Understanding Fertility Clinic Advertising and Donor Egg Traceability Nadezhda Hospital and Medspa, Sofia, Bulgaria 

What Patients Should Know Before Treatment

Purpose of This Page

This page is intended to inform patients about potential discrepancies between fertility clinic advertising and actual clinical practices, with a particular focus on donor egg traceability, patient consent, and transparency in cross-border fertility care.

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Donor Egg Traceability: A Critical Patient Safety and Consent Issue

What patients are often shown

Patients may be presented with:

• Donor profiles containing physical traits, medical history, and other characteristics;

• The impression that a specific donor has been selected and reserved for their treatment;

• A donor profile can be presented and you will select that profile;

• The donor egg profile that is shown to you is for marketing purposes ONLY, it does not guarantee availability;

• The donor egg you have been shown may be substituted and combined with the sperm without informing you of the substitution;

• The embryo with the substituted donor egg may be represented to you as if it is the marketed donor egg profile when it is not;

• They may transfer the embryo into your body allowing you to believe that it is the donor egg profile that you selected;

• The donor profile that you have been shown is not legally enforceable;

• Even though the donor sheet is not legally binding, it functions psychologically as consent. Clinics benefit from this without having to guarantee anything;

• If it is that the donor eggs are substituted they are required to inform you before combining it with the sperm but they may not because phenotype is not guaranteed in Bulgaria, therefore, they do not have to inform you. The fact that women are not aware of this may be exploited by Medspa and Nadezhda Hospital;

• You may undergo embryo transfer and never be told that the donor eggs were substituted;

• You can ask the hospital however, they may deny providing you with any information on the substituted donor eggs and show you the donor egg profile that you selected.

What may not be clearly disclosed

Patients may not be explicitly informed that:

• Donor eggs are owned, controlled, and supplied by the hospital, not the intermediary agency;

• The intermediary may not have authority over which donor eggs are ultimately used;

• Donor eggs may not be individually traceable to a specific donor profile provided to the patient;

• You may not be provided with a document outlining consent and usage to a preselected donor egg;

The 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 and witness signature.

They may 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.

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Restrictions on Transferring Donor Eggs or Embryos

What patients may expect

• The ability to transfer unused donor eggs or embryos to another clinic;

• Access to full documentation identifying the donor and egg batch.

Reported concerns

• Donor eggs or embryos cannot be transferred out of the clinic;

• Blocking transfer: 

1. Withholding mandatory traceability documents

• Most jurisdictions (including the EU) require specific documents before any lawful transfer can occur, such as:

  • Donor identification codes (not the donor’s identity, but the unique traceability code)

  • Infectious disease screening certificates

  • Chain-of-custody records

  • Consent forms tied to that specific donor material

  If the hospital does not issue these, the receiving clinic cannot legally accept the embryos/eggs, even if they belong to you.

   This is one of the most common and powerful blocking methods.

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2. Claiming “incomplete” or “non-compliant” consent

• Hospitals may assert that:

  • Consent was “broad” or “conditional”

  • Consent does not include export

  • Additional signatures or approvals are required

  Even if this is disputable, they can pause the transfer until it’s “resolved.”
  Administratively, this creates a stalemate.

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3. Asserting ownership or custodial control

• Some clinics structure contracts so that:

  • The hospital or intermediary claims custody until certain conditions are met (e.g., fees paid, internal approvals, storage compliance)

  • The embryos are framed as being “under treatment” or “not yet released”

  This allows them to say:

  “We are not refusing; we are unable to release at this time.”

  That language matters legally.

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4. Using storage or fee leverage

• They may block transfer by stating:

  • Storage fees are outstanding

  • Administrative/export fees must be paid first

  • Paperwork processing is contingent on continued storage

  This puts patients in a coercive position: pay to keep access, even if trust is broken.

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5. Delaying tactics

• Even without outright refusal, they can block transfer by:

  • Repeatedly requesting new forms

  • Saying documents are “under review”

  • Claiming regulatory audits or ministry guidance is pending

  Delays alone can make transfer practically impossible, especially across borders.

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6. Intermediary control (agency model)

• When an agency sits between you and the hospital:

  • The hospital may say the agency must initiate paperwork

  • The agency may say the hospital must authorize it

  This “ping-pong” effect blocks transfer without anyone explicitly refusing.

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The key point

• Paperwork is power.
  In reproductive medicine, whoever controls documentation controls movement.

  That’s why lack of transparency or traceability is not a minor issue—it directly affects:

  • Your legal control

  • Your bodily autonomy

  • Your ability to leave and seek care elsewhere

• Patients are not provided with sufficient documentation to establish:

  • donor identity linkage (even in anonymous systems)

  • batch or lot traceability

  • confirmation that the eggs used match the donor profile shown

Why this matters

Traceability is essential for:

• informed consent

• medical record integrity

• future health disclosures

• patient autonomy and choice

Without traceability, patients cannot independently verify what biological material was used in their treatment.

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Substitution of Donor Eggs Without Explicit Disclosure

Patient-reported concern

Patients may not be clearly told if:

• the originally presented donor eggs are unavailable;

• substitute donor eggs are used instead;

• a new donor profile has been assigned or created.

Why this is significant

Using donor eggs that differ from what a patient consented to — without explicit disclosure and renewed consent — raises serious concerns regarding:

• informed consent

• ethical standards in reproductive medicine

• patient autonomy

Even in anonymous donation systems, patients must be informed of material changes to donor selection.

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How This Relates to Advertising Claims

Marketing materials often emphasize:

• “customized care”

• donor selection

• transparency

• patient-centered treatment

When donor sourcing, substitution, or traceability limitations are not disclosed upfront, advertising may create expectations that are not supported by the actual care structure.

This can seriously impact on your ability to move any embryos that have been created from the hospital to another if you are not satisfied with the treatment.

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What Patients Should Ask Before Treatment

Patients considering donor egg IVF may wish to ask:

• Who owns and supplies the donor eggs?

• How is donor egg traceability documented?

• Can unused eggs or embryos be transferred to another clinic?

• What happens if the selected donor eggs are unavailable?

• Will I be notified and asked to re-consent if a donor change occurs?

• What written documentation will I receive confirming donor linkage?

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Why Transparency Matters

Fertility treatment involves irreversible biological decisions. Transparency about donor egg sourcing and traceability is not optional — it is fundamental to:

• ethical medical practice

• informed consent

• patient trust

Patients deserve clear, accurate information that aligns advertising, consent documents, and clinical reality.

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Final Note

This page is intended to promote patient awareness and informed decision-making. Patients are encouraged to request written clarification on donor sourcing, traceability, and consent procedures before entering treatment or making payment.

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.