Women are born with an exact number of oocytes, which does not increase and does not recover through the years, but undergo reduction. But today women often think for their education, career and social realization first, and after that comes the desire for a baby. Often this desire comes at a later stage of a woman’s life when the idea for a baby becomes a hard-to-reach dream because the first oocyte reduction occurs before a woman’s 30th year. But not only age is a factor; some women lose their ovarian reserve even earlier. It means that their ovaries do not produce oocytes, or the produced are a few and not good enough for fertilization and forming an embryo.

The only chance for these women to fulfill their dream for a baby id to receive an oocyte, which could be fertilized with sperm from the husband/partner through IVF procedure and after embryo transfer to develop in the desired pregnancy. Also in some cases, it is required the use of donated semen. Dr. Shterev Hospital has a contract with an international cryobank, which offers a catalog with its donors, including their characteristics. This cryobank could be used in cases of male infertility, but also when a woman does not have a partner and want to use donated oocytes and sperm cells.

When is a woman diagnosed with diminished ovarian reserve?
• Age: most often the recipients are women in advanced reproductive age because this leads to higher risk of miscarriages, genetic disorders, etc. 
• Women with poor response to hormonal stimulation, who produce few or inferior oocytes, and because of this IVF/ICSI procedures have no success.
• Premature menopause because of autoimmune disease, surgery, endometriosis or some medicine.
• Women with genetic diseases.
• Women who have undergone chemotherapy or radiotherapy.

What are the steps?
Step 1: Including in a waiting list of recipients.
Step 2: Finding a suitable donor and synchronizing the menstrual cycles of both women.  It happens with medicine for ovarian function support and preparation of the uterus endometrium for better embryo implantation.
Step 3: Ultrasound examination performed by a reproductive specialist in Dr. Shterev Hospital.
Step 4: The donated oocytes are fertilized with husband/partner’s semen (except in the cases of semen donation).
Step 5: Embryologists observe the fertilization in the next days.
Step 6: In the day of the embryo transfer, the patient and the reproductive specialist discuss the embryos development and the number of embryos which will be transferred in woman’s uterus.
Step 7: Normally when more embryos with good quality are available women is offered to cryopreserved them for a certain period.

The In Vitro Fertilization with donated oocytes has a higher success rate, because the donors are young, well educated, in good health and with proven fertility function. The recipients know only donors’ medical, genetic and psychological characteristics. According to the Bulgarian legislation, the donation of oocytes is anonymous. The identity of the recipients is also disclosed, except in cases of relatives donation.

The innovations and progress of modern medicine give a chance to a lot more couples for conceiving and giving birth to a healthy baby. By the physicians, embryologists, and biologists every patient has his trusted team, which offers its support through the hard path to the big dream and the greatest gift of the new life.