ROPA method: women in search of happiness
The road to motherhood is not easy for many women: the dashed hopes, the unfulfilled dreams, the agony of waiting for a moment that never comes. All these difficulties represent a great emotional burden for the woman and her partner, which in the case of female couples is exacerbated by the stereotypes and social taboos surrounding motherhood among same-sex couples. In addition, the current laws in most European countries are restrictive and not very inclusive regarding same-sex marriage and all the rights associated with it.
Fortunately, in Spain we have a legal framework that protects women’s reproductive rights regardless of their sexual situation. Since 1988, the Assisted Reproduction Act has enshrined the right of women to start their own families freely and responsibly. In 2006, this right was expanded by allowing women to access assisted reproduction techniques regardless of their marital status or sexual orientation.
When a homosexual couple, composed of women, decides to have a child thanks to artificial insemination techniques, various treatments are available to them:
– In vitro fertilization (IVF) with donor sperm.
– Artificial insemination with donor sperm.
– Double donation of eggs and sperm.
– Adoption of embryos donated by other couples.
– Egg retrieval by the partner or “ROPA” method.
All of these treatments are suitable for any woman who wants to become pregnant, but the ROPA method is best suited to the needs of a couple of women. The ROPA method, also known as “shared motherhood,” is an assisted reproduction treatment that involves both women, meaning one woman is the egg donor and the other woman is the embryo recipient.
This treatment is entirely focused on female couples and aims to make both women feel like they are an important and necessary part of the process. But what exactly does this method consist of? The ROPA method is simply in vitro fertilization between two women. The procedure is very similar to egg donation, with the only difference that the “donor” in this case is not anonymous, but one of the future mothers.
Deciding what role each will play, i.e., who will be the surrogate and who will provide the eggs, is a decision made solely by the couple as a couple.
From a medical point of view, it makes the most sense for the eggs to be provided by the younger woman, as the quality of the eggs decreases with age and chromosomal changes can occur, especially after the age of 35. It is also essential that the woman providing the eggs has a good ovarian reserve, as in this way embryos of the highest possible quality can be obtained, which greatly increases the chances of pregnancy.
The phases of the ROPA method
- Stimulation of ovulation: when the couple decides who will provide the eggs, they receive treatment with hormonal preparations so that there is an even stimulation with the maturation of several eggs. The drug is usually administered subcutaneously by the patient herself through a series of injections into the abdominal area. During the treatment, which lasts about 7 to 12 days, the woman must visit the doctor regularly for ultrasound checks to observe the growth of the follicle count and thus determine the optimal time for egg retrieval.
- Egg retrieval: The eggs are retrieved from the ovary by aspirating the fluid in the follicles, where the eggs mature. This is an elementary procedure called ovarian puncture or follicular puncture. This procedure takes only 30 minutes and is performed under light anesthesia. Usually, hospitalization is not required after the procedure, so the woman can go home the same day.
- Fertilization of the oocytes: After obtaining a sufficient number of oocytes, they are analyzed to check which ones have the best stage of maturation. They are then fertilized with the sperm of an anonymous donor, who must be compatible both physically and immunologically with the woman who is to bring about the pregnancy. Spanish legislation regulates the screening and approval of donors and establishes the required tests and examinations. At IVF-Life, we go even further by performing additional tests to use donor sperm with the greatest guarantee of safety. Fertilization can be performed conventionally or with the ICSI method (intracytoplasmic sperm injection).
- Embryo culture: after fertilization of oocytes with sperm, the fertilized oocytes with the highest probability of implantation are selected and kept in culture for a period of 3 to 6 days.
- Endometrial preparation of the recipient: This is where the other woman in the couple who will eventually carry the pregnancy to term begins to play a key role. Initially, she will undergo different hormone treatment than her partner, as the goal is different. She will be prescribed estrogens and progesterone in different ways (oral, vaginal, etc.). In this phase, the aim is to promote the growth of the endometrium so that it reaches the optimal size and thickness for embryo implantation, i.e. approximately between 7 and 10 millimeters.
- Embryo transfer: When the uterus of the woman in which the pregnancy is to develop is receptive, the highest quality embryo is selected and placed in the uterus. It is a painless and quick procedure that does not require any anesthesia or special care. It is only recommended to come with a full bladder to facilitate visualization of the uterus. At IVF-Life, we focus on transferring a single embryo of the highest quality, avoiding the possibility of multiple pregnancies, which can lead to complications for both the mother and the babies.
- Vitrification of unused embryos: The Spanish legal framework allows the transfer of a maximum of 3 embryos in the same procedure. Viable and high-quality embryos that have not been transferred are cryopreserved by vitrification to be used in future treatments if the first attempt fails or if there is a desire for more offspring.
- Pregnancy test: After embryo transfer, a period of about two weeks is required to perform the appropriate tests to confirm whether the treatment was successful and pregnancy has occurred.
This procedure allows one of the women to provide genetic hereditary material and the other to give birth to her future child.
How does the pregnant mother change the genes of the embryo?
Before implantation of the embryo in the endometrium of the pregnant mother, there is a transfer of cells between the mother and the embryo. This happens because the body mimics the usual fertilization process in which the embryo takes about five days to move from the fallopian tubes to the uterus. The ROPA technique also attempts to mimic the natural fertilization process. Therefore, the embryo develops in a special incubator for five days before the embryo transfer is performed. In addition, the woman who receives the embryo is given special drugs that increase the receptivity of her uterine lining and facilitate implantation.
After implantation in the uterus, implantation does not occur until the following 24 to 36 hours, when the embryo finally attaches itself to the uterine lining. During this time before implantation, the pregnant mother produces endometrial fluid containing genetic information that is absorbed by the embryo and influences its future development.
This information, previously recorded by the embryo, may result in the expression or non-expression of certain gene functions in the embryo.
What does the pregnant mother contribute to her partner’s embryo?
It has long been known that the pregnant mother has an influence on the genetics of the embryo developing in the womb. This influence on the genetics of the embryo is explained by epigenetics.
Epigenetics is the science that studies what effects or changes external or environmental factors can have on genetic function without causing changes in the DNA sequence.
These environmental factors determine whether certain genes are activated or not, and that the information contained in cellular DNA is interpreted by the cells in one way or another, resulting in phenotypic changes. The genes carried by the embryo do not belong to the pregnant mother, but she can change them through her genetic load.
There are certain periods in child development when the child’s genetics are more susceptible to changes in DNA, always as a result of these environmental factors. These periods are: Preimplantation, Pregnancy, Infancy, Childhood and Puberty.
Numerous scientific studies have shown the effects and consequences of the environment on the development of the child, such as dietary habits, exposure to certain toxic substances or lifestyle habits. For this reason, more and more importance is given to the influence of a pregnant woman’s lifestyle and habits on her future child. It has also been shown that breastfeeding is of enormous importance and has numerous positive effects on the future development of the baby.
All this proves that pregnant mothers who undergo egg donation or embryo donation treatment will develop a biological and, to some extent, a genetic bond with their future children, proving that they will share with them much more than the womb in which they grew up.
For all these reasons, the ROPA method has become a fantastic option for all those women who would like to become mothers but are reluctant to use egg donation to achieve this.
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