GAMETE DONATION

GAMETE DONATION

In Italy, the Constitutional Court (n.162/2014) in 2014 has changed the legislative scenario (Law 40/2004) by affirming that the restraint to get access to gamete donation in ART was unconstitutional. The use of donor gametes is currently legal for all heterosexual couples, married or partners, who cannot rely on their own reproductively competent gametes.

WHAT IS GAMETE DONATION?

Gamete donation involves the use of assisted fertilization techniques employing gametes (oocytes and/or spermatozoa) resulting from voluntary and selfless donation by a donor.

– Egg donation: when donated oocytes (OD) are used while the sperm are from her partner.

– Sperm donation: when donated sperm (SD) is used while the oocytes belong to her partner.

WHO CAN GET ACCESS TO GAMETE DONATION ART?

In Italy, ART treatment with donated gametes is only permitted for couples of different sexes, whether married or living together with a diagnosis of infertility. Therefore, neither single women nor same-sex couples will be able to have recourse to gamete donation.

WHY CHOOSING A GENERA CENTRE?

The greatest problem facing all the Centres today is the retrieval of both male (spermatozoa) and female (oocytes) gametes. The 10 years of prohibitions imposed by Law 40 (2004/2014) have led to the fact that in Italy there are very few donors of reproductive cells and that the gametes used come mainly from banks in other European countries.

The Genera centres have established ongoing medical-scientific and professional collaborations with leading foreign centres in the sector, aimed at the execution and application of the most advanced medical techniques for the diagnosis and treatment of infertility.

All our partners perform the cryopreservation of donor oocytes by vitrification. This is, to date, the most effective technique adopted by our centers since 2008 with excellent results in terms of survival (90%) and embryo development; the results obtained after the use of vitrified oocytes are comparable to those obtained with fresh oocytes, as published by our group in the prestigious journal Human Reproduction (Rienzi et al., 2017, 2020).

THE SAFETY OF OUR TREATMENTS

-Donor screening

All donors are subjected to infectious and genetic tests for the maximum protection of the recipients in accordance with Legislative Decree 191/07 and Dir. 17/2006 at 3, in the manner and under the conditions provided for by the medical protocols adopted described in European Directives (n.2004/23/EC, 2006/17/EC and 2006/86/EC).

– Data protection and confidentiality.

All data, including genetic information, are rendered anonymous in such a way that neither the donor nor the recipient can be identified in compliance with anonymity and privacy provisions (Legislative Decree no. 191/2007).

-Phenotypic concordance between parents and children

Donors are selected after verification of specific subjective requirements and phenotypic characteristics, guaranteeing as far as possible the compatibility of the main phenotypic characteristics of the donor with those of the recipient couple (skin colour, eyes and hair, blood group), in compliance with the criteria and conditions of quality and safety as required by European Directives (n.2004/23/EC, 2006/17/EC and 2006/86/EC).

-Maximum number of donations

The gametes (oocytes and spermatozoa) of the same donor cannot determine more than 10 births. This limit may be waived only in cases where the couple who have already had a child intend to have another from the same donor (Conference State Regions 4 September 2014 n.162).

-Donor anonymity

The contribution of the donor/donor is solely genetic, from a legal point of view the legal parent is the one who has expressed the willingness to use the technique. The gametes donor does not acquire any parental legal relationship with the child and cannot assert any rights or obligations against him/her (Legislative Decree n.191/2007).

GAMETE DONATION TECHNIQUES

ART with sperm donation can be carried out either through first level techniques, such as intrauterine insemination (IUI), or through II and III level techniques, such as ICSI (In Vitro Fertilization).

SD-IUI: the workup of the couple

STEP 1

First consultation by our experts in reproductive pathophysiology

STEP 2

Planning and prescription of the preliminary examinations for the treatment

STEP 3

Evaluation of examination results and activation of the specific workup for the couple

STEP 4

Careful selection of the donor based on the results of genetic testing and concordance with the physical characteristics of the couple

STEP 5

Preparation of the patient by means of ultrasound monitoring of follicular growth and hormonal controls from the second or third day of the cycle

STEP 6

Thawing of donor spermatozoa and preparation of seminal fluid by capacitation

STEP 7

Performing intrauterine insemination

STEP 8

Pregnancy test

SD-ICSI: the workup of the couple

STEP 1

First consultation by our experts in reproductive pathophysiology

STEP 2

Planning and prescription of the preliminary examinations for the treatment

STEP 3

Evaluation of examination results and activation of the specific workup for the couple

STEP 4

Careful selection of the donor based on the results of genetic testing and concordance with the physical characteristics of the couple

STEP 5

Controlled Ovarian Stimulation: patient preparation by ultrasound monitoring of follicular growth and possible hormonal check-ups from day 2-3 of the cycle

STEP 6

ICSI technique: Collection of the female partner’s oocytes under local anesthesia or mild sedation. Thawing of donor sperm and insemination of oocytes

STEP 7

Embryo Transfer

Repeat step 7 in case of frozen supernumerary embryos

STEP 8

Pregnancy test

IVF/ICSI with oocyte donation (or both oocyte and sperm donation)

OD-ICSI: the workup of the couple

STEP 1

First consultation by our experts in reproductive pathophysiology

STEP 2

Planning and prescription of the preliminary examinations for the treatment

STEP 3

Evaluation of examination results and activation of the specific workup for the couple

STEP 4

Careful selection of the donor based on the results of genetic testing and concordance with the physical characteristics of the couple

STEP 5

Endometrial preparation of the patient for transfer by ultrasound monitoring and hormonal check-ups from day 2-3 of the cycle.

STEP 6

OD-ICSI: Thawing of the donor’s oocytes and insemination with the male partner’s spermatozoa

STEP 7

Embryo Transfer

Repeat step 7 in case of frozen supernumerary embryos

STEP 8

Pregnancy test

PSYCHOLOGICAL COUNSELLING

The Genera centres offer couples the possibility to take advantage of a psychological consultation with the aim of overcoming the many doubts that the couple and then the parents have about the children to come.

Among the main concerns is the acceptance of a child with a genetic inheritance not completely borne by the two parents and doubts about whether or not to communicate to their child its origins and possibly with what times and methods.

These issues are also addressed in the book “An Unexpected Journey” realized by the psychologists of the center and offered to couples as a guide and accompaniment in the following phases of the course.