Alternative methods in the treatment of infertility (donation clinic)
Considering the fact that in a group of couples, the only way to have a healthy child is to use a donated embryo, in order to meet the needs of this group of couples, the donation clinic operates in a centralized manner in this field.
Important principles in the donation clinic include: the donor’s normal general health, the similarity of the donor’s and recipient’s appearance (phenotypic) characteristics, and the confidentiality of the donor’s identity from the recipient.
Also, much attention is paid to the views of the recipient couple regarding the donor’s cultural and religious characteristics. The donation clinic evaluates, accepts or rejects the treatment of the recipient and donor after determining the necessity of alternative treatment (donation) and observing the minimum necessary indicators in the selection of donors and recipients.
In the donation process, expert consultations and recommendations in various fields of obstetrics and gynecology, embryology, andrology, internal medicine, endocrinology, infectious diseases, genetics, psychiatry, law, and social medicine are considered in deciding whether to accept, reject, or how to treat.
Many women with the problem of infertility and lack of eggs with the following problems are candidates to receive donated eggs:
Women with hypergonadotropia, those with premature ovarian failure, those with a history of oophorectomy (removal of the ovaries) or a history of chemotherapy or radiation therapy, Turner syndrome, cases of ovaries not responding to ovulation stimulation or the presence of definite symptoms of low storage Ovary, recurrent untreatable miscarriage and repeated failure of IVF fertility methods (women who have failed at least three previous ART cycles, or whose eggs and embryos have not been of good quality), a genetic disease caused by A woman can transmit it to her child, and it cannot be identified and treated using available laboratory methods such as PGD, PND, etc., and people tend to use alternative treatments.
Infertility in old age: whenever the wife is over 40 years of age.
Egg donation includes the preparation and collection of eggs from the donor woman, its fertilization in the laboratory with the egg recipient’s husband’s sperm, and the transfer of the resulting embryos to the recipient’s uterus (infertile couple).
Embryo donation: many couples deprived of having children due to problems such as not having gametes (eggs/sperms) or not being able to fertilize eggs or not having healthy embryos, are forced to use gametes and otherwise Embryos are donated. In this method, the embryo (embryo) grows in the uterus of the infertile recipient woman. The method that is used today in infertility treatment centers to form the embryo (embryo), is the fertilization of the washed sperm of the spouse in a laboratory environment and its insemination by microscopic injection into the eggs obtained from Vaginal puncture is the ovary.
This is done after stimulation of ovulation using hormonal drugs and assisted reproductive treatments. Usually, stimulation of ovulation leads to the capture of multiple eggs and, as a result, the formation of more embryos than the couple needs. In this way, it is possible to use embryos (embryos) in excess of the couple’s needs for those couples whose infertility treatment is not possible with any other method. In such cases, embryo donation should be done with the consent and written consent of the donor couple, after evaluating their health in authorized specialized infertility treatment centers and in a completely confidential manner. In some cases, embryo donor couples refer to authorized centers only with the intention of donating.
Considering the fact that other people are involved in the formation of the resulting embryo (embryo) as an embryo donor, the need for legal advice, obtaining informed consent, careful examination and evaluation of the health of donors and recipients, as well as ensuring the necessity of presenting The treatment is important to the recipients before the treatment. Counseling and preliminary evaluation of the donor: acceptance of the donor, either embryo or egg donors, is done according to the rules and ethical guidelines. In this consultation, which is preferably done by a social medicine specialist and in one or more sessions, along with getting to know the donors, issues such as the complete consent of the donor and his wife (if married), their motivation, stability in decision-making, criminal records , the level of education and the relationship of couples with each other are examined.
Due to the personal nature of religious and jurisprudential issues and due to the existence of differences in the opinions of eminent taqlid authorities in the methods of donation clinics, it is emphasized that couples should be aware of the fatwas of their taqlid authority and the non-responsibility of the infertility treatment center is explained in this regard.
Since endocrine diseases are associated with fertility disorders in many cases, it seems necessary to evaluate the endocrine system of patients and refer to an endocrinologist before trying to get pregnant or start infertility treatment cycles. Due to the chronic nature of endocrine diseases, most patients need frequent visits to an endocrinologist for a long time during pregnancy and after that.
Endocrine glands whose dysfunction leads to infertility problems include the pituitary gland, thyroid, adrenal glands, and gonads.
The pituitary gland is a small gland under the brain and secretes many hormones. Among the most important hormones secreted by this gland that affect fertility disorders, we can mention prolactin (milk secreting hormone) and gonadal stimulating hormones. For example, sometimes prolactin hormone may be excessively secreted and cause menstrual disorders, milk secretion in women, infertility and sexual disorders in men. Also, the reduction or non-secretion of gonad stimulating hormones from this gland causes delay or cessation of menstruation as well as infertility in both sexes.
The thyroid gland is located in the neck and in front of the trachea. Thyroid hormones play a very important role in cell differentiation, regulation of body metabolism, reproductive disorders and abortion. Common thyroid diseases include hypothyroidism, hyperthyroidism, and simple and nodular goiters.
Adrenal glands are two small glands above the kidneys and they secrete many hormones that regulate blood pressure, regulate immune responses, develop secondary sexual characteristics, and regulate body metabolism.
Gonads are ovaries in women and testicles in men that secrete female and male hormones in both sexes. These hormones are responsible for secondary sexual characteristics, puberty and fertility. Among the common diseases that occur due to dysfunction of the gonads, one can increase the secretion of male sex hormones in women with symptoms such as menstrual disorders, excessive hair growth, male pattern baldness in women, resistant acne. Treatment and infertility are associated, he pointed out.
Other diseases related to the endocrinology clinic, metabolic diseases such as blood sugar disorders (type 1 and 2 diabetes and gestational diabetes), disorders related to blood lipids, obesity, bone metabolic diseases (osteoporosis) and disorders related to the regulation of calcium and phosphorus. and vitamins
Legal advice today, one of the new methods of pregnancy and infertility treatment is the use of alternative fertility methods, i.e. donation methods. Assisted reproductive methods are often performed using the woman’s own egg and her husband’s sperm; However, if there are severe problems in the egg or sperm and the individual’s sex cells do not have the ability to reproduce, it is possible to use a donated egg, donated sperm, donated embryo, or a surrogate uterus (surrogate uterus) to treat couples’ infertility.
Considering that other people are involved as donors in these methods, it is important to be familiar with legal and religious issues.
In the field of legal issues, all Shari’a and legal issues related to each method are tried to be explained to the clients by the legal advisor, relying on the existing laws and regulations and the fatwas of the Supreme Authorities, so that the applicants to use these assisted reproductive methods, with knowledge and fully aware of doing this action. Conducting legal consultation before the donation process (donated egg, donated sperm or donated embryo) and setting up surrogacy contracts (surrogate womb) are among the most important legal actions.
In cases of egg donation and surrogacy, it is necessary to go to notary offices and complete legal procedures
In this consultation, an initial acquaintance with the couple applying for treatment is made, and while providing the necessary information, the couple is prepared for the treatment. The legal standards and obligations and responsibilities of couples applying for surrogacy treatment, the effects and results of treatment and the provisions of informed consent should be fully discussed by expert lawyers in counseling sessions and the legal questions of couples should be answered.
The terms of the contract between the pregnant couple and the woman in the womb should be carefully discussed and taken into consideration. Drafting and signing of this contract and completion of the consent forms must be done in a meeting with the presence of all parties to the contract (the pregnant couple (fetus) and the pregnant woman (and her wife)). In order to evaluate the reproductive health of couples applying for surrogacy, gynecologists, obstetricians, andrologists and urologists examine them, and the conventional health of couples is examined through the evaluation of internal diseases, infectious diseases, psycho-social health, and genetic counseling.
Evaluations of the woman with a uterus (and her husband): The purpose of counseling with a woman with a uterus and her husband is to inform and inform them about the treatment process and its short-term and long-term aspects and problems. During the consultation, ethical, medical, legal, psychological, social issues, risks and possible side effects of this method are explained to the woman with uterus and if she is married, to her husband.
In the counseling session, issues such as the full satisfaction of the pregnant woman and her husband, their motivation to attend the treatment process, stability in decision-making, couples’ relationships with each other, criminal records, history of previous marriages and divorces, cultural and economic level, citizenship, etc. It is a review. After legal consultation, explaining the contract and obtaining informed consent, the reproductive health of the pregnant woman is evaluated by a gynecologist and obstetrician.
Normal physical and mental health, no addiction to drugs and psychotropic substances, no incurable diseases, no factors causing high-risk pregnancy, and physical and mental fitness of the pregnant woman (and her husband) should be checked and verified by the medical team.
In this regard, general clinical and paraclinical counseling and evaluation, internal and infectious disease counseling and evaluation, and mental-social health counseling and evaluation are performed.
After confirming the health of the couple applying for treatment and the woman with the uterus (and her husband) and providing information about how to treat and announcing the readiness of the center, the couple applying for the treatment and the woman with the uterus (and her wife), the draft of the contract according to the aforementioned issues, prepared and in a meeting In the presence of all parties, the contract is signed along with informed consent documents.
The legal standards and obligations and responsibilities of the donor couple, the principle of confidentiality and the effects and results of the donation treatment should be fully explained by lawyers familiar with the legal issues of infertility treatments in the counseling sessions and the legal questions of the couples should be answered and finally, their informed consent. To be taken for further treatment. After initial consultation and evaluation and obtaining informed consent, reproductive health and ability to donate in embryo and egg donors are examined from the point of view of obstetrics, gynecology, embryology, andrology and urology specialists. Conventional health evaluation of the donor, including general clinical and paraclinical consultation and evaluation, consultation and evaluation of internal diseases, infectious diseases, genetics, and psychological-social health consultation and evaluation are also performed.
Recipients of embryos (embryos) and eggs: based on the “law on how to donate embryos (embryos) to infertile couples” and its executive regulations, when the infertility of legal and religious couples (either alone or both) is proven after medical procedures, the centers Infertility treatment specialists will be authorized to transfer embryos (embryos) resulting from insemination outside the womb of legal and Islamic couples and after the written consent of the couples who own the embryos (embryos) into the woman’s womb, in accordance with the Shari’a standards and the conditions stipulated in the law. Infertile couple should take action.
Also, according to the fatwas of eminent authorities, in cases where only the female factor is the cause of infertility, if the infertile couple wishes, donated eggs are used. The diagnosis and proof of couple’s infertility is confirmed after the examination and diagnosis of the specialized group, and only in the case of the absence of suitable ovum or suitable embryo, alternative treatments (donations) are used. The purpose of these measures is to ensure the impossibility of treating the person through conventional treatments, other than donation, and to avoid further legal and legal problems.
Surrogate womb: One of the important causes of infertility is the mother’s (wife’s) inability to carry and nurture an embryo (embryo) in the womb. Uterine replacement becomes necessary when a couple has all the necessary factors for the formation of a child, but due to not having a uterus or a healthy uterus, the possibility of having a child has been denied to them. The ectopic fertilization technology has made it possible for such couples that the embryo (embryo) resulting from the fertilization of the mother’s egg and the father’s sperm applying for surrogacy treatment in the embryology laboratory, is transferred to the uterus of a third party in a suitable position.
One of the biggest dreams of every man and woman in life is to experience the pleasurable feeling of becoming a mother and father. Many women and men think and feel that they can have children whenever they want, get married and start living together, but things don’t always go according to plan and some people have problems in achieving this sweet dream.
Certainly, just as much as the idea of pregnancy and holding a child is lovely, the idea of not having a child and facing infertility can be worrying and even scary, and it can bring intense psychological pressure that may make the path of infertility treatment difficult. As a result, continuing this difficult path requires the calmness and empathy of the couple along with the help of an expert and experienced and compassionate psychological counseling.
تمام خانم های زیر ۳۵ سال که همسر نداشته باشند و حداقل یک زایمان موفق در گذشته داشته باشند میتوانند کاندید اهدا باشند . فرد دهنده اهدا تخمک از نظر سلامت جسمی و روانی بررسی میشود .
