Donor Egg Fiasco at Nadezhda Hospital in Sofia, Bulgaria using Medspa.

The Donor Eggs That Couldn’t Be Verified: My IVF Experience in Sofia, Bulgaria at Nadezhda Hospital

I want to share my experience with donor eggs to help other women who may be considering IVF abroad. I had the embryo transfer at Nadezhda Hospital in Sofia, Bulgaria. Although I wanted to directly transact with the hospital being an EU citizen, I was forced to go through Medspa. Medspa is a medical tourist company located in Sofia, Bulgaria. It should be noted that Medspa does not have an independent Google review page and are posting reviews on their website only. The ability for the public to make independent reviews of this company is important for women who decide to proceed.

When you strip all of the marketing away this “donor egg package” is merely:

1) The creation of embryo(s), and;

2) Embryo transfer(s).

This is an incredibly expensive package. Where success is not prioritized BUT financial outcomes are.

The Consultation Appointment

The was under 5 minutes, no medical or was filled out and I was accepted on the spot. These are .

When a Fertility Clinic Skips Intake, It’s Not an Accident

One of the most overlooked red flags in fertility treatment isn’t the lab, the donor, or even the outcome. It’s the intake.

At a reputable fertility clinic, intake is not a formality. It’s a critical medical step. Doctors normally spend significant time asking about a patient’s medical history, gynecological history, prior treatments, medications, and risk factors. This information is what allows them to design a treatment plan that is safe, ethical, and appropriate.

So what does it mean when a clinic conducts an intake in under five minutes, with no meaningful questions about medical or gynecological history?

It usually means the treatment plan already exists — and the patient is being fit into it.

Why intake matters in fertility care

Fertility treatment isn’t cosmetic or elective in the usual sense. It involves:

A proper intake allows clinicians to:

Identify contraindications and risks
Tailor protocols to the individual
Ensure informed consent is real, not theoretical
Document decision-making and accountability

Without intake, treatment planning becomes guesswork — or worse, automation.

The problem with “package-based” fertility treatment

Some clinics operate on a package model rather than a medical one. In this system:

Protocols are standardized
Donor options are pre-selected
Outcomes are marketed in averages, not individuals
Patient history is treated as irrelevant

From a business perspective, this model is efficient. From a medical perspective, it is deeply concerning.

In a package-based system, the clinic does not need to know much about the patient because individual variation is inconvenient. The less the clinic documents, the less it is required to respond to.

Plausible deniability as a business strategy

When a clinic does not gather medical history, it creates built-in protection for itself:

If complications arise: “We followed the standard protocol.”
If a donor choice is questioned: “Treatment was not individualized.”
If consent is challenged: “The patient accepted the package.”

This is known as plausible deniability — a way to limit responsibility by limiting knowledge.

In medicine, that should never be acceptable.

What patients should expect — and demand

Any fertility clinic claiming to practice ethical, patient-centered care should:

Take a written note oral detailed medical and reproductive history - you should be filling out a form created by the medical facility which has you document your medical and gynaecological history. This should not be done verbally - you want to avoid situations which introduce plausible deniability.
Explain why a specific protocol is being recommended
Document alternatives and risks
Treat intake as the foundation of care, not a checkbox

If a clinic seems uninterested in your history, it’s worth asking why.

The bottom line

Fertility treatment is not fast food. It is not a pre-packaged product that should work the same way for every body.

When a clinic skips intake, it’s not because they’re efficient. It’s because they don’t want to know — and not knowing protects them more than it protects you.

Patients deserve better than that.

Pre-Treatment Concerns

I have hypothyroidism, but my thyroid was never tested nor documented by the high-profile doctor that MedSpa promotes. Proper thyroid function is critical for fertility and early embryo development, yet this basic step was overlooked.

Standard pre-treatment workup vs. comprehensive evaluation

Many fertility clinics have a “standard” pre-treatment panel that includes basic labs like:
Blood counts
Infectious disease screening
Hormone panel (sometimes just FSH, LH, estradiol, AMH)
But thyroid function (TSH, free T4) is not always included in standard pre-IVF or embryo transfer packages, especially if the patient is asymptomatic.
Consequences:
If thyroid disease is not detected, (hyperthyroidism or hypothyroidism) the clinic may not be legally or ethically required to refer the patient or adjust medications, because it wasn’t discovered.
Once it is detected, the doctor has clear obligations:
Adjust hormone replacement or post-transfer medications
Ensure closer monitoring
Possibly delay transfer until stable
Since the hospital does not want to customize the pre-transfer treatment and post-transfer monitoring, I would be required to travel to another hospital to perform the pre-transfer and post-transfer monitoring and pay extra for a supposedly all-inclusive and customized donor egg package.

Why clinics may use “limited” screening

There are a few reasons (some practical, some systemic):
Minimizing complexity and risk for the clinic
Detecting thyroid disease before transfer creates extra monitoring and liability, because:
Standard luteal support and progesterone protocols may need modification
Thyroid patients are at higher risk of miscarriage or complications
Some clinics may deliberately limit tests to avoid discovering conditions that would complicate the standard package
Cost and efficiency
Every additional test increases patient cost and clinic resources
Clinics offering “fixed packages” may exclude tests that are only mandatory if symptoms appear
Liability vs. convenience balance
If the condition is not screened, the clinic can proceed without extra monitoring and still argue it followed standard protocols
If the condition is discovered, they must modify care, which increases monitoring, follow-up, and potential legal exposure

Ethical and medical implications

From a patient safety perspective, this is suboptimal — thyroid disorders can significantly affect IVF success and pregnancy outcome.
From a clinic perspective, limiting pre-treatment workup reduces their immediate obligations and simplifies standard care packages.

Limited pre-treatment screening may be intentional (or at least systemic) because discovering hyperthyroidism (or hypothyroidism) requires extra monitoring and changes to standard protocols.
If thyroid issues are missed, the doctor may argue they followed the “standard package,” so they do not have a duty to refer or adjust medications.
If thyroid issues are detected, then they have to act, which complicates the treatment plan — and this is precisely why some clinics prefer limited pre-treatment labs.

Undetected thyroid issues means ongoing treatment opportunities

If either hypo- or hyperthyroidism is missed during pre-treatment:
The patient may proceed with embryo transfer using standard medication protocols.
Thyroid issues can affect implantation success, miscarriage risk, or early pregnancy complications.
If the patient experiences failed cycles or early pregnancy loss, they are likely to return for additional IVF attempts, repeating the same “standard package.”
From the clinic’s perspective, this can unintentionally lead to more cycles, more fees, and more monitoring, because:
The first cycle may fail due to undiagnosed thyroid issues.
The patient comes back for a second attempt, sometimes unaware of the thyroid issue.
Eventually, the condition may only be discovered after repeated failures or complications.

How this connects to limited pre-treatment

Limited screening reduces the chance of discovering complicating conditions up front, which keeps the first cycle simple and predictable.
Once complications arise, patients often return for additional treatment, generating more revenue for the clinic.
Detecting issues early would require:
Modifying standard protocols
Extra monitoring
Possibly delaying the transfer
Managing more complex liability
So from a systemic view, limited pre-treatment tests can indirectly lead to more returning patients.

Ethical vs. systemic perspective

Ethically, full pre-treatment evaluation (including thyroid testing) is better for patient safety and pregnancy outcomes.
Systemically, clinics may offer minimal screening because it’s simpler, cheaper, and avoids early complications — whether consciously or not.
During preparation for the embryo transfer, there were further issues:
The lining of my uterus (endometrium) was measured differently by different staff: the midwife said 6 mm, the doctor said 7 mm, and optimal measurement suggested 8 mm. I was not informed that 8 mm is generally considered optimal.
The doctor prescribed PRP (platelet-rich plasma) as the only option. PRP has not been shown to improve outcomes in cases like mine. More importantly, this treatment would not sustain the endometrial lining through the implantation window, whereas ongoing estrogen therapy — which was not offered — could have provided optimal support.
Other standard, less expensive options, like waiting or using an estrogen patch to maintain the lining, were never discussed nor offered.
This left me feeling pressured, uninformed, and excluded from key decisions about my own care.

Donor Egg and Embryo Issues

The clinic showed me a donor profile sheet — but this was only symbolic. At the time it was presented I was not informed that it was meant to provide general information about age, hair/eye color, and blood type.
And that the donor eggs could be substituted for another phenotype without informing me.
Clinics use it to help patients feel informed, but there is no legal obligation to match it exactly, because:
Phenotype traits are biologically variable, and not every egg will produce the expected traits;
Donor anonymity laws prevent clinics from disclosing identifying information about the donor, so patients cannot verify phenotype.
It is not legally enforceable, because:
The law prioritizes health and traceability over appearance, a donor's physical traits are considered preferences, not contractual guarantees;
Even if a patient "selects" a profile there is no legal mechanism to enforce it;
Clinics are compliant legally as long as they follow screening, consent, and traceability rules, regardless of whether the requested phenotype is honored.
In my case, when the donor profile sheet was presented to me in English, I expected that it was the phenotype that would be used.
Legally, the only enforceable rights are related to:
Informed consent for procedures;
Access to donor safety and traceability documentation;
The right to refuse treatment or withdraw consent.
While it influenced my decision, I was unaware that it did not guarantee the donor eggs used actually matched that phenotype, and I was never informed that the clinic could substitute the donor eggs without my knowledge.
In my opinion, when they realized that I would not engage in business based upon their inability to supply my requested phenotype this donor sheet was produced to guarantee them my business. While they fully understood that I could never enforce my phenotype selection.
Phenotype selection is not legally enforceable under EU or Bulgarian law — clinics only need to verify donor safety and traceability, not guarantee physical traits.
At the time I made my phenotype request I was informed that they did not have it at the hospital and were not able to provide that to me. Later I was presented with the selection of a few donor eggs from Ukraine matching my request.
I later discovered the identifying information on the document was a Ukrainian hospital ID, not the donor ID. I will never be able to confirm that the donor eggs fertilized with the sperm are associated with that donor profile.
Medspa presented that document to me, which at the time I relied upon to be truthful and the matching phenotype available. I believed that I would receive donor eggs based upon the availability of that phenotype. I then made the decision to proceed.
I have not been able to independently verify the origin of the donor eggs — whether they were from Ukraine as the clinic said, or sourced locally.
Infectious disease documents, which show donor screening for HIV, Hepatitis B/C, syphilis, etc., are essential for safety but do not provide phenotype information. They have not provided these documents after they were requested.
After waiting 30 days and requesting documentation multiple times, the clinic still refused to provide the non-identifying donor ID and traceability, and infectious disease documents leaving me unable to transfer the embryos safely to another clinic, and unsure about the actual phenotype used to create the embryos.
At this stage, I am unable to use the embryos as I was not informed nor did I agree to the substitute in phenotype. I was fully aware of the sperm but now it has been combined with an unknown donor egg and I am unable to proceed.
I was also asked by both the IVF treatment coordinator and the doctor if I wanted to transfer two (2) embryos without being informed of the associated risks. I was only told that it would help the other. I am not certain that is factual if there are greater complications associated with gestating two babies.
When I had the embryo transfer I felt the medical doctor repeatedly hitting the inside of my uterus which was painful and he did it for both embryo transfers. I do not believe that is normal during a transfer and that it may irritate the lining increasing implant failure.
In addition, given the lack of transparency, it is theoretically possible that more than one donor could be involved in the creation of the embryos.

Emotional Impact and Transactional Nature of Care

This experience has been deeply traumatic for me. During the embryo transfer, I believed that the donor eggs being used were the ones I had carefully selected. To later discover that the clinic could substitute donor eggs without informing me left me feeling betrayed and powerless.
It became clear that, for the hospital, the process was purely transactional. Decisions seemed driven by routine procedures, pre-set packages, and financial assumptions, rather than by my individual medical needs or personal choices. I felt that my consent and bodily autonomy were violated, and that my trust in the clinic was taken for granted.
IVF is not just a medical procedure — it’s an intensely personal, vulnerable, and emotional journey. Feeling informed and in control is crucial, and when a clinic treats care as transactional rather than patient-centered, the emotional consequences can be long-lasting.

Post-Transfer Experience

After the embryo transfer, I quickly realized that the care I received was standardized and not tailored to my medical needs.
I was given a routine medication package that the clinic appears to use for all women, regardless of individual circumstances.
The most important aspect of post-transfer care is that it should be customized to the patient. Since I am in menopause, my body’s needs were different, and I should have been given a tailored plan to maximize the chances of implantation and early pregnancy success.
The clinic forgot to provide continued, optimal estrogen therapy after the transfer. I was forced to rely on a lower dosage, which may have compromised the implantation window coupled with the PRP which has not shown long term usage.
On the day of transfer, I was informed for the first time that I would need to find another doctor to manage my care after the transfer. I had no time to prepare and was left scrambling to find medical support for a critical stage of the IVF process.

When “Informed Consent” Wasn't Really an Option

I was denied the right to question or adjust my post-transfer medication, specifically progesterone, because I’m not a medical doctor. Even though I wanted to optimize my hormone levels for the best possible outcome, the clinic refused to discuss alternatives or adjustments with me for the next cycle. This directly contradicts their claims of customized care.

This is a clear example of lack of informed consent: true consent requires that patients are fully informed, can ask questions, and are allowed to make decisions about their own care. A patient’s medical background does not negate their right to participate in decisions about their body, yet in this case, my autonomy was ignored.

It highlights a serious problem in some fertility clinics: treatment is presented as fixed and unquestionable, leaving patients powerless even in decisions that directly affect their health and outcomes.
This experience made it clear that the clinic’s approach was one-size-fits-all, with little regard for individual medical conditions, needs, or informed consent. The combination of a standard medication package, missed estrogen supplementation, and being left to secure follow-up care on my own contributed to a sense of abandonment and lack of control over my treatment.

Combined Takeaways from My IVF Experience

Pre-Treatment Awareness
Ensure all relevant tests are completed before starting IVF. For example, thyroid testing is critical if you have hypothyroidism. But the doctor that they are advertising has the medical credentials to be aware of the importance of this testing. Why it was not performed is questionable.
Ask for all treatment options, including their effectiveness, potential risks, and costs. Don’t assume the medical doctor will disclose alternatives.
Confirm that any pre-treatment will support your body throughout the implantation window, not just appear advanced or expensive.
Transfer Considerations
Understand that donor phenotype selection may not be legally enforceable. Even if the clinic shows you a document, it may be symbolic and not verifiable.
Ask whether the clinic could substitute donor eggs without your knowledge and how this is documented.
Verify that the endometrial lining and hormone levels are optimized for your individual circumstances.
Post-Transfer Care
The clinic only informed me after the transfer that the donor egg package ends at the transfer. In reality, they are not responsible for the standard post-transfer medication package that they are providing you. And expect you to find another medical doctor without informing you. However, the provision of post-transfer medications for up to 12 weeks suggests that you do not require medical supervision.
Confirm that post-transfer care will be customized to your medical needs, especially if you are in menopause or have other conditions.
Ensure you receive adequate and continued hormone support, such as estrogen, for the entire implantation window.
Ask who will manage your care after transfer and when you will be informed — do not assume the clinic will handle follow-up automatically.
Donor Egg and Embryo Documentation
Always request non-identifying donor ID and full traceability documents before agreeing to IVF or embryo transfer.
Verify infectious disease screening and the lab that performed it — this helps confirm safety.
Understand that without proper documentation, embryos may not be legally or safely transferrable, even if you trust the clinic.
General Advice
Ask questions, request documentation, and do not rely solely on appearances or symbolic paperwork. Which sadly, if it is presented to you the critical limitations should also be mentioned.
Advocate for your autonomy and informed consent at every stage.
Understand that IVF abroad may appear glamorous, but trust and high-profile marketing do not replace thorough, patient-centered care.
What Women Should Understand About Clinics Like MedSpa

I was unprepared to use MedSpa, however, I was not able to directly transact with the hospital. I was forced to go through Medspa to access the services. I believed they would act in my best interests. I trusted that the high-profile reputation and marketing reflected genuine patient-centered care.
However, it became clear that when they did not inform me about critical issues — such as my inability to enforce donor phenotype selection and the possibility that the clinic could substitute donor eggs without my knowledge — their actions were aligned more with the hospital’s interests than mine.
This is an important lesson for other women: a clinic’s reputation or marketing does not guarantee transparency, patient autonomy, or that your reproductive choices will be respected. Being aware of this reality is essential before beginning treatment, especially abroad.
The failure to be provided with a consent document detailing:

Donor profile and ID, lab batch info.

Medical screening results for the donor eggs.

Fertilization and embryo transfer plan.

Signature section where you agree to proceed.
They can use any available eggs, including pooling or substitutions, without needing additional consent.
It avoids scrutiny: if you complain afterward, they can point to broad consent for the IVF package or the profile, and argue that you agreed to proceed.
They minimize liability: since there’s no signed consent specifically for the donor eggs, they aren’t explicitly breaking a rule if the exact eggs differ.
This is not an oversight or mistake. The clinic deliberately structured the process so that patients sign forms for every step — travel, translation, injections, and IVF packages — but not for the actual creation of embryos using donor eggs. By providing only a marketing profile and not a verifiable consent form linked to a specific donor ID and batch, the clinic creates a situation where any available donor eggs can be used without explicit patient approval.
The absence of a signed, detailed consent form for donor egg selection cannot be interpreted as accidental: it gives the clinic flexibility to substitute eggs or pool batches, while maintaining the appearance that the patient consented. This approach maximizes their financial and operational control, but it removes the patient’s ability to make an informed choice about the exact eggs used, which is a critical aspect of reproductive consent and patient safety.

In short, withholding proper donor-egg consent is a strategic procedural gap, not a clerical error.
Comparison of Medspa Clients with Hospital Patients.
Medspa package patients

Pay a flat package, often including marketing profile selection, travel, and embryo creation.

Hospitals may use whatever donor eggs are immediately available in their inventory for this stream.

Traceability and pre-transfer consent are often less rigorous, because the package is designed to maximize efficiency and revenue.

Regular hospital patients

May have full medical oversight, committee-approved donor allocation, and documented consent.

The hospital would ensure phenotype matches, donor ID traceability, and post-transfer monitoring.

More oversight increases staff time and limits flexibility, but provides full patient protection.
Medspa patients are treated differently

Marketing-driven approach → looks like patient choice, but is actually flexible for the clinic.

Allows hospital to use leftover or less “ideal” eggs without losing revenue.

Reduces labor and paperwork compared to regular patient pathway. For example, no medical or gynecological history, no consent form confirming donor allocation.

Decision to Step Away

Being required to use a donor egg is already a very difficult situation for a woman and having the same phenotype can be important to deal with the situation. Having this minimized and disregarded has left me devastated. As a result of these experiences and the emotional impact, I am unable to continue medical care at this clinic. I no longer trust the medical team to act in my best interest, and I am uncertain whether I can safely use the donor eggs or if I want to given their uncertain phenotype.
The donor phenotype I carefully selected was non-negotiable for me, and the fact that the clinic could substitute eggs without my knowledge means I cannot verify that my wishes were respected. Until proper documentation is provided, and until I feel confident in the integrity of the process, I feel that continuing treatment there is impossible.
I trusted that the clinic was acting in my best interests, but because they did not disclose the limitations of the donor profile system or the possibility of substitution, my expectations were violated. Moreover, the clinic appears to have a habit of not disclosing the limitations of treatment with other aspects of my care. They appear to rely on the patients not fully understanding how the donor system actually works. And do not clearly explain that donor profiles are informational only and that substitution is possible.
Patients are vulnerable by design. IVF patients are often:
emotionally invested;
under time pressure;
dealing with grief, fear or urgency.
Clinics know this and often streamline explanations, focusing on reassurance rather than full transparency. Not because patients are unintelligent - but because full transparency might cause patients to hesitate or walk away.

Showing a donor profile sheet:
makes a patient feel involved;
creates emotional buy-in;
encourages continuation.
Even though the donor sheet is not legally binding, it functions psychologically as consent. Clinics benefit from this without having to guarantee anything.

How this undermines autonomy, true informed consent requires:
knowing what can change;
knowing what cannot be enforced, and;
knowing what happens if preferences can't be met.
When those critical limitations aren't explained before committing, patients consent to a version of reality that does not exist. Consent relied upon what I was NOT told. Withholding material information undermines informed consent.

This underscores an important lesson: trust, transparency, and informed consent are not optional — they are essential for any fertility journey.

Below is the advertisement from the Nadezhda Hospital website. This is strictly marketing only. So even though the website promises "profiles, including education degrees, hobbies and interests, and details about their physical features (skin, hair and eye color)." In reality, you can not hold the clinic legally accountable if the eggs don't match- unless they misrepresent safety or screening. It is not the website wording itself that is the problem -- it's that the clinic used that marketing to induce consent, without clarifying the limits, which materially affect the patients ability to give fully informed consent.

Even if the donor profiles on the website are strictly marketing material, the clinic still has an obligation under informed consent standards to make clear to the patient that:

1. The profiles are informational only.

2. Phenotype, hobbies, education, or interests are not guaranteed.

3. Donor substitutions can occur without patient knowledge.

4. Any physical or personal characteristics shown cannot be legally enforced.

If this is NOT communicated to the patient before treatment, it undermines consent.

Think about it this way: the marketing creates a reasonable expectation, and if patients make irreversible medical decisions based upon that expectation, the clinic has a duty to clarify the limits. Failing to do so is exactly what regulators consider material nondisclosure.

So even if the website is "just marketing," the law expects patients to be informed before the procedure that the profiles are symbolic and non-binding.

At this stage, there is nothing that can be done. But warn other women about their practices. Nadezhda hospital nor Medspa will not provide a refund for the services nor will Nadezhda hospital agree to provide me with the infectious screening nor identify the phenotype of the donor eggs that were used to create the embryos.

Learn more about IVF and donor egg programs at Nadezhda Women’s Health Hospital in Bulgaria here.
Explore options for assisted reproduction and infertility treatment in Bulgaria on MedSpa’s official page here.
Check out all-inclusive IVF packages and fertility travel services in Bulgaria here.
Find detailed information about egg donation IVF and donor sperm IVF at Nadezhda Women’s Health Hospital here.
Learn how fertility treatment for single women, couples, and advanced maternal age patients is offered in Bulgaria here.
Discover assisted reproduction techniques like ICSI, IMSI, blastocyst transfer, and PGD in Bulgaria here.

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Donor Egg Fiasco using Medspa and Nadezhda Hospital