# Is Downregulation necessary when using donor egg?



## tinaki35 (Jul 20, 2018)

Hello!

I am having a donor egg procedure in Greece in a couple of months. 

I can not get the medication here in the States for downregulation. The clinic says it's not necessary that they will match my cycle with the donor.

Of course, I am happy not to have to go through downregulation as I've heard it has nasty side effects. But will my donor egg procedure still be effective without downregulation?

thank you!


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## Costache (Aug 6, 2018)

Hi tinaki35,

I presume you are the recipient.

I goes like this: without downregulation, you start estrogen pills following your menstruation, according your doctor's plan. In theory, the high dose of estrogen pills have a suppressing effect on your ovaries, limiting oocyte development and preventing an unexpected ovulation.

AFAIK, it is recommended to take estrogen pill for a maximum of 19-20 days. The duration of donor stimulation and oocyte retrieval is about 14 days from the start of program. If you have a rather regular cycle, the clinic can anticipate the date of your next mestruation and prepare the donor accordingly.

I would suggest you to discuss with the clinic a simulated medicated cycle. Before the actual cycle, follow a estrogen pill treatment similar to actual stimulation cyle. If the simulation fails (thin endometrium or other issues), it is a pretty good indication the same will happen when you actually perform the real donor egg procedure.


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## tinaki35 (Jul 20, 2018)

thank you! Do you think there is more success if the recipient is downregulated? or does it matter as long as the protocol you described is followed?


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## MadameG (Jan 13, 2012)

Hi Tinaki, is there a reason why you can’t get the medication in the US? Considering IVF is so common there, it would be worth looking into this a bit further. Perhaps your clinic is just requesting a brand that isn’t commonly available and there is an alternative option? What’s the medicine called? Not everyone suffers with the side effects, I personally do but I know many ladies who breeze through it  xxx


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## Baking Queen (Jul 7, 2014)

I did a fresh DE cycle with downregulation, which resulted in my daughter. I recently did a DE FET with no down regulation and I’m 13 weeks pregnant. So I think the answer is that it doesn’t really matter. I believe they do it with fresh DE cycles as it means they have a bit more control over your cycle if your donor had to stim for more than expected so transfer is later.
Hope that helps.
BQ. xx


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## Costache (Aug 6, 2018)

tinaki35 said:


> thank you! Do you think there is more success if the recipient is downregulated? or does it matter as long as the protocol you described is followed?


In donor egg procedures, medicated cycles with downregulation are usually used for fresh transfers. Frozen embryo transfers are usually done without downregulation.
Without downregulation, the ovaries are still working to some degree, and it's possible they will help to build a thicker endometrium.

There is a lot to know about endometrium preparation protocols.

My advice is: know your body. Know things like endometrial thickness and its echographic structure at ovulation time. If medicated stimulation results are worse than your natural cycle "numbers", it is a good sign your body is not responding very good to drugs. You should discuss with your doctor for a different drug protocol (drug type, dose etc). A mock (simulated) medicated cycle is quite cheap and spares you of nasty surprises during the actual cycle.


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