changes might be made to our protocol and what additional tests might help.
If we have PGT-A-tested donor egg embryos, we don’t normally need additional testing before the first attempt, as the success rate is about 80% for implantation. However, there is still a 20% unsuccessful rate, and we need to understand the specific causes of this 20% in each case.
Eloise Edington
Yes, that makes complete sense. For those with questions about donor conception, donor eggs, or pregnancy loss, please reach out to the IFG team. Dr. Natalia and the team are happy to answer your personalized questions, so please follow the link in our bio for more information.
You mentioned emotional support at IFG. Could you talk a bit about what support is available for your patients?
Dr. Natalia Pylypenko
Yes, of course. We have a yoga instructor and a therapist in our team, and we offer these services as needed. We also provide psychological counseling if a patient requires it.
We think it’s very important to be in touch 24/7, and we have a WhatsApp group with all of our doctors, medical coordinators, and embryologists to answer any questions.
For example, if a patient has cramps or starts bleeding, we provide support after embryo transfer up to 20 weeks of pregnancy. We’re available for protocol changes and medical support throughout.
Eloise Edington
If someone wants to do another cycle after pregnancy loss, whether from donor conception or not, could they start the next cycle immediately?
Dr. Natalia Pylypenko
Yes, this can be discussed.
Right now, for example, we’re preparing a few patients who had previous unsuccessful attempts and are starting a new cycle immediately after.
This is always decided on a case-by-case basis. We need to make sure the patient is emotionally, psychologically, and physically ready. If everything is okay, then we can proceed.
Sometimes it can be difficult for women, and they need two, three, or even five or six months to recover before feeling ready to try again.
Eloise Edington
If someone has had pregnancy loss following conception with donor eggs, would they tend to look at moving on to another donor and using other donated eggs? How long should they try with the same donor’s eggs?
Dr. Natalia Pylypenko
Good question. When we receive this question, we meet with our team to discuss each case individually.
We track the success rate of each donor’s eggs, as we are also a donor bank, so we know which eggs have been used and where. If eggs from a particular donor aren’t available in the bank, we may need to change the donor.
Another option is to create a mixed program. For example, if we have eight oocytes, we might use eggs from two or three different donors, or the couple may wish to change the donor based on characteristics like hair color.
We don’t have any data suggesting that each new attempt requires a different donor, but this is always discussed during the preparation stage.
Eloise Edington
When someone purchases donor eggs, how many are they likely to receive?
Dr. Natalia Pylypenko
They can book, for example, eight to fifteen oocytes. Normally, to reach four blastocysts, we ask them to book around fifteen oocytes.
Eloise Edington
Is there anything people should be aware of or prepare for before starting treatment again following pregnancy loss with donor eggs?
Dr. Natalia Pylypenko
This is a very interesting question. Psychological counseling is essential. The patient needs to share their expectations and schedule with their fertility specialist. For example, some of our patients travel from the U.S. or Canada to Europe, so we need to arrange all steps carefully.
We prioritize emotional well-being and encourage patients to be open with their specialist, as fertility treatment can yield different results each time.
Eloise Edington
Thank you, that’s a very good answer. I hope this helps clarify things for people.
As mentioned, the team at IFG is happy to help with personalized treatment plans, and they handle complex cases and those that need support after loss.
Please reach out to the IFG team through the link in bio for support, and thank you very much, Dr. Natalia, for your time today.
We hope to connect again for more sessions with IFG. Thank you for your time, and I hope our session today is helpful for many people out there.
