Does donating half of your eggs reduce your chances of success in in-vitro fertilization? A comparative study using the egg sharing model.

Abstract

Objective: Egg donation is an established infertility treatment associated with good success. However, there is a shortage of altruistic donors, who are exposed to potential risks with no direct benefit to them. In egg sharing, women who are undergoing in-vitro fertilization (IVF) donate some of their eggs, thus increasing the availability of donated eggs, without putting a third party at risk. But does this practice reduce their chances of success as opposed to keeping all their eggs? Design: A prospective cohort study, comparing the outcome of IVF in a group of patients who donated half of their eggs with a similar group who kept all their eggs. Materials/Methods: In our egg-sharing programme, IVF patients <36 years with normal basal follicle stimulating hormone (FSH) consented to donate half of their eggs if they produced >5, in return for reduced cost treatment. The outcome of 54 such cycles where patients donated half of their eggs (sharing group) were compared with the outcome of 107 women, matched for age and basal FSH, who were undergoing their first IVF cycle and kept all their eggs for their own treatment (non-sharing group). A maximum of 3 embryos were transferred. The mean age was 30.2 years for the sharing group and 30.7 for the non-sharing group. The corresponding values for basal FSH were 6.3 and 6.1 IU/L, respectively. All were not significantly different (p 0.05). Also, the proportion of the various aetiologies of infertility in both groups were not significantly different. Differences in proportions were analysed using Chi square statistics and differences in means by the unpaired t test. Results: As illustrated in the table below, there was no significant difference in the number of eggs collected from each group. Although the non-sharing group patients had significantly more embryos transferred per patient, there were no significant differences in the pregnancy or implantation rates. However, the sharing patients had less embryos remaining after transfer (and thus available for cryopreservation). Results (reported as ‘means’). Table 1Outcome/GrouplegendNS: non significant (p > 0.05). Implantation rate: number of fetal hearts on scan at 6 weeks gestation/number of embryos transferred. Surplus embryos: embryos available for patient-embryos transferred.Sharing (n = 54)Non-sharing (n = 107)Eggs collected16.214.2NSEmbryos transferred2.12.5p < 0.01Pregnancy rate33%34%NSImplantation rate13%17%NSSurplus embryos25.8p < 0.001legend NS: non significant (p > 0.05). Implantation rate: number of fetal hearts on scan at 6 weeks gestation/number of embryos transferred. Surplus embryos: embryos available for patient-embryos transferred. Open table in a new tab Conclusions: IVF patients <36 years with normal basal FSH who produce >5 eggs could participate in an egg sharing programme without reducing their chances of success in the fresh cycle. This will increase the availability of donated eggs as well as abolish the risk to third party. In addition, it will reduce the cost of treatment to the donor without affecting her chances of pregnancy. However, it will reduce the number of surplus embryos potentially available for cryopreservation.