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Information and authorization documentfor the Oocyte Donation Programme

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Ginemed Clínicas - Information and authorization document for the Oocyte Donation Programme

“The doctor is responsible for informing patients about theaims, methods, risks and disappointments concerning theprocess of Oocyte donation treatment. This informationenables patients to consent to the programme through theinformed consent form.”

First of all, we would like to thank you for theconfidence you show in our Clinic; rest assured thatwe know how to correspond. Ginemed Clinicas hasat your disposal the best team of medical experts,biologists and psychologist as well as moderntechnology to ensure the best results. You can counton us to achieve your dream of having a baby.

At Ginemed, we are at your disposal 365 days a year so you can rely on us at any moment. Every patient has generally herown gynaecologist who follows her medical case and is responsible of it, however such a complex process is managed by awhole medical team since there is no specific day of beginning or end concerning the treatment. Specific tests will be fulfilledby the most experienced professionals depending on their specialization area.

As a guarantee, we want patients to know that we are submitted to regular externaudits. Ginemed Clinicas have been the first Andalusian centre to obtain the qualityaccreditation according to ISO 9000-2008 standards.

What is a Programme of Oocyte Donation?A programme of oocyte donation (or egg donation) is a technique of Assisted Human Reproduction in which the female gamete

(ovule) is donated by a woman other than the one who will receive the resulting embryo. The oocytes of the donor are fertilizedwith the sperm of the recipient couple. Once the embryos have been obtained, they are introduced inside the recipient’s uterusin order to make implantation possible and, in this sense, achieve the desired pregnancy.

Oocyte donation is authorised and regulated by law (Spanish Act 14/2006 of 26 May) and according to this law, maternity isto be granted to the woman who becomes pregnant and manages to fulfil this pregnancy.

The donor has no legal rights or obligations on the descendants. The whole process is subject, by law, to ethic and legal guarantees of anonymity, for both donors and recipients.


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Oocyte /Egg DonorsEgg donors are women who donate their gametes (ovules) in an altruistic way to other women (recipients) who, without

these gametes would have no possibility of getting pregnant and therefore, becoming mothers.

In order to obtain these ovules, donors have to undergo a number of previous controls to guarantee their good physical andmental health.

The requirements demanded by Ginemed Clinicas to be able to donate ovules are the following:- Age between 18 and 30 years old.- Family history WITHOUT genetically or hereditary transmitted diseases (chromosomopathies, genopathies or

metabolopathies)- Proper physical and mental health.- Good intellectual level.- Absence of gynaecological diseases: gynaecological examination, smear test and ultrasound scan must be normal.- A normal chromosomal test (normal karyotype).- Blood group and Rh factor.- Normal blood test, at both hematologic and biochemical levels: Hemogram, Clotting Tests, Glucose, Cholesterol, Triglycerides,

Liver Tests, Uric Acid, Urine Test, etc.- Absence of transmissible diseases, in order to avoid infection of both the recipient and the future foetus. At Ginemed Clinicas

we reject HIV, Hepatitis B, Hepatitis C, German measles, Herpes Virus, Cytomegalovirus, Syphilis, Gonorrhoea, as well asinfections caused by Chlamydia, Toxoplasmosis, etc.NOTE: In the case of HIV, tests will be made on the donor six months before the date of donation, and therefore not being able to discard donor’ssero-conversion 6 months before donation.

- Previous fertility record.- Proper response to ovary stimulation treatment.- Absence of excessively conspicuous physical features. - A maximum number of 6 descendants, including descendants by Human Assisted Reproduction.

Once the candidate has been selected, shewill be at the disposal of Ginemed Clinicas, forwhen a recipient requires her donation.

Then, the donor will undergo a procedure ofprogrammed ovary restraint-stimulation,similar to that we carry out in normal in vitrofertilization processes. This treatment goes onuntil the day the oocytes are extracted.

Oocyte donation, as the rest of human organor fluid donations is an altruistic act, i.e., withno profit motive in mind, with the only aim tohelp fellow creatures.

At Ginemed Clínicas we do not remunerateegg donations, however, if we take intoconsideration that donors undergo a treatmentof ovulation stimulation and that the eggretrieval is carried out at a specific moment andnot when the donor wishes, having to undergoa process of anaesthesia-sedation and ovarianpuncture, current law allows an economiccompensation for treatments, travelling expenses and availability for donors. The compensation they receive tries to cover forthe trouble, inconvenience and availability they undergo during the donation process.

Donors are young women who, aware of the problem, take the voluntary decision to become donors. They usually becomethe best donors, and they generally come from universities. Donation is always voluntary, anonymous and altruistic.


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Egg RecipientsThe main conditions for being included in an egg donation

programme are the following:• Primary ovarian failure with presence of uterus. Women who

do not menstruate when reaching puberty.

• Premature ovarian failure, in this case ovaries produce ovulesthat cannot be fertilized. This includes real menopause, early menopause and the hypergonadotropic hypogonadism.

• Chromosomal alterations in women such as translocations, inversions and chromosomal deletions, genetic problems suchas the Turner Syndrome, gonadal dysgenesis, Swyer Syndrome, etc.

• Previous failures of In Vitro Fertilization: - Women with little response to ovarian stimulation - Repeated failure of Intra-cytoplasmatic Injection (ICSI). - Repeated failure of embryo implantation (previous failure of pregnancy). - Cases of own oocytes of bad quality

• Repeated miscarriages, owing to bad quality of oocytes or to chromosomal alterations of either the woman or the embryos.

• In cases of ovarian surgery, chemotherapy or radiotherapywith conservation of uterus. Generally caused byoncological problems.

• Ovaries inaccessible for obtaining oocytes, such as in thecases of frozen pelvis or with multiple adhesions not solvedby surgery.

• Women over 40 with normal ovarian cycles, though theprobability of pregnancy with their own ovules is very little.These patients have, as well, a high rate of miscarriagesand high risk of foetal chromosomal alterations, associatedto age, such as Down syndrome and Edwards Syndrome.There is no age limit to carry out these techniques, sincethe probabilities of success depend on the donor’s age.Genetic alterations associated to advanced maternal agedo not occur in egg donations, since donors are youngwomen always under the age of 30.

0

10

20

30

40

50

60

70

5.79.3

15.5

29.6

63.3

40-44

Age

% Natural sterility

35-3930-3425-2920-24


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Previous conditions and procedure for recipients and their partnerBefore starting a cycle of Human Assisted Reproduction through oocyte donation, we shall carry out the following tests on

the recipient woman and her partner:• Medical and gynaecological record with analysis of pregnancy viability. • Blood group and Rh of both male and female. • Serology regarding HIV, Hepatitis B, Hepatitis C and Syphilis of both members. • If we use the partner’s sperm, a sperm capacity study will be necessary (spermogram, sperm fertility test, hormonal tests,

blood karyotype and study of sperm DNA fragmentation, at a minimum) • Gathering and analysis of physical characteristics of the recipient, which will be filed at Ginemed Clínicas together with a

passport photo.

In some cases, we need to control the endometrial condition through a hysteroscopy or a hysterosonography, or sometimesan endometrial biopsy. We may also prescribe a transfer test.

Couples who wish to be included in the Programme of Oocyte Donation, will be registered and informed as soon as GinemedClínicas has a donor or donors suitable for their specific case.

Psychological support in Ginemed ClínicasA child represents one of the most important personal and familiar projects in our lives. Many feelings can rise: desire, dreams,

doubts and fears. Your state of mind plays an important role during the treatment. We know that and we will do everything wecan in Ginemed Clínicas to help you. The psychologist is here to hear you whenever you need and you can talk to her about thedifficulties you may be facing during the treatment.

The high success rates of our egg donation programme rely on three main pillars: - A careful donor selection. - Assuring to each recipient at least 8 oocytes. Thus, we will be able to select the most viable embryos and we will generally

cryopreserve the remaining embryos for a later cycle.- A very high quality work performed by our Assisted Reproduction laboratory.


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Treatment of recipient womenTreatment is aimed at achieving an optimal endometrium, as receptive as possible, for when we carry out embryo transfer.

This technique requires an important psychological effort on behalf of the couple, due to the stressful situation produced. AtGinemed Clínicas we are aware of this and we offer all the help you may require.

In any case, you shall know it is a complex technique, which requires perfect coordination of those involved (donor andrecipient), and therefore the programme may be interrupted by causes originated from any of them.

The treatment guidelines are personalised, so they may differ from what we describe next.

Pairing of menstrual cycleFor proper pairing, we generally prescribe contraceptive treatments, or similar, allowing us to induce menstruation whenever

we need it. When the donor begins with the stage of hypophysary suppression we get in contact with possible recipients in orderto assess the moment of the cycle they are in and to adapt it to the donor’s cycle. To facilitate the pairing between donors andrecipients, we usually use GnRH analogues.

Endometrial growthIn order to ensure the endometrial growth for a higher level of embryo reception, we use estrogens. Regular medical controls

and ultrasounds have to be performed to control the evolution of the endometrium. These controls will be performed in thecountry of residence of the patient and we will follow the evolution from a distance.

Along with the estrogens, we generally use support treatments with vitamins for women and antioxidants for men. Besides, a contributory treatment with aspirin will also improve the endometrial oxygenation.

Endometrial preparation to embryo receptionWhen the egg donor is at the optimum moment of ovarian follicular maturity, we prescribe her Human Chorionic Gonadotropin

(HCG), as this will trigger the last maturing process of the oocytes. In some specific cases we also prescribe ChorionicGonadotropin to the recipient.

Progesterone administration begins one day before or on the same day the puncture is made to the female donor. Administrationis usually done via the vagina with the dose prescribed in each particular case.

At the end of stimulation of the donor we know the number of existing follicles, as well as their quality, so we can make anestimation of the number of oocytes we are able to obtain with the puncture. In case that they are insufficient, the recipient willbe contacted to cancel the cycle of Oocyte Donation. In the same way, it is possible that at the time of extraction there are notenough oocytes, that they do not present good quality or that they are not mature yet, and so we would have to cancel the cycle.

When there is a risk of hyper-stimulation of the donor, the cycle would also be cancelled.

Donor Recipient


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Fertilization process in the laboratoryIt is done on the same day of the egg retrieval made to the donor. On this day we need

a semen sample. If the partner has difficulties in obtaining the sample or if the couplecannot be present on the day of the puncture, we will use a previous frozen sample let bythe male partner during its first visit to the Clinic. This frozen sample will be available onthe day of the puncture. Please, inform us if you are not able to come and we will preparethe frozen semen sample.

To obtain an optimal semen sample, previous sexual abstinence is required for one ortwo days. Sexual abstinence longer than two days is not recommended.

Immediately after the egg retrieval process, we will know the exact number of oocytes.

We will try to obtain at least 3 embryos of high quality for the embryo transfer. This isthe reason why we need at least 8 oocytes from the donor. According to Spanish currentlaw, we can transfer a maximum of three embryos per transfer. The best embryos will beselected in order to obtain the best possibilities of success. Embryos which are nottransferred will be criopreserved and can be used during a subsequent cycle.

At Ginemed Clínicas, we use all the human and technical means to achieve the highest possible number of embryos. Biologistsassign the oocytes to each recipient according to morphological criteria between donors and recipients. Therefore, it is impossibleto determine the number of oocytes that will be fertilized by the sperm prior to fertilization.

After extracting the ovules, the experienced biologists of Ginemed Clínicas will proceed to fertilize them with sperm that waspreviously reserved for each specific case, either through traditional In Vitro Fertilization or through Sperm Micro-injection.

For traditional In Vitro Fertilization we place an ovule on a micro-drop of an enriched culture means, in ideal CO2 andtemperature conditions, to which between 25,000 and 50,000 spermatozoa are added, favouring physical contact and thereforeenabling the sperm to fertilize the ovule “in a natural way”. After fertilization we observe the growth of the embryos and preparethem for their transfer to the recipient woman’s uterus.

Through Sperm Micro-injection (ICSI) we introduce aspermatozoon, with the help of a micro-needle, into an ovule. Weuse more and more this technique because the results are slightlybetter than those obtained through traditional In Vitro Fertilization(FIV). Indeed, the rates of pregnancies are higher with ICSI than withFIV. Any man, who has sperm, is a candidate for Sperm Micro-injection (ICSI).

In case of lack of sperm when ejaculating, we could try getting itby testicular biopsy. This technique is carried out by our specialised team and it is generally performed previously so we canhave the frozen sample prepared for fertilization.

In 2008, we became the first Centre in Spain to integrate thenew High Magnification Microscope. Thanks to this recentMicroscope, spermatozoa view can be enlarged 6,600 times(compared to a traditional microscope which makes 400 timesmagnification) and enables us to perform a better spermselection (also called Super ICSI or IMSI) and to choose the bestspermatozoa. The use of this microscope has increasedconsiderably the pregnancy rate particularly when the malepartner presents seminal troubles. This new technique has alsoresolved previous medical cases failures.

The day after the puncture, our biologists will inform about the results obtained, indicating the number of fertilized ovules(zygotes). This number will help to make us an idea about the number of embryos available for transfer, knowing that zygotesdo not always reach the embryo stage and that embryos do not always offer sufficient quality for transfer, hence the importanceof ensuring 8 oocytes to each recipient.

Spermatozoa x 400 Spermatozoa x 6600


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Embryo transferEmbryo transfer is a relatively simple process which does not require

anaesthesia. The patient will be placed in a gynaecological position andthe doctor will introduce the embryos inside the uterus with a very thincannula which will be passed through the cervix.

The transfer is carried out between 2 and 5 days after the oocyteretrieval, generally on the third day.

Depending on each medical case, we propose you a number ofembryos to transfer, though the final decision is yours. Spanish law ineffect (14/2006 Act) establishes a limit of three embryos for eachembryo transfer.

At Ginemed Clínicas, we perform embryo transfers under ultrasound guidance to ensure the proper placement of the embryosin the uterine cavity. This technique also improves pregnancy rates.

After the transfer, the patient stays at our clinic for about an hour. After that, she can go back home and continue a normallife. It is recommended to rest for the following 24 hours and avoid any violent effort or sport during the two following weeks.Although patients do not live in Seville, they can travel back home the same day the transfer is done.

At Ginemed Clínicas, we encourage patients to lead a normal life. We advise them to take their mind off things and to relax,because anxiety and stress are not good. Choose pleasant activities on the following days and wait for the results with calmness;you have overcome the most difficult obstacles and you just need to wait for the embryo implantation inside the uterus.

After the transfer, the prescribed treatment continues for the first three months of pregnancy or until we have two negativepregnancy tests.

Pregnancy is normally determined 12 days after the transfer by a blood test which measures the level of the HCG hormone.If the first test is positive, an ultrasound will be performed two weeksafter. If the first test is negative, we will need to repeat it to confirm theresult before to suspend the treatment.

Do not suspend the treatment without previous medical indication.

Embryo Vitrification and Thawed Embryo TransferViable embryos which are not immediately transferred will be frozen

-cryopreserved- for later attempts. These pre-embryos remain frozenat -196ºC. Vitrification differs from the traditional slow embryo freezingmethod since embryos will be immediately frozen at 23,000ºC perminute. Thanks to this recent technique, we avoid the formation ofcrystals and consequently we will hardly ever have lesions of theembryo’s cellular structure.

Nevertheless, the process of freezing and unfreezing may affectembryos’ viability and some of them might result damaged. Ourbiologists will indicate the adequate moment for vitrification of theembryos which are not transferred.

Concerning thawed embryo transfers, female patients only needto perform a hormonal treatment to ensure the endometrialpreparation for the embryo transfer. Patients have to visit their doctor(in their home country) in order to follow the endometrial evolutionthrough regular ultrasounds. According to the evolution, we will setthe transfer date. Frozen embryo transfer process is the same as forfresh embryo transfer. After the transfer, we prescribe medicalsupport for the luteal phase.


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Thanks to vitrification, we obtain pregnancy results which are very similar to the rates we have with fresh embryos. Since 2006, all the embryos of our Clinic have been cryopreserved through vitrification.

There are no physical or psychological differences between babies born through a transfer of cryopreserved-thawed embryosand those born from natural pregnancies or other techniques of medically assisted reproduction.

Embryos will remain frozen until the woman determines their destination: they may be transferred in later cycles; they alsomay be donated to research or to other couples. Embryos can be maintained frozen except if the woman does not present themedical conditions which are necessary for the embryo transfer; in this case, she can end with the cryopreservation withoutany further use.

The informed consent form concerning the cryopreserved embryos must be renewed at least every two years. If this consentis not signed after a four-year period, embryos will be at disposal of Ginemed Clínicas.

If you wish to perform the transfer in Ginemed Clínicas but you have previously frozen embryos in another centre, we will tellyou how to proceed to the transfer of these embryos in the best conditions and guarantees.

Embryo Donation CyclesThere is the possibility to use frozen or vitrified embryos from a programme of embryo donation. The available embryos for a

donation programme come from couples who have donated them voluntarily, after signing a document for the donation. The process is identical to the cycle of frozen embryos.

Medical Supervision of Women during pregnancy: antenatal careOnce pregnancy is confirmed, patients will be under supervision

of their usual gynaecologist in their home country. Antenatal carewill be the same as for any pregnancy, since evolution is similar tonatural pregnancies. We will previously provide your gynaecologistwith the patient’s medical record.In any case, it is important for usto know about your pregnancy and how the baby is developing.

Both the miscarriage rate and the risks of fœtal malformationsare similar to the rate presented after spontaneous pregnancies.Complications occurring during the 2nd and the 3rd trimester arealso the same as for spontaneous pregnancies.

According to a survey performed by the European Society ofHuman Reproduction, there is no difference of developmentbetween the children born through an IVF treatment and childrenborn through a spontaneous pregnancy.

Success RateThe rates of success of a programme of embryo donation are

significantly higher than those of an IVF programme, since thedonors are always young women.

The clinical pregnancy rate published in March 2009 by theSpanish Association of Fertility is about 50% per cycle of transfer,for a total of 6,518 cycles. The same survey makes reference to arate of pregnancies of 38.7% for a total of 23,573 cycles of IVF-ICSI.

The results of Ginemed Clínicas revised in March 2009 give usa pregnancy rate of 55.3 % per cycle with transfer (resultsobtained throughout 2008). It is important to add that, followingthe recent changes introduced in June 2008, the global resultsfor the second semester of 2008 including January - February2009 reached 68.91%.


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In optimal conditions, that is, with two or more good qualityembryos (grades 1-2) and a properly transformedendometrium, over 8 millimetres, with a correct transfer, weachieve pregnancy rates higher than 75 %.

In any case, the higher number of good quality embryos weobtain and the more cycles we carry out, the real possibilitiesof pregnancy increase significantly. We recommend amaximum of 3 cycles.

RisksMultiple pregnancies are more frequent in cases of Assisted

Reproduction than in normal population.

The information published, over a total of 9,714 pregnancies,concluded that 70.4% are single-foetus pregnancies, 25.8% twofoetuses,3.6% three foetuses and 0.2% four foetuses.

If for any reason, the couple does not accept the possibilityof multiple pregnancy they must notify it from the beginning,in order to transfer only one embryo, knowing and acceptingthat the possibilities of success are lower.

A pregnancy of 3 or more foetuses implies a situation of risk. In these cases, the couple has to assess the possibility ofreducing the number of embryos (selective elimination of one or more embryos).

Sometimes there are minor side effects, originated from the medication used, most of the times these side effects areheadaches and liquid retention.

Apart from the physical risks described there may be signs of anxiety and depression in the couple, and even producingsometimes alterations in the couple’s relationship. The signs of anxiety are normal during the period of time between the embryotransfer and determination of the HCG blood test, that is, until confirmation of the pregnancy. This anxiety increases when therehave been previous failed cycles.

With regard to the possibility of higher risk in advanced age pregnancies, no differences in age have been described up to 45years old. Older than this age, the cases of hypertension tend to increase and according to some publications, the cases ofgestation diabetes as well. Publications also describe an increase of premature births after the age of 45. These complicationsare higher after the age of 50, though there is little bibliography in this respect.


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Supplementary Techniques Regarding Human Assisted Reproduction

HatchingThrough this technique, the qualified biologists of Ginemed Clinicasmake an orifice

inside the pellucid zone of the embryo. The aim is to facilitate the embryo implantationinside the uterus. This technique is reserved to specific cases since it means a smallrisk of lesion for the embryo.

We use this technique when embryos have poor quality, either due to alterationsof the pellucid zone or to a high degree of fragmentation and division. We generallyuse it in cases of advanced age regarding women (>38 years old), when we have fewoocytes available, when we have already had failures of implantation or in case offrozen embryo transfer cycle since thawing may affect the pellucid zone.

The Human Reproduction laboratory will tell us when we have to perform this technique.

Fragment aspirationDuring the process of cell division, fragments may sometimes be produced, making the

embryo development difficult. In this case, we proceed to a fragment aspiration to eliminatethese fragments and improve the embryo quality. Consequently, this will also improve therates of pregnancy.

Our laboratory will perform this technique if necessary; this technique is not foreseeableand will be carried out if necessary, when embryo fragments are produced.

Embryo culture until blastocystThis technique allows the Reproduction laboratory to develop embryos until reaching the

blastocyst formation, that is to say 5 or 6 days after the oocyte retrieval.

Such a technique offers a higher rate of success since embryo implantation inside thewoman’s uterus is easier than when transferring an embryo on the second or third day ofdevelopment. However, it is harder to reach the blastocyst stage in a culture medium andconsequently there is a risk of loosing some viable embryos.


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Other programmes regarding reproduction

Preimplantational Genetic Diagnosis (PGD)Thanks to this technique, we can determine if, from a genetic point of view, an embryo is normal or not before being transferred

to the patient’s uterus.

Biologists perform an orifice inside the pellucid zone of the embryo (like for hatching) and through this orifice, they extractone or two embryo cells called “blastomere”. Then, biologists analyse the cell nucleus and more specifically the chromosomes.In order to detect possible anomalies, they will analyse the chromosomes through fluorescent tracers (FISH technique) or theembryo DNA (PCR technique).

During this process, embryos continue their evolution in the culture medium. Healthy embryos will be transferred once weknow the preimplantational genetic diagnosis.

We use this technique to prevent hereditary diseasessuch as hemophilia, cystic fibrosis, etc. We also use it to rule out chromosomalalterations such as the Down and Edwards syndrome.

It is especially indicated after various failures of embryoimplantation, for women who present repeatedmiscarriages and when there is a high risk of having a babywith genetic alterations (Down syndrome).

We only perform this diagnosis on specific demand.Please, contact us if you wish to have more informationconcerning this technique. We remain at your disposal toprovide any complementary information.

For further information concerning the PGD, an informationdocument is available

Fertility for women with no male partnerBoth single women and female couples who wish to

become pregnant are more and more numerous. Reasonscan be very diverse: some of these women have not metthe man with whom they want to found a family withoutnecessarily renouncing to their maternal project. Otherwomen who live with a same-sex person may also wish tobecome mothers.

Nowadays, these situations are very common in oursocieties. The Spanish law (14/2006 Act of May 26) grantsthe same rights and obligations to women who want tofound a family with or without male partner.

For further information concerning this topic, aninformation document is available

Fertility preservation thanks to the OocyteVitrification Programme

The aim is to preserve the fertility potential when awoman wishes to vitrify her own oocytes to use them inthe future. In such a way, her fertility potential does notdecrease.

For further information please contact us, an informationdocument about this programme is available.


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Price list of Infertility Treatments(From 01/07/2011 to 31/12/2012)

According to the existing law, we inform you about the different treatments carried out by Ginemed Clinicas as well as thecorresponding prices.

Payments must be made before the beginning of treament (50%) and on the day of the embryo transfer (50%).

Storage for frozen semen, cryopreserved embryos or testicular biopsy shall be paid in advance, according to an annual basis.If maintenance lasts less than a year, we will reimburse you the corresponding amount. The payment shall be accompaniedwith the signed consent form concerning freezing and storage.

Herein, we do not take into account drugs prices. Hospitalisation prices and surgical treatment are included.Previous tests are charged independently according to their realization.In case of cancellation, payment shall only be made for the phases the patient has performed until the treatment is stopped.

If the cycle is cancelled for a cause beyond the recipient’s control, i.e. because of the donor, the low quantity or quality of oocytes,nothing will be charged to the recipient.

The GINEMED Administration Department can inform you should you have any question concerning the payment.

Previous tests concerning fertility

- Information visit (without examination or ultrasound) ....................................................................... Free- Procreation medical visit (with examination and ultrasound, if necessary) .................................... 120 €- Results visit (with ultrasound, if necessary) ........................................................................................ 65 €- First psychological evaluation examination .......................................................................................... Free- Following psychological examinations (each)...................................................................................... 75 €- Andrology examination............................................................................................................................. 120 €- Genetic advice examination..................................................................................................................... 160 €

Tests performed at Ginemed Clínicas (we will only be charged for the tests which are performed) - Spermogram with Sperm fertility test .................................................................................................... 75 €- Freezing of Sperm or testicular biopsy for later use ............................................................................. 120 €- Storage of frozen sperm or testicular biopsy......................................................................................... 25€/month

If more than 4 banks. ............................................................................................................................... 40€/month- Sperm cleaning procedure in case of transmissible diseases: Hepatitis B or Hepatitis C............... 825€

(Includes sperm freezing for a use during the same cycle but does not include storage)

- Y chromosome microdeletion analysis .................................................................................................. 400 €- Male hormonal test (3 hormones: FSH, Estradiol, Testosterone) ....................................................... 70 €- Testicular ultrasound ................................................................................................................................ 55 €- Serology and blood tests for males (HBsAg, AcVHC, HIV, Group and Rh)........................................... 90 €- DNA Fragmentation test ........................................................................................................................... 50 €- Sperm donor (external laboratory)......................................................................................................... 375 €- Hormone blood test for women (4 hormones: FSH, LH, Estradiol and Prolactin) ............................ 85 €- Serology and blood tests for women (HBsAg, HCV, HIV, Lues serology (RPR),

Rubella IgG, Toxoplasma IgG, Blood group and Rh, Hemogramm and blood sugar) ......................... 160 €- Blood clotting test (PT) ............................................................................................................................ 25 €- Periferic blood karyotype ......................................................................................................................... 90 €- Smear test.................................................................................................................................................. 35 €- Mammography (at Ginemed Clínicas) ................................................................................................... 75 €- Mammary echography (at Ginemed Clínicas) ...................................................................................... 55 €- Transfer test (cannule is included) ........................................................................................................ 100 €

Surgical interventions regarding infertility

- Obtaining spermatozoa through testicular biopsy o epididymis puncture ....................................... 1,010 €Details:- Surgeon and surgeon assistant.- Operating room and medication.- Laboratory and biologist.


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- Testicular biopsy with meiosis analysis................................................................................................. 2,160 €Details:- Biopsy.- Meiosis Analysis + anatomical pathology.- Specific material of laboratory.If we perform anatomical pathology, prices increase according to the number of samples.If anaesthesia or sedation are necessary, price increases by 295 €.

- Polypectomy through hysteroscopy ...................................................................................................... 915 €Details:- Bedroom or recovery room.- Operating room costs and fungible material.- Anaesthesia costs (include fees and medication)- Gynaecologist costs and assistant.

Oocyte Donation Cycle

- Complete cycle of Oocyte Donation ........................................................................................................ 5,725 €Details:- Donor’s expenses to be paid by the Recipient.

· Clinical assessment and Psychological examination for the donor.· Gynaecological examination, ultrasounds assessments and blood tests.· Compensation for the donor (according to Law).· Ovarian stimulation.· Cycle Monotoring.· Egg collection.· Operating room for follicular punction.· Recovery room.· Sedation for egg collection procedure.

- Endometrial stimulation (Recipient).- Laboratory fertilisation.- ICSI.- Ultrasound-guided embryo transfer.- Operating room.- Recovery room.

Medication for the donor ............................................................................................................................ 875 €

Common processes of optionnal use

- Vitrification of the embryos which are not transferred ........................................................................ 425 €(the firth four months of cryopreservation are included)

- Storage of vitrified embryos .................................................................................................................... 25 €/monthIf more than 4 banks: .............................................................................................................................. 40€ per month

- Hatching .................................................................................................................................................... 245 €- Long-term embryo culture medium until blastocyst stage................................................................. 375 €- IMSI Microscope......................................................................................................................................... 235 €- Embryo reduction ..................................................................................................................................... 1,065 €

(with anaesthesia or sedation: plus 295 €)

Cycles performed with vitrified embryos

- Own vitrified embryos Cycle .................................................................................................................... 1,400 €(Fragment aspiration is not included) Detail:

- Preparation and control of cycle (consultations and ultrasounds) - Laboratory: defrosting, culturing, post-defrosting - Hatching- Embryo transfer with ultrasound (includes operating room and bedroom)

- Vitrified embryos cycle with a programme of embryo donation ......................................................... 1,870 €Detail: same as above more storage fees of donated embryos

Preimplantational Genetic Diagnosis (PGD)

See specific information file.

Fertility preservation through egg vitrification

See specific information file.

We hope that all this information has enabled you to understand better the mechanisms linked with Medically AssistedProcreation. Please, do not hesitate to ask us, should you have any question or doubt. Rest assured that the staff of GinemedClínicaswill put all its experience at your disposal: both from a human and scientific point of view, we will do everything we canto achieve your dream of having a baby at home.


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Application form and informed consent for Egg Donation Treatment

Application form and informed consent for the carrying out of medically assisted procreation techniques,in compliance with Spanish law (14/2006 Act, May 26, 2006) :

Mrs: ........................................................................................................ Identity number: ..................................Mr:........................................................................................................... Identity number: ..................................

We, the undersigned, hereby request and authorize the medical staff of Ginemed Clínicas to carry out a medically assistedprocreation treatment through the following technique (tick where appropriate). We request them to take the necessarymeasures and decisions according to medical and scientific criteria, in order to achieve pregnancy.

Egg donation programme (full process)Embryo donation programme (full process)

Special conditions applying to my case (tick where appropriate)Use of donor sperm Getting spermatozoa by puncture or testicular biopsyMaintaining frozen sperm samples or testicular biopsy for later useOthers........................................................................................................................................................

Specific risks:...............................................................................................................................................

We request the freezing of viable embryos which are not transferred. We understand and agree that they can be kept frozenuntil the patient decides either to transfer them during a subsequent cycle, to donate them to another couple for their ownattempts at pregnancy or to offer them for scientific research. If the woman does not satisfy the medical conditions which arenecessary to enable the transfer, it is possible to put an end to embryos storage without any utilization. The whole egg programmeand vitrified embryos are ruled by Spanish law. The parties concerned shall expressly waive their own jurisdiction or any otherlegal rule and they shall submit to Seville Courts and Tribunals jurisdiction for any dispute or litigation concerning theinterpretation, validity and effectiveness of this informed consent. We understand and agree that neither “Ginemed Clínicas”,nor Sevillana de Ginecología y Medicina, S.L., nor the staff who looks after us, cannot be held responsible for the damage causedto cryopreserved embryos by unforeseeable medical causes (such as wars, floods, natural catastrophes, vandalism, fires, etc).This consent includes the first fourth months of freezing. We understand and agree that the consent to the storage of embryosshall be renewed at least every two years. If the aforesaid consent is not signed after a four-year period, embryos will be at thedisposal of Ginemed Clínicas.

Doctor providing information and obtaining the consent: .....................................................................

WE HAVE BEEN INFORMED AND WE UNDERSTAND:- The indications concerning the carrying out of our treatment - The protocol to be continued during the whole process- The staff in charged of this protocol- The known risks of the technique - The success and failure possibilities of the aforesaid technique- The financial cost of the process

Information concern both written one and oral one. We agree that we have been informed about the medicines which are usedfor each case and that some of them do not appear explicitly even if there are necessary. We accept the responsibility of anykind of complication which can appear during the process as well as the legal implications which may follow from this process.

Besides, we are informed that:- The staff may increase any received information- Some images or personal information may be used for teaching or scientific aims, provided that such measures do not

impair the anonymity principle. - We may revoke this consent at any moment and for any reason.

WITNESS my hand and official seal.

………/……………/………… …………………………………………………………………Date Signatures


we make your dreams come true

Consultation offices, Operating rooms andLaboratory for Assisted Reproduction:

C/ Farmacéutico Murillo Herrera, 3

41010 Seville - Spain

(GPS: 37º22'52.00"N / 6º 0'4.60"W)

Tel: +34 661 975 282 / +34 607 759 506Fax: +34 954 991 195

[email protected]


ginemed_ovodon_uk

Documents

programme of oocyte

oocyte donation programmewe

egg donation

ginemed clnicas information

ginemed clinicas hasat

women recipients

gametes ovules

authorization documentfor