Immunology when using donor eggs

[Skittles11]

Hello Hope everyone is doing as well as they can be

Sorry to be writing again. I don't really know where else to ask these kind of questions.

We have looked into donor egg treatment both in UK and abroad and have had a few consultations. But remain undecided on the clinic and I don't know if that's because I am being fussy, we just haven't found the right clinic or maybe I haven't fully accepted moving to donor eggs.

I think I am concerned that because I have faced so many complex issues, it needs to be a clinic that is responsive, patient centred and equipped to deal with more complex issues. I like the clinics I've spoken to but feel there is always something missing.

I think I'm quite worried that most clinics spoke to do not offer immunes treatment other than low dose steroids and clexane. I had tests which showed high NK cells and cytokines and had tried intralipids and IVIG to address it (to be fair, my transfer still didn't work in spite of using them).

So a couple of questions-

- Does anyone know of any excellent donor egg clinics either in UK or abroad (prefer Spain but not a deal breaker) who have really taken into account complex and individual histories to create their treatment plans?

- How important are immune treatments if using donor eggs?

- Which clinics support immune treatments? The Spanish ones I spoke to (two out of three) do not really use them at all and do not feel it adds anything. This makes me feel is the immune thing all a big waste of money especially as Spain is a leading country especially with successful egg donation treatments.

Thanks all for any input

X

[PagingMom]

Hi I don't have experience in Spain but I went to Cyprus. I will PM you the name of the clinic.

[Freshcucumber in reply to PagingMom]

Hello, would you mind pm the name of the clinic too please? Thank you x

[JA-fnuk Partner Nurse Fertility Network UK]

If mentioning clinics by name please use PM

Thank you

Janet-Partner

[minnesota_girl]

Hi skittles, my view on this is that part of the reason that donor treatment in Spain is so successful is because simply donor egg is more successful overall, and they tend to deal with couples who have had lack of success with own eggs and so it probably means in a lot of cases that a standard protocol with donor eggs will often work. I did feel my clinic in Spain took into account my personal results and they followed immunology protocols including clexane, intrallipid and low dose steroid. I do know their view is that those meds work on immunology levels and they don't often vary it for individuals. But also my first donor cycle aty Spanish clinic worked so there's something there.

I agree choosing a patient centric clinic is the most important aspect. I also found the guarantee super important because they really tested well to be happy to give us the guarantee and I felt protected by this.

💕💕💕

[Doodlebug23]

Hey me again, not stalking you honest! Not sure if one of the clinics you have has a consult is mine in Spain? I am more than happy with them and the definitely tick the boxes for donor, responsive and complex cases.

As you know I’m using DE and never any wait as they have their own egg bank.

I have my own personal assistant who always responds to emails either the same or next day (I can call her too) and there’s an emergency number for out of hours and weekends. After each failed transfer I get a zoom consult in less than a week to discuss next steps. My plan gets emailed to me by my PA straight away and I get updates after each stage.

I exchanged messages with someone else off here (can’t remember who) who had been referred to my clinic as she had complex issues.

Not sure about the immune issues. I asked and they could offer at an extra cost outside my programme, all of the tests, but when I asked pre this 4th transfer they weren’t recommending for me. My doctor said he felt none were proven enough and was balancing the cost benefit for me. So the option was there, I just didn’t take it due to the cost. I’m kind of hoping now after 4th fail they want to do some more tests. X

[Batsford]

Hi Skittles, I don’t know about any clinics in Spain, but I’m having immunology treatment through Professor Shehata in Epsom and he seems to be incredibly skilled in this area and uses a wide range of drugs. I will then have a donor FET through my own clinic in Bristol, as we have a number of remaining donor embryos stored there, which are also PGA tested. Best of luck!

[Wishing2023]

I am now under a recurrent miscarriage clinic & having IVF using donor eggs. As well steroids, blood thinners & progesterone that I was on during my last successful OE cycle (that ended in miscarriage), I’m also being put on antibiotics, aspirin & hydroxychloroquine. Not sure if this will help!? 🤞🏽🙏🏽

[ValaI]

hi Skittles, you are so right on your observations.

Same like you we moved to DE in Spain (can share name in pm if curious) and decided to follow their protocol with the first fresh transfer which resulted in a BFN despite a 20 y old donor!!

At the follow up meeting they proposed to go with a natural cycle to which I said I could not consider due to my previous results of high NK cells, thyroid issues and autoimmune disorders so I let them I will see a reproductive immunology specialist in UK and that I would prefer to follow his protocol.

They agreed and I am waiting results from few additional tests I have done with a clinic in London. So let’s see!! But indeed they only gave me clexane and steroids and that’s it.

While from my previous cycles with my own eggs I only had a chemical from a fresh with untested 2 day embryo + thorough with immune medicine transfer I had in ARGC. All other PGS tested frozen my embryo transfers were unsuccessful..

Not sure if this will help much but happy to update as things go along…

Xoxo

[Wishinandahopin]

*edited to remove names of clinic - I will DM You.

I don’t know if they do egg donor treatment but a clinic in Madrid definitely have Reproductive Immunologist as we were based in london with their london clinic and we remotely saw the immunologist in their Madrid clinic.

From my understanding the RI issue that is most relevant with donor eggs is KIR AA as that will reject embryos more that have the wrong HLA-C type which can come from the sperm or donor egg. The RI in Madrid specialises in this. I had it (not with donor eggs) and I had to take an immune medication up to 12 weeks and it seemed to work after a fair few failures- I’m 20 weeks now.

I did find through everything I had to massively advocate and push for myself to get the best and most tailored treatment and I did a lot of my own research and it did pay off in the end- hopefully.

Wishing you the best of luck!

[SushiTilly]

After my second failed DE cycle the Spanish clinic has advised I do test as well that relates to immunity. I went back to ask why, how, when, what sort of changes they'd introduce and treatment. They came back to say I don't need it. 🤔

I did contact UK based fertility health team for advice and I checked out HFEA website on immunological treatment it seemed the jury is still out. I got totally lost in dilemma. Never easy making right decision, interesting to read different perspectives here.