Cryopreserved Donor Oocytes Research Articles

Can RFID tagging of receptacles containing straws of cryopreserved donor oocytes be used to identify and track samples between different clinic sites?

Background and Aim: RFID technology has been used in IVF laboratories for over a decade for sample identification and witnessing at ambient temperatures. RFID-tagging of cryopreserved samples is not routinely used in fertility settings, although its use is established in biobanks providing automation in cryosample identification, reading RFID-tags at temperatures as low as –196°C.

P-245 Cumulative live birth rates in egg donation regarding the origin of oocytes (fresh or cryopreserved oocytes) in unsynchronized cycles

Abstract Study question Is there a difference in cumulative live birth rates between the two groups of fresh or cryopreserved donor oocytes? Summary answer In egg donation cumulative live birth rates achieved with fresh donor oocytes are similar to those with cryopreserved donor oocytes. What is known already The improvement techniques of cryopreservation of gametes and embryos with vitrification has played an important role in ART and Oocyte Donation Programs. Oocyte donation is a worldwide established method for women with premature ovarian failure, those with repeated (IVF) failure, or those who have inherited genetic abnormalities. The increasing use of Oocyte cryopreservation has improved the outcomes and the success rates. However, cryopreserved-donated oocytes have been still achieved lower live birth rates in comparison to fresh donor oocytes. Study design, size, duration This study was carried out in Assisting Nature IVF Unit from January 2015 to December 2020. 191 recipient’s cycles were examined for the cumulative live birth outcomes according to the origin of oocytes. Group A include cycles with fresh donor oocytes from the retrieval day and Group B include cycles with cryopreserved donor oocytes. Participants/materials, setting, methods 191 recipient cycles participated in the study. Group A (n = 133) received fresh donor eggs in which the formed blastocysts were cryopreserved and then were thawed for the first embryotransfer (ET). Acceptors in Group B (n = 58) received cryopreserved donor eggs and carried out a fresh embryotransfer. The rest of formed blastocysts were cryopreserved and thawed in the next ET. All acceptors transferred at most two embryos and they occurred maximum 3 embryotransfers in egg donation. Main results and the role of chance In Group A 755 fresh donor oocytes were utilized when in Group B were 269 cryopreserved oocytes. Fertilization (87% Group A, 84% Group B) and blastulation rates (70% Group A and 65% Group B) were similar between two groups. Cumulatively the live birth rate in Group A was 61% (1st ET: 51,1%, 2nd ET: 9%, 3rd ET: 0,9%). Acceptors with a failure in the first ET carried out a second ET or in the third ET with cryopreserved blastocysts. In Group B acceptors achieved 59% live birth rates (1st ET: 50%, 2nd ET: 9%). Some acceptors after the failure of the first ET carried out a second ET and delivered a healthy baby. There was not observed significant difference in live birth rate between two groups. The vitrification and warming stages in oocyte cryopreservation has been dramatically improved in recent years and therefore in our study seems to have equal live birth rates as in the fresh oocytes in egg donation program. Limitations, reasons for caution Large scale studies are required with further investigation with more equal number of studied patients between groups. Moreover, information regarding sperm quality parameters, embryos quality or endometrium should be considered. Wider implications of the findings Acceptors should be reassured that the origin of oocytes does not have impact in the likelihood of becoming pregnant. Trial registration number NONE

Fresh embryo transfer after in vitro insemination of fresh vs. cryopreserved anonymous donor oocytes: which has a better live birth rate? A Society for Assisted Reproductive Technology Clinic Outcome Reporting System analysis

To determine if transfer of fresh embryos derived from fresh or cryopreserved donor oocytes yields a higher live birth rate. Historical cohort study. Society for Assisted Reproductive Technology Clinic Outcome Reporting System database. A total of 24,663 fresh embryo transfer cycles of donor oocytes. None. The primary outcome was live births per number of embryos transferred on day 5. The secondary outcomes included number of infants per embryo transfer, surplus embryos cryopreserved, and characterization of US oocyte recipients. A total of 16,073 embryo transfers were from fresh oocytes and 8,590 were from cryopreserved oocytes. Recipient age, body mass index (BMI), gravidity, and parity were similar between the groups. Most recipients were of White non-Hispanic race (66.9%), followed by Asian (13.7%), Black non-Hispanic (9.3%), and Hispanic (7.2%). Fresh oocyte cycles were more likely to use elective single embryo transfer (42.5% vs. 37.8%) or double embryo transfer (53.2% vs. 50.4%) and resulted in more surplus embryos for cryopreservation (4.6 vs. 1.2). The live birth rate from fresh oocytes was 57.5% vs. 49.7% from cryopreserved oocytes. Negative predictors of live birth included the use of cryopreserved oocytes (odds ratio [OR] 0.731, 95% confidence interval [CI] 0.665-0.804), Black non-Hispanic race (OR 0.603, 95% CI 0.517-0.703), Asian race (OR 0.756, 95% CI 0.660-0.867), and increasing recipient BMI (OR 0.982, 95% CI 0.977-0.994) after controlling for recipient age, number of embryos transferred on day 5, and unexplained infertility diagnosis. The proportion of multifetal deliveries was greater in cycles utilizing fresh (26.4%) vs. cryopreserved (20.6%) oocytes. The live birth rate is higher with use of fresh oocytes vs. cryopreserved oocytes in fresh embryo transfer cycles. Negative live birth predictors include recipient Black non-Hispanic or Asian race and increasing BMI.

Racial and ethnic disparities among donor oocyte banks in the United States

To determine whether racial and ethnic distributions of oocyte donors contributing to US oocyte banks differ from the demographics of US women and donor oocyte recipients. Cross-sectional study. United States donor oocyte banks, US census, and fertility clinics reporting to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Oocyte donors from 12 banks, women aged 18-44 years based on the 2019 census, and US recipients of cryopreserved donor oocytes from 2012 to2015. None. Proportions of donors identifying as each racial and ethnic group. Of the 1,574 oocyte donors, 678 (43.1%) identified as white compared with 54.8% of US women and 69.1% of donor oocyte recipients. Proportions of donors identifying as Hispanic or two or more races were larger than those of US women and donor oocyte recipients (Hispanic: 24.1% vs. 20.8%, and 24.1% vs. 8.8%, respectively; two or more races: 16.1% vs. 2.3%, and 16.1% vs. 0.5%, respectively). African American donors were underrepresented compared with US women (8.9% vs. 14.0%) and oocyte recipients (8.9% vs. 10.8%). Although the proportion of Asian donors was similar to that of US women (7.7% vs. 7.1%), Asian donors were underrepresented compared with donor oocyte recipients (7.7% vs. 10.6%). Racial and ethnic distribution of oocyte donors differs significantly from the demographics of US women and cryopreserved donor oocyte recipients. These data suggest a need for targeted recruitment of African American and Asian oocyte donors.

Fair allocation of cryopreserved donor oocytes: towards an accountable process.

A growing number of people desire ART with cryopreserved donor oocytes. The allocation of these oocytes to couples and mothers to be is a 2-fold process. The first step is to select a pool of recipients. The second step is to decide who should be treated first. Prioritizing recipients is critical in settings where demand outstrips supply. So far, the issue of how to fairly allocate cryopreserved donor oocytes has been poorly addressed. Our ethical analysis aims to support clinics involved in allocation decisions by formulating criteria for recipient selection irrespective of supply (Part I) and recipient prioritization in case supply is limited (Part II). Relevant criteria for recipient selection are: a need for treatment to experience parenthood; a reasonable chance for successful treatment; the ability to safely undergo an oocyte donation pregnancy; and the ability to establish a stable and loving relationship with the child. Recipients eligible for priority include those who: have limited time left for treatment; have not yet experienced parenthood; did not undergo previous treatment with cryopreserved donor oocytes; and contributed to the supply of donor oocytes by bringing a donor to the bank. While selection criteria function as a threshold principle, we argue that the different prioritization criteria should be carefully balanced. Since specifying and balancing the allocation criteria undoubtedly raises a moral dispute, a fair and legitimate allocation process is warranted (Part III). We argue that allocation decisions should be made by a multidisciplinary committee, staffed by relevant experts with a variety of perspectives. Furthermore, the committees' reasoning behind decisions should be transparent and accessible to those affected: clinicians, donors, recipients and children born from treatment. Insight into the reasons that underpin allocation decisions allows these stakeholders to understand, review and challenge decisions, which is also known as accountability for reasonableness.

Reprint of: Comparison of concomitant outcome achieved with fresh and cryopreserved donor oocytes vitrified by the Cryotop method

Reprint of: Comparison of concomitant outcome achieved with fresh and cryopreserved donor oocytes vitrified by the Cryotop method

New national outcome data on fresh versus cryopreserved donor oocytes

BackgroundImprovements in oocyte cryopreservation techniques and establishment of cryopreserved donor oocyte banks have led to improved access to and lower cost of donor oocytes, upending the traditional practice of fresh oocyte donation. The objective of this study was to examine national trends in utilization and live birth rates with fresh versus cryopreserved donor oocytes.MethodsA retrospective analysis of 2013 through 2015 aggregate U.S. national data reported by the Society for Assisted Reproductive Technology which included 30,160 IVF cycles with either fresh or cryopreserved donor oocytes was performed.ResultsDuring the study period utilization of fresh oocyte donations rapidly declined by 32.9%, while cryopreserved oocyte donation increased by 44.4%. Fresh donor oocytes produced significantly higher live birth rates per recipient cycle start than cryopreserved donor oocytes (51.1% vs. 39.7%). Over the three-year study period fresh donor oocytes produced stable live birth rates per recipient cycle start while those with cryopreserved oocytes significantly declined year-by-year.ConclusionDespite rising popularity of cryopreserved donor oocytes, prospective patients should be counselled that fresh donor oocytes still represent standard of care due to higher live birth rates.

Prevalence of a healthy birth following in vitro fertilization with fresh versus cryopreserved donor oocytes in the united states: a 2012-2014 national study

Prevalence of a healthy birth following in vitro fertilization with fresh versus cryopreserved donor oocytes in the united states: a 2012-2014 national study

Cryopreserved donor oocytes yield significantly lower birth rates than fresh oocytes

Cryopreserved donor oocytes yield significantly lower birth rates than fresh oocytes

Banked frozen donor oocytes demonstrate high efficiency in conversion to live born infants; a collaborative multi-site experience

Previous studies have shown a <7% oocyte to live born infant rate in fresh donor cycles. The purpose of this study was to evaluate the efficiency of cryopreserved donor oocytes compared to those from fresh donor cycles.

Single blastocyst transfer in patients utilizing vitrified donor oocytes from a donor bank

Compared to fresh donor oocytes, cryopreserved donor oocytes are more convenient for a recipient since no synchronization is needed between recipient and donor cycles. We assessed the outcome and feasibility of single blastocyst transfer in patients utilizing vitrified donor oocytes from an oocyte bank.

A survey of current oocyte cryopreservation (OC) practice and utilization in the USA

OBJECTIVE: To learn about the current practice and utilization of oocyte cryopreservation (OC) among US ART programs. DESIGN: Cross-sectional survey. MATERIALS AND METHODS: A national conference on third-party reproduction in early 2013, a 1-page survey questionnaire was offered to all attendees. Descriptive statistics were compiled. RESULTS: Of the 74 ART programs with representatives attending the conference, 32 (43%) completed the survey, from 19 states with broad geographic and program size representation. 24 (75%) of these programs currently offer OC; 5 plan to do so in the next year. Over 90% stated they offer OC for elective fertility preservation and for cancer patients; 58% offer OC for donor eggs and at retrieval for IVF. The majority had no age limits for OC in cancer patients; for elective OC, 88% had no upper age limit or a limit of 40 yr or older. Most programs reported very low OC volume, with interquartile ranges of 0-10 annual retrievals with OC and 0-2 embryo transfers (ET) after prior OC. Only 3 programs had experience of bothR 25 retrievals with OC andR 10 ETafter OC. 87% of programs have onsite cryostorage for oocytes; only 12% reported that their storage consents are time-limited. Only 36% reported a pregnancy with ET after non-donor cryopreserved oocytes; 85% had a pregnancy with cryopreserved donor oocytes. The majority have contracted with an outside donor egg bank. 72% (100% of responses) stated they require STD screening before non-donor OC. 50% of programs advertise elective OC on their website. Insurance plans in mandated states do not cover OC even for cancer patients. CONCLUSION: Declared no longer experimental by ASRM in 2012, OC practice and utilization in the USA are still in their infancy despite high adoption rate. Common age limits set by programs for elective OC do not appropriately reflect oocyte biology.

Legal Implications of Commercial “Egg Banking”: Variations in State Laws Concerning the Use of Cryopreserved Donor Oocytes in the USA

Following recent improvements in oocyte cryopreservation techniques, commercial “egg banks” (CEBs) have emerged as entities offering cryopreserved donor oocytes to intended recipients, analogous to existing sperm banks. However, legal uncertainties about commercial “egg banking” result from variations in local regulations, together with the ability to ship donor oocytes anywhere in the US.

A persistent misperception: assisted reproductive technology can reverse the “aged biological clock”

Delaying motherhood should be a free choice made in full knowledge of all the consequences, but modern women have alarming misconceptions about their own reproductive systems and the effectiveness of assisted reproductive technologies. Doctors and health professionals must begin to discuss fertility preservation with their patients and make sure that young women truly understand all their options. Preventing age-related infertility is the responsibility not only of doctors and medical practitioners but also of society at large. Social, economic, and personal pressures are causing women to decide to conceive later in life, yet those who choose to delay motherhood are stigmatized as being selfish and unconcerned about starting a family. This stigma must be banished, and age-related infertility should be faced as a medical problem.

Egg freezing for age-related fertility decline: preventive medicine or a further medicalization of reproduction? Analyzing the new Israeli policy

In December 2009, the Israel National Bioethics Council (INBC) issued recommendations permitting egg freezing to prevent both disease- and age-related fertility decline. The INBC report forms the basis of Israel's new policy regarding egg freezing. This article analyzes the medical section of the INBC's recommendations, comparing it with guidelines formulated by medical regulatory bodies in Europe and the United States. Our findings suggest that the INBC's recommendations consider age-related fertility decline to be a medical problem, and hence treat the new technology favorably, as preventive medicine, which we perceive as another instance of medicalization. The technology's risks are downplayed by the INBC, unlike the positions of medical organizations in both Europe and the United States, which consider the new technology experimental. This may culminate in raising false hopes about women's possible late genetic motherhood leading to involuntary future childlessness.

Efficiency of using vitrified donor oocytes from cryopreserved oocyte bank

OBJECTIVE: Splitting a cohort of fresh donor oocytes among several recipients is an effective practice in reducing the cost of donor oocyte treatment. Compared to fresh donor oocytes, cryopreserved donor oocytes are more convenient for a recipient since no synchronization is needed between recipient and donor. We evaluated the efficiency of vitrified donor oocytes from oocyte bank.

Molecular profiling of human oocytes after vitrification strongly suggests that they are biologically comparable with freshly isolated gametes

To assess the effects of vitrification on the biomolecular profile of oocytes, we analyzed through real-time reverse transcriptase-polymerase chain reaction eight genes encoding critically important proteins for embryo development and compared this partial transcriptome with that of freshly collected gametes isolated from the same women. The comparison of the molecular profiles demonstrated that our vitrification protocol does not alter the biomolecular quality of oocytes: in fact, between the two groups we found the absence of statistically significant variations. Accordingly, this cryopreservation technique might be helpful in preserving women's fertility.

Oocyte vitrification—Women's emancipation set in stone

The techniques of vitrification of oocytes and the subsequent warming process being used today are now producing results far superior to the results that are obtained with slow-freezing techniques, and it would seem that this is the method of female fertility preservation that will be widely used in the near future. The reported success of the use of this method should stimulate a renewed debate on oocyte storage for fertility preservation without a medical indication.

Comparison of concomitant outcome achieved with fresh and cryopreserved donor oocytes vitrified by the Cryotop method

To evaluate the outcome of oocyte vitrification using the Cryotop method, observed in an egg donation program by simultaneously evaluating embryos derived from vitrified and fresh oocytes coming from the same stimulated cycle. Cohort prospective randomized study. Instituto Valenciano de Infertilidad (IVI) Valencia, Spain. Thirty oocyte donors and 30 recipients with informed consents. Vitrification by the Cryotop method. Warming 1 hour after vitrification. Microinjection of surviving MII and fresh oocytes, evaluation of fertilization, embryo development, and clinical results. Survival, fertilization, and cleavage rate. Embryo quality, pregnancy rate (PR), and implantation rate. Survival rate observed was 96.7%. There was no difference in fertilization rates (76.3% and 82.2%), day 2 cleavage (94.2% and 97.8%), day 3 cleavage (80.8% and 80.5%), and blastocyst formation (48.7% and 47.5%) for vitrified and fresh oocytes, respectively. Embryo quality on day 3 and on day 5-6 were similar for vitrification and fresh oocyte group (80.8% vs. 80.5% and 81.1% vs. 70%, respectively). A total of 23 embryo transfers were carried out in the vitrification group. Pregnancy rates, implantation rates, miscarriage rates, and ongoing PR were 65.2%, 40.8%, 20%, and 47.8%, respectively. The Cryotop method preserves the potential of vitrified oocytes to fertilize and further develop, which is similar, when evaluated simultaneously, to fresh counterparts. Excellent clinical outcome indicates the possible use of this technology for egg donation programs, as well as a high potential for establishing oocyte banking.

Oocyte donation using cryopreserved donor oocytes

Objective: The use of cryopreserved semen in donor insemination programs is now mandatory in most countries to minimize the transmission of HIV and other diseases to recipients. Previously, cryopreserved oocyte donation has not been practical due to the low efficiency of oocyte cryopreservation itself. We report here our encouraging results on oocyte donation using cryopreserved donor oocytes from our oocyte bank. The survival, fertilization, implantation, and pregnancy rates were analyzed and compared to those of sibling fresh oocytes and cryopreserved embryos obtained from the same cycles.