In response to a shortage of suitable egg donors and long waiting times for treatment in the UK, Create Health Clinic has introduced an Overseas Egg Donation Programme in partnership with Pedios In-Vitro Fertilisation Center in Nicosia, Cyprus.  Pedios In-Vitro Fertilisation Center was chosen after we had completed a careful evaluation of European Clinics where donors are available.  We have also examined the medical facilities and care standards in this Centre to ensure they meet the high standards we have set.

Pedios In-Vitro Fertilisation Center has a long and established Donor and Recipient programmes and has access to a large and diverse pool of young and highly suitable Caucasian donors.  The Center was established in 1986 by Dr Krinos Trokoudes who graduated from the Athens University Medical School and trained at University of Toronto, Canada.  Under Dr Trokoudes, it was the first Centre in Greece and Cyprus to achieve pregnancies with GIFT, ZIFT, Ovum Donation, ICSI and TESA.    It was also the first IVF Centre worldwide to have achieved pregnancy in Globozoospermia.  According to the Guinness Book of Records, Dr Trokoudes achieved a pregnancy after IVF in the oldest mother in the world between 1992 and 1993.  The woman at that time was 49 years and 54 days.

Create Health Clinic’s Overseas Egg Donation Programme is fully supported and co-ordinated by a team of specialist.  The programme would involve:-

• Initial Consultation. Before joining the waiting list for the Overseas Egg Donation Programme, you will need to have an Initial Consultation, during which the doctor will take a full medical history and perform a physical examination.

• Blood tests will be arranged. Please be aware that these results must be less than 12 months old at the time of treatment or the tests will have to be repeated.

• Ultrasound scan. This is necessary to check the pelvic organs. In some circumstances, the uterine cavity may need to be assessed in a more detailed way, by ultrasound or keyhole diagnostic surgery.

• A mock cycle. Prior to your treatment, this may be requested by your Consultant to ensure that the lining of your uterine cavity develops normally on medication.

• Counselling. The social, ethical and legal aspects of egg donation are discussed with a counsellor at a separate appointment.

• The drug regime will be explained in full by our Fertility Nurse Co-ordinator.

• A donor matching session will be held with the assistance of our Fertility Nurse Co-ordinator.

• Semen analysis. An appointment will be made for the male partner's sperm to be analysed in our laboratory

How is treatment co-ordinated with overseas the Clinic?

Most of your treatment will occur at Create Health Clinic, but you and your partner will need to travel to Cyprus to provide the semen sample at the time of the egg collection and to have the embryo transfer a few days later.

Before being matched with a donor, you and your partner will need to undertake screening tests and meet our Fertility Nurse Co-ordinator to complete the Donor Characteristics Form. You will also have an appointment with one of our counsellors to discuss the implications of treatment.

Once the pre-treatment screening tests have been completed, your details will be communicated to the Centre in Cyprus which has available screened donors. You will then be matched with the first suitable donor.

Payment for the treatment cycle is then required to initiate the Donor Selection Process. Using information supplied by the clinic, our Fertility Nurse Co-ordinator will then identify a donor that matches the characteristics you have chosen.

After you have been advised of the characteristics of your potential donor and you have decided to proceed with the treatment based on this donor, we will notify Dr Trokoudes, who will determine the possible dates for treatment. These dates will be based on the cycle of the donor. When your cycle has been synchronised with the donor's, the proposed dates for treatment can be finalised, your drugs will be prescribed and appointments will be arranged for the monitoring which is necessary prior to travelling to Cyprus.

What are the Screening Tests prior to treatment?

Before a recipient can be matched with an overseas egg donor, the following tests must be carried out:

Female

• Chlamydia

• CMV

• Hepatitis B

• Hepatitis C

• High Vaginal Swab

• HIV

• Syphilis

NB: These tests must be less than 12 months old at the time of treatment.

• Baseline scan
  Trial embryo transfer Mock cycle
  (see separate sheet)

• Nurses talk
  Counselling

Male

• Hepatitis B

• Hepatitis C

• HIV

NB: These tests must be less than 12 months old.

• Semen Analysis

• Nurses talk with partner
  Counselling with partner

Counselling

A fertility counsellor will see all recipient couples prior to treatment. This support is also available at any time during or after treatment. Our counsellor is Mollie Graneek and she can be contacted directly on 07710631702 to make your appointment.

Semen Sample

Your partner will be required to produce a semen sample at Pedios In-Vitro Fertilisation Centre, Cyprus on the morning of the egg collection. Three days sexual abstinence is required prior to producing the sample.

How will the donors be selected?

At your first meeting with our Fertility Nurse Co-ordinator you will complete a Donor Characteristics Form in which we document the characteristics you would like the donor to have. When you are ready to go for treatment, the nurse will send this information to Pedieos IVF Centre and they will use this information to identify a donor who matches your criteria Only one donor will be allocated to you and you will be advised of her characteristics and be able to approve the selection before the commencement of the final stages of treatment.

Will the donation be anonymous?

Yes, at the time of donation. The rules on anonymity are strict and are in the best interests of all concerned.

No identifying information will be given to you about the donor. Likewise, the donor will not receive any information about you. The anonymity laws changed in the UK on 1st April 2005. After this date, changes in UK law will enable children born as a result of donation to request identifying information about the donor on reaching the age of 18. This does not apply if you are using an INTERNATIONAL DONOR.

Who are the Donors?

Donors are women of 18-34 years of age. Most of them are 21-30 years old and either students or graduates. They will have a normal body weight, healthy medical and genetic history and will have tested negative for all the infectious disease screening performed according to the standard criteria of the HFEA.

What information will I be given about my donor?

Donors will be of European Caucasian origin unless you have a different requirement. We will also provide you with information on:

• Age

• Build

• Education

• Eye colour

• Hair colour

• Height

• Weight

How can I be sure that the donation will be safe?

• All egg donors will be screened prior to being accepted and the following criteria must be met:

• Less than 35 years old

• No personal history or family history of genetic or familial illness

• BMI of less then 32

• FSH level less than 8

• Two Ovaries

• No history of previous low ovarian response to stimulation.

• No more than 2 previous unsuccessful IVF attempts

In addition, all donors are screened and must have clearance on the following:

• Chlamydia

• CMV

• Cystic Fibrosis Gene

• Hepatitis B

• Hepatitis C

• HIV

• Normal Chromosome Analysis

• Syphilis

• Thalassaemia

What happens if the donor withdraws consent?

After receiving information and counselling, donors are requested to give their consent to Egg Donation. It is important to note that they are free to modify or even withdraw their consent at any time until the embryos are transferred to the recipient. If your donor withdraws from the programme after embryos have been created and frozen, you will be allocated a new donor immediately at no additional cost.

How many eggs will I receive

As all donors will respond differently to stimulation it is not possible to give an exact number of eggs that will be received.The aim of the programme is that you will receive a number of eggs that when fertilised will make at least 2 good quality embryos.

What is the drug regime?

Patients who are menopausal (i.e. with no periods): Oral oestradiol valerate tablets (Progynova) are given for 10 - 14 days, at a dose of 6mg daily (3 x 2mg tablets) or as determined in your mock cycle, to thicken the womb lining (endometrium). The endometrial thickness is then checked by ultrasound scan. The day of the donor's egg collection, progesterone support will commence in the form of Cyclogest 400mg vaginal pessaries, twice daily.

Patients with naturally occurring periods (i.e. not thought to be menopausal): In order to synchronise both recipient and donor cycles for fresh embryo transfer it is essential to "switch off" the recipient's cycle. The recipient will need to take Buserelin (Suprefact or Suprecur) or Nafarelin (Synarel) nasal spray daily, from day two or day 21 of the menstrual cycle, until the day before the donor's egg collection. The endometrium is prepared by giving oral oestradiol valerate (Progynova) and progesterone support as above.

For both groups of patients, the drug regime is continued until a pregnancy test is performed.

How long will I need to stay in Cyprus?

Your stay in Cyprus will be approximately five-seven days long. The exact timing depends on your donor's egg collection. If egg collection is at the end of the week, you may need to stay slightly longer for the embryo transfer. It is advisable to arrive in Cyprus at least one day prior to the donor's egg collection. Please be aware that the cost of travel and accommodation is NOT included in the cycle charges and must be organised and paid for by the recipient.

Proposed travel dates cannot be confirmed until your donor has commenced ovarian stimulation. As cycle responses can vary in time please be fully aware that you may have a minimum of 48hours notice of the exact date of egg collection before you would need to travel. It is therefore not advisable to make any arrangements before ovarian stimulation has been started, as your dates for treatment cannot be guaranteed before then.

What will happen once I arrive in Cyprus?

Your first contact will be at Pedios In-Vitro Fertilisation Center, Nikosia, Cyprus, You will need to make a maximum of two visits to the clinic whilst in Cyprus:

Please click here for a map of Cyprus indicating the location of the clinic in Nicosia.

• The first  appointment will be made for the male partner to provide the semen sample on the day of the donor's egg collection.

• The second visit will be on the day of your embryo transfer.

The Embryo Transfer in Cyprus

Procedures leading to embryo transfer

• After 11.00am on the day following the donor's egg collection, ring the clinic to find out if the eggs have fertilised. Unfortunately, not all eggs will fertilise and from those which do fertilise, not all embryos will divide into two to four cells. Only healthy, normal-looking embryos will be transferred into the uterus.

• On the morning of egg collection, the recipient's partner produces a fresh semen sample, which is used to inseminate the donated eggs.

Embryo replacement occurs two to three days later. If you have had a 'Trial Embryo Transfer' you will know that this procedure feels very similar to having a cervical smear test and should not be uncomfortable. Very occasionally, however, period-like cramps are experienced. Embryo transfer takes approximately five minutes to perform, after which it is necessary to rest for ten minutes before returning to your hotel.

Number of embryos

We will transfer no more than two embryos in accordance with UK regulations introduced as a result of a well-documented increase in multiple pregnancy rates following assisted conception when three embryos are returned. Multiple pregnancies are associated with an increased risk of miscarriage and complications during pregnancy. These include the premature birth of very small babies which may be handicapped or not even survive. In addition to these risks, a multiple birth can create enormous strains for the parents, including financial difficulties and emotional and physical exhaustion.

What am I able to do after treatment?

Almost anything you like - although prolonged strenuous exercise or activity is not recommended. The embryos are quite safe within the uterus and you can walk, bathe, shower and undertake normal daily activities. Sexual intercourse can be resumed whenever you feel like it.

The procedure following embryo transfer

• For fourteen days following the embryo transfer you should continue to take oestradiol valerate (Progynova) as before, plus daily progesterone (Cyclogest or Gestone).

• On the fourteenth day it is essential to perform a pregnancy test on an early morning urine sample. This is the first opportunity to find out if implantation has been successful or not.  It is also the only way to make an early diagnosis of ectopic pregnancy, as no period will occur if the transfer has been unsuccessful, because oestrogen and progesterone hormone support are being given.

• If the result is negative, you must continue on the medication for two further days and then repeat the pregnancy test.

• If the result is again negative all drugs must be stopped and, after the onset of the next period, you should return to your usual hormone replacement therapy or your natural cycle.

• You will automatically be returned to the end of the waiting list, unless the Nurse Fertility Co-ordinator is otherwise informed.

Fresh Transfer

Recipients of fresh eggs should be aware that there is an extremely small chance that HIV infection may be transmitted from the donor at the time of embryo transfer. Although all donors are screened for HIV on at least two occasions, the signs of infection sometimes take weeks to show in the blood. To avoid this risk the embryos can be frozen and stored for six months after which time the donor can be re-screened. In the Cyprus program, pregnancy rate achieved with frozen/thawed embryos, however, is lower than that with fresh embryos. For this reason it is preferable to use fresh eggs/embryos.

After the fresh embryo transfer, if there are surplus embryos available of sufficiently good quality, they can be frozen and stored for your use in a future treatment cycle.

Your Pregnancy

• If the pregnancy test is positive, the same drug regime is followed until the 12th week of pregnancy. It is important to continue the medication.

• A scan will be arranged in order to confirm the number of embryos which have implanted and to monitor the fetal heart beat at six weeks' gestation.

We hope that you will have a trouble-free pregnancy. You should be aware, however, that you are more likely to experience problems with your blood pressure than women who conceive with their own eggs. Increased rate of pregnancy-induced hypertension, pre-eclampsia, hospital admission and Caesarean Section have been reported and you should be aware of this.

Other Information

How much will my programme cost?

At Create Health Clinic, we do not have ‘hidden costs’ and will always give you a true estimate of your treatment and other costs.

An example of a typical egg donation cycle will involve the following:-

Initial Consultation£175.00
Screening Tests Female£300.00 (approximately)
Male £150.00 (approximately)
Semen Analysis   £90.00 (approximately)
Baseline Scan £240.00
Mock Embryo Transfer£150.00
Drugs £300.00 (approximately)
Counselling £90.00 per session
Ovum Donation IVF Cycle £4700.00

Cancellation of treatment

If you decide to cancel your treatment for non-medical reasons once the donor has commenced the stimulation of her ovaries, the full fee will have to be paid. If you decide to cancel prior to this, a refund will be given minus the cost of any treatment already received.

If the donor's cycle is cancelled, then your treatment will be cancelled and you will be re-matched with the next available donor at no additional cost.

How do I register on the Programme?

For any further information, or if you are interested in participating in this programme, please contact us.