Frozen donor embryos may often go unused: study

NEW YORK (Reuters Health) - Many women who successfully have a baby using donated eggs do not try to achieve a second pregnancy with the excess embryos they've chosen to store, a study at one fertility clinic suggests.

The findings, say the researchers, suggest that more fertility treatment centers should consider offering "shared donor" programs - in which eggs from a single donor are given to two women seeking in-vitro fertilization (IVF) rather than one.

The approach means fewer eggs go to each patient, but it also means lower costs -- and, the current study suggests, potentially fewer unused embryos.

The cost of IVF varies from clinic to clinic, but in the U.S., the average cost of one IVF treatment cycle is $12,400, according to the American Society for Reproductive Medicine.

The cost is higher when a woman must use donor eggs rather than her own; compensation to donors also varies, but is typically in the neighborhood of $5,000.

Insurance plans may not pay for fertility treatment, though some U.S. states have laws that require some degree of coverage.

The new study, published in the journal Fertility and Sterility, included 829 women who underwent IVF using donor embryos at the New York University (NYU) Fertility Center between 2000 and 2004.

Overall, more than half -- 54 percent -- had a baby, or multiples, after the first attempt. Of those women, 177 -- or 40 percent -- had also elected to freeze and store any extra embryos that were not implanted during the first IVF attempt.

But by August 2009, only 21 percent of those women had returned to the clinic to try for a second pregnancy using the stored embryos, according to Dr. Jaime N. Knopman and colleagues.

The picture was different, however, for women whose initial IVF attempt failed. Of the 128 who had elected to freeze their excess embryos, 87 percent returned for a second try.

The findings, according to Knopman's team, suggest that most women who conceive using donor eggs "are satisfied after experiencing only one successful outcome."

They add that many women who give births to multiples may be especially likely to feel this way; of 81 study patients who had twins after their first try, 74 did not return to try again with their frozen embryos.

The NYU fertility center offers patients the option of using an "exclusive" or shared anonymous donor. In the second case, two women receive eggs from one donor, as long as there are at least 12 eggs available.

According to Knopman's team, the current findings suggest that exclusive-donor approaches, with their higher number of unused embryos, "may not be very efficient in terms of necessity or cost."

With the number of women who want donor eggs growing, and the number of donors being limited, "centers should consider a shared donor program," the researchers write.

Shared-donor programs, they suggest, "will maximize efficiency, reduce costs, and achieve fertility for a larger number of infertile patients."

They add that such policies "would also markedly reduce the number of unused frozen embryos."

SOURCE: Fertility and Sterility, online January 7, 2010.