Tandem is a term used mainly for sports activities carried out by two people. The term in IVF is similar but is used to describe a females own egg collection, in line with an egg donor also selected.
Effectively a TANDEM cycle when used in IVF on the day of the planned egg collection of the patient, donor eggs can be collected and both sets of eggs can be injected with their partner`s sperm and the best developing embryo can be transferred.
Who is eligible for a Tandem cycle?
Deciding to go ahead with a Tandem cycle is not an easy decision, so it is advised that you seek counselling and consider your options open to you before deciding.
Women who decide to fall pregnant for the first time at a more mature age (44-45yrs), may have undergone tests and told that hormone are too low to proceed with their own eggs, they may consider a Tandem cycle as this will eliminate the what if factor, again your doctor will advise you accordingly and this is why you seek advice from a Gynaecologist who is experienced in IVF and Donation treatments.
Women who have a low egg reserve will look to go ahead with a Tandem cycle to build on the number of eggs on egg collection day with donor eggs.
How do you prepare for a Tandem cycle?
The preparation for a Tandem cycle is a mixture of the preparation for IVF and also an Egg Donation cycle, so a form of birth control or down regulation is used to synchronise your menstrual cycle with your chosen donors. Of course the necessary tests will be carried out to monitor hormone levels (TSH, AMH, Prolactin etc.) as well as a ultrasound to make sure collecting your eggs is a viable option. Your partner will also require a sperm test to make sure that the sperm is of a good quality before proceeding.
When choosing a donor, we will guide you and offer you as much information as possible, our donors are anonymous so their identity cannot be revealed and they are protected under the Azerbaijani Law. In turn your identity is also not revealed to the donors and so patients are protected too from the confidentiality law.
When selecting a donor, we will ask for main characteristics i.e. Blood group, Eye colour, Hair, Skin tone etc. and of course if you have any specific requests these will be taken into consideration also. We also encourage you to provide your partners details and also a picture of you both so that a donor can be matched by our donor coordinator as accurate as possible.
We will first offer you a choice from two donors and if you feel the profile is not exactly what you are looking for then we will offer you a further two donors until you are happy with your selection.
What does the Tandem treatment Process entail?
It is important that the dates for yours and your chosen egg donor are synced as best as possible as if the egg collection can be carried out on the same day then a fresh embryo transfer can take place. Stimulation will begin on day two or three of the menstrual cycle and will last between 11-13 days. Ultrasounds and blood tests will be needed at certain stages of the stimulation, so the female will be closely monitored to check follicle development. This is the same for your chosen Egg donor, so you will start simultaneously.
Once the stimulation process is completed and the follicles are of a certain size to be triggered, the last injections are applied and these are to invoke ovulation and also help to increase the number of mature eggs collected. There are two different types of trigger injections that can be used individually or in combination (containing hCG / containing GnRH analogue) but these injections are also sold under different brand names in different countries. Based on your follicle development, your doctor will determine which trigger injections should. Egg collection (OPU) is performed, 34-36 hours after the trigger injection is administered at a certain time. Your donor will also be examined and the egg collection will be ideally planned for the same day as your egg collection.
On the day of your egg collection, the sperm sample will also be needed from your partner (we recommend a minimum of 2-3 days abstinence). The sperm sample will then be processed within the laboratory and then the one good looking quality sperm will be injected into each of your own mature egg as well as the eggs collected form your chosen donor.
After the egg collection procedure, a new medication protocol will begin (e.g. Progesterone) to prepare your body for the transfer of the embryos to maximise your chances of pregnancy.
Which embryos do we transfer?
This is a decision made by you with your doctor and embryologist, embryo development will be monitored and you will be guided. If the embryos developed from your own eggs are of a good quality, the embryos developed from the donor can be frozen and you may have only your embryos transferred. The pregnancy success in this case varies according to your age.
If the embryo quality of the couple is not suitable for transfer or embryos do not go on to develop, the embryos developed from the donor egg are transferred but of course you will be counselled and guided and do what you feel is best. In this case the chances of pregnancy is 75-80%. In some cases, both embryos developed from you and the donor eggs can be transferred at the same time, even if the double embryo is transfer in quality and if there is double approval. In this case, there is a chance of 75-80% pregnancy. However, it is not possible to know which embryo is pregnant except for genetic tests.