Embryo Donation Research Articles

Diagnosing a genetic disease in a donor-conceived child: case report and discussion of the ethical, legal, and practical issues.

We describe the unexpected challenges pediatricians may experience when children conceived with assisted reproduction are diagnosed with a rare genetic condition. A local case series triggered a dialogue between many stakeholders with varied expertise. Indeed, diagnosing a genetic disease in a child conceived by embryo, egg, or sperm donation is becoming more common now that genetic testing and in vitro fertilization (IVF) are readily accessible. However, how and whether to share that information with other stakeholders in the gamete donation process has not been fully explored, and the clinical responsibilities of the treating clinician remain ill-defined. This work centers on a patient with a confirmed diagnosis of X-linked nephrogenic diabetes insipidus. Ultimately, we found the same AVPR2 mutation in two children from two families conceived by egg donation. It led to multigenerational cascade diagnoses in the family of the shared, anonymous egg donor. First, we review current genetic testing practices in gamete donation and third-party reproduction. Then, we provide an overview of relevant genomic, ethical, legal, and psychosocial considerations for sharing relevant genomic information. Finally, and to maximize the best interests of genetic relatives, we discuss how a pediatrician can play a role in the early disclosure of relevant clinical information to all stakeholders in the gamete donation process, starting with the fertility clinic. While these clinical cases are cast in a Canadian context, we submit that its important lessons generally apply to medical systems of nearly all developed countries, broadly defined.

PSII-14 Climate and conception: Investigating the resilience of equine embryo survival to ambient temperatures in southeast Texas

Abstract Amidst the unique challenges posed by the humid and hot climate of southeast Texas, this study aimed to assess the establishment of pregnancy from transferred equine embryos, hypothesizing that an increase in ambient temperature would lead to a decrease in pregnancy establishment. To achieve this, we utilized 17 embryo donors and 46 recipient mares (3 to 9 yr of age), all anatomically and clinically normal with no history of reproductive problems. Breeding records for 49 transferred d 8, grade-1 embryos from a single private horse farm in southeast Texas, along with the reported high and low ambient temperatures on the day of transfer, were analyzed using logistic regression via PROC GLIMMIX in SAS v9.4 with fixed effects for the reported high and low ambient temperatures on the day of transfer, with a random statement for donor and sire. The pregnancy rate for all embryo transfers was 79%. Surprisingly, our results revealed that neither the reported high ambient temperatures (P = 0.16) nor reported low ambient temperatures (P = 0.19) significantly influenced the likelihood of pregnancy establishment observed at d 14 post-ovulation of transferred equine embryos. Furthermore, no statistically significant influence (P > 0.05) on pregnancy establishment was observed when embryo transfers were conducted outside of the thermal neutral zone (5°C to 20°C). Within the context of our study, these results suggest that environmental temperatures in southeast Texas do not significantly impact equine pregnancy outcomes.

Perspectives on Spare Embryos amongst IVF users: An Exploratory Study from a Selected District of the Southern Indian State of Karnataka.

Perspectives of IVF users on their spare embryos is a less explored subject in the Indian context despite the country's population and abundance of IVF clinics. We conducted a qualitative study using in-depth interviews in a selected district of the Indian state of Karnataka. Seven individuals were recruited independently of any assistance from an IVF clinic. The interviews explored participants' knowledge and perception of the spare embryos using a set of guiding questions exploring the theme of the informed consent process, views on research, preferences for embryo donation, the role of family and the dynamics of decision-making, amongst other things. The interviews were qualitatively analysed using Corbin and Strauss's grounded theory approach. Our findings reveal that the participants do not learn about the prospects of spare embryos from the very start of their IVF journeys, and they may not be informed about the various options available to decide the fate of the spare embryos. Irrespective of their views on research and moral perceptions of embryos, participants expressed a sense of responsibility and ownership towards their embryos and a general reluctance to donate them. Our findings have implications for guiding future inquiries on this subject, which can better the informed consent process and unravel the role of ownership in the ethics of spare embryos in the Indian context.

Gender differences in behaviors toward acceptance of donor egg, sperm, and embryo in Northern Thai infertile couples.

This study aimed to examine the behavior towards the acceptance of donor egg, donor sperm, and donor embryo of Northern Thai infertile couples, separated between men and women. A cross-sectional study was conducted at the CMEx Fertility Center, Chiang Mai, Thailand. The questionnaires consisted of sociodemographic questions and the acceptance of couples toward donor egg, sperm and embryo. The couples filled in the answers separately. A total of 250 infertile couples were assessed. There were no differences in the acceptance rate of donor egg, sperm and embryo between the men and the women. Male acceptance rates were 25.6%, 18.8%, and 18.8%, respectively; while female acceptance rates were 24.4%, 18.4%, and 19.2%, respectively. Most couples (over 70%) concordantly rejected the donation program. Around 10% of couples had discordant answers. The concordance accepted for couples for donor egg, sperm and embryo was only 20%, 13.2%, and 14.8%. Older people and those who had been infertile for a longer period were significantly more likely to accept donation programs. There is no difference concerning the acceptance of donor gametes and embryo among men and women. Most participants reject the utilization of donor programs, the overall acceptance rate is relatively low. This may indicate the need for more adequate information and education for the community to enhance prevention programs rather than focus on the treatment with donor gametes or embryos.

O-179 From secrecy to transparency: The journey of donor identity in reproductive medicine in Portugal

Abstract Thanks to significant medical advancements in reproductive medicine, people have more opportunities to achieve their parenthood goals. Third-party reproduction allows individuals and couples who might not otherwise be able to conceive to have the chance to build their family, thanks to the availability of donor gametes and gestational surrogacy. Gamete donation policy in Europe varies by country, raising ethical and legal concerns. In recent years, shifts from anonymity towards openness in donor legislation have occurred in several countries. Globally, in the last decade, there has been an increase in the number of families created using egg, sperm or embryo donation. The number of IVF/ICSI cycles using donor eggs or sperm in Portugal totalled 1890 in 2019 and 54 in 2020 (an unusual year due to the Covid-19 pandemic). In Portugal, the first medically assisted reproduction (MAR) law was approved in 2006, and gamete donations were anonymous. Ten years later, in 2016, Portugal’s MAR legal framework changed, and access to MAR was broadened to all women, independent of their marital status and sexual orientation. Therefore, treatment with donor sperm, oocytes, and embryos became available to recipients, including heterosexual couples, lesbian couples, and single women. In 2018, there was another change in the law and gamete donations became non-anonymous. In Portugal, identity-release donation allows the donor to remain anonymous to the intended parents during treatment (although they may have access to some non-identifying information about the donor). Nevertheless, the child can request the National Council for Medically Assisted Reproduction access to the donor’s personal information (full name) once they turn 18. Considering this legal framework, the number of previous donors who were contacted and asked whether they would maintain their donation despite the non-anonymity was residual. The identity-release framework did not seem to have affected the number of donations either. Donations are more frequent in private clinics than in the Portuguese public gamete bank, and this leads to waiting lists that can reach two years for a treatment involving oocytes or sperm donation. In this context, efforts to increase gamete donation, particularly in the National Health Service, are crucial. A study is currently being conducted in Portugal to pinpoint the main reasons why people do not consider being gamete donors. Preliminary results in a sample comprising 297 participants (82.2% females), with a mean age of 25.43 (SD = 7.88) years old and a mean of 14.09 (SD = 2.06) years of education, revealed that 73 (24.6%) stated that they would not consider being a donor because of the non-anonymity and 39 (13.2%) indicated that they would not consider becoming a donor due to concerns about being contacted in the future and requested responsibilities. These results may contribute to informing future initiatives aiming at promoting awareness on the topic of gamete donation. Another relevant topic is secrecy, which refers to parents not disclosing information to their offspring or their social group about donated gametes’ conception. Disclosing is recommended as an ongoing process, preferably when the child is young. This disclosure process may benefit from counselling or other support resources (e.g., children’s books, patients’ associations).

P-712 A national survey of women’s perspectives and experiences of pursuing donor eggs

Abstract Study question What are the experiences of women who consider a donor egg, and the outcomes of those who receive donor eggs for conception? Summary answer Of 255 respondents, 59 women (23.1%) were formally placed on a donor egg waitlist, despite 80.6% respondents considering donor eggs with an IVF clinic (166/206). What is known already There is a shortage of donor eggs worldwide. Oocyte donation is a treatment option that is increasingly used for infertile women, as seen through the percentage of patients undergoing IVF who are over 40 years. Previous international studies report oocyte donation recipients to be predominantly aged 34-40 years, white, nulliparous, well-educated, married and financially secure. Although there are records in Australia for the number of donor and recipient cycles undertaken, there is no published data on the number of patients considering a donor oocyte, or on oocyte donor waitlists. In Australia egg donation is altruistic, non-commercial and not anonymous. Study design, size, duration A 52-point online survey was distributed via social media to women in Australia who had ever considered or pursued donor eggs, or come to the end of their own IVF treatment. The survey was sent to all clinical members of the Fertility Society of Australia and New Zealand (FSANZ) and available on the Victorian Assisted Reproductive Technology Authority (VARTA) website. The survey was open from 1 February to 30 April 2023. Hospital ethics approved. Participants/materials, setting, methods A cross-sectional, anonymous, online survey of women in Australia who were potential egg donor recipients. Survey questions included demographics, potential donor egg recipient preferences, IVF clinic experiences, barriers, any impact of the COVID-19 pandemic, attitudes around the reimbursement for donor eggs, and fertility costs already incurred. Responses were collected via the Qualtrics XM platform. Statistical analysis for quantitative data was analysed using Microsoft 365 Excel. Qualitative coding performed on the commentary in free text fields. Main results and the role of chance This study identified a large gap between those who considered a donor egg (80.6%), pursue a donor egg on an IVF clinic waitlist (23.1%), and those who actually received a donor egg. Of the 59/255 women who were placed on an oocyte donor waitlist at an IVF clinic in Australia, less than a quarter (23.1%) received a donor egg (13/58), with a pregnancy and live birth rate of 76.9% and 61.5%, respectively. Thus, of those that were on an Australian waitlist, one quarter received donor eggs, with over half of these recipients having a live birth. ‘Women preferred donor eggs from Australia than overseas, preferred an unknown donor from an IVF clinic program, and wished to know source information for themselves and children in the future. Attitudes towards financial reimbursement were generally positive towards compensation. Barriers to pursuing donor eggs included grief of loss of own fertility, cost, availability and time. When on an Australian donor egg list, many respondents still looked at other sources of donor eggs in Australia and overseas. Reasons women came off an Australian donor egg waitlist included receiving donor eggs and donor embryos elsewhere, including from overseas, as well as advancing age and expense. Limitations, reasons for caution Risk of respondent selection bias of those who chose to response to a public survey, with incomplete data for some respondents. Given survey in English, may have underrepresentation of some cultural groups and sampling a limited range of women from diverse social, economic and religious settings. Wider implications of the findings In this first paper of potential egg recipients’ preferences in the Asia-Pacific region, we have identified a gap where demand for donor eggs exceeds local supply. A majority of potential recipients would support financial reimbursement for eggs already cryopreserved by women initially freezing for own elective purposes. Trial registration number not applicable

P-198 Time to maximum blastocyst expansion (tmBE) may represent a novel metric for assessing embryo competence

Abstract Study question Can the time to achieve maximum blastocyst expansion (tmBE) and the frequency of spontaneous collapses serve as useful indicators of embryo competence? Summary answer Compared to the frequency of spontaneous collapses, tmBE was a better indicator of embryo competence, potentially serving as a valuable metric for embryo selection. What is known already Identifying the most viable blastocyst for transfer is essential for success in assisted reproduction. In scenarios with good prognosis, such as oocyte donation, blastocyst selection may require a more nuanced approach, given the high number of available good quality embryos. Exploring indicators of embryo competence beyond traditional morphology-based criteria may be beneficial, however an in-depth understanding is still lacking. Blastocyst expansion and contraction dynamics have been suggested to play a role in developmental and chromosomal fitness. However, their predictive value has not been investigated across a wide range of patient populations. Study design, size, duration This is a single-center retrospective study of 287 blastocysts transferred in autologous (n = 88) and heterologous (n = 199) cycles, performed between September 2019 and September 2022. Only fresh single embryo transfers were considered. We compared blastocysts across two groups: advanced maternal age (AMA) patients (>35 years old, n = 88) and oocyte donors (<35 years old, n = 199). We evaluated well-established indicators of embryo quality, as well as novel metrics, including tmBE and the frequency of spontaneous collapses. Participants/materials, setting, methods Conventional indicators of embryo quality included blastocyst grade and morphokinetic timings (tPNf, t2, t3, t4, t5, t8, tSB and tB). tMBE was defined as the maximum time (hpi) required for the blastocyst to reach its largest diameter, extending beyond tB. Blastocyst contractions were measured as a decrease and subsequent recovery of the blastocoel area over time. ImageJ was employed for size measurements. p<0.05 was considered statistically significant after Two-tailed Student’s t-test or Chi-square test. Main results and the role of chance We observed a significant difference in live birth rates between oocyte donors and AMA patients (40% vs 18%, p=0.0004). Nevertheless, there were no differences across blastocyst expansion scores between oocyte donors and AMA patients (5= 58% vs 65%; 4= 38% vs 30% and 3= 4% vs 5%, p > 0.05), nor in their morphology score (Excellent= 57% vs 61%; Good= 24% vs 18%; Average= 15% vs 16% and Poor= 4% vs 5%). In terms of morphokinetics, when comparing oocyte donor and AMA embryos, the only significant difference was observed at tPNF (22.0±2.4 vs 22.6±2.3; p= 0.04). No differences were found at t2, t3, t4, t5, t8, tSB and tB. Additionally, the frequency of spontaneous collapses showed no significant differences between the oocyte donor and AMA group (1.4±1.2 vs 1.5±1.0, p=0.66). However, blastocysts from oocyte donors reached tmBE significantly faster than AMA embryos (115.0±4.8 vs 117.2±3.4; p = 0.0003). When these variables were further correlated to clinical outcomes, the frequency of spontaneous collapses did not appear to influence live birth in either group. Notably, however, tmBE was significantly shorter for embryos resulting in a live birth, across both the oocyte donor (113.5 vs 115.4, p = 0.04) and AMA group (115.6 vs 117.6, p = 0.04). Limitations, reasons for caution This is a single center retrospective study with a relatively small sample size, especially in the AMA group. Caution should be made when generalizing results to other patient populations, as confounding were not taken into consideration. No data on the chromosomal status of embryos was available. Wider implications of the findings Our results suggest that tMBE may serve as a reliable indicator of embryo potential, allowing a more nuanced embryo selection, particularly in cases with a high number of good quality embryos. This study opens avenues for further research into novel metrics for assessing embryo competence Trial registration number not applicable

Bioethical assessment of embryo donation for research

Background: The present study aims to assess, from the bioethical tool, the use of embryos for scientific research and its impact on society. The research question is posed: "What bioethical aspects are related to the donation of excess embryos from cryopreservation laboratories?". The secondary objectives include determining the level of knowledge of the population about assisted reproduction techniques, identifying knowledge about the possible destinations of cryopreserved embryos and evaluating the positioning capacity of the population regarding ethical and moral issues. Methods: Observational study of a statistical nature through a questionnaire with relevant questions on the subject of bioethics in the investigation of surplus embryos from cryopreservation. The study population was composed of people of different sex and age, who are interested in gynecology issues. Results: The survey reveals that 55.8% knew about assisted fertilization techniques, 80.8% knew what IVF was, 69.2% were unaware of related laws, 84.6% understood informed consent in cryopreservation , 46% would not sign a long-term consent, 80.4% knew about cryopreservation, 82.7% support embryo freezing, 72.5% support embryo research, and there are divided opinions about its status : 60.8% cells, 51.9% human beings. Conclusion: The survey reveals that the participants have a general knowledge about assisted fertilization techniques and support the cryopreservation of embryos for research. However, there is a lack of knowledge about the laws that govern these techniques. Opinions are also divided on the nature and status of the frozen embryos. These results are relevant for the ethical debate and the regulation of practices related to embryos.

Gamete and embryo donation guidance

This document provides the latest recommendations for the evaluation of potential sperm, oocyte, and embryo donors, as well as their recipients, incorporating recent information about optimal screening and testing for sexually transmitted infections, genetic diseases, and psychological assessments. This revised document incorporates recent information from the US Centers for Disease Control and Prevention, the US Food and Drug Administration, and the American Association of Tissue Banks, with which all programs offering gamete and embryo donation services must be thoroughly familiar, and replaces the document titled "Recommendations for gamete and embryo donation: a committee opinion," last published in2013.

Racial disparities in the outcomes of euploid single frozen-thawed embryo transfer cycles – analysis of the Clinical Outcome Reporting System of the Society for Assisted Reproductive Technology 2016–2018 data

ObjectiveTo evaluate if in pregnancies conceived with the transfer of single genetically tested embryos, maternal race and ethnicity relate to pregnancy outcome. DesignRetrospective cohort. SubjectsAutologous frozen -thaw embryo transfer (FET) cycles with transfer of single genetically tested embryo in SART-CORS for years 2016-2018; cycles associated with diagnoses of recurrent pregnancy loss, gestational carrier, donor egg and donor embryo were excluded. ExposureInformation on race and ethnicity linked with in vitro fertilization and FET cycles available in the SART-CORS. Main Outcome MeasuresMultivariable analyses utilizing generalized estimating equation examined the relationship between categories of race and ethnicity with the following outcomes: Pregnancy (+βhCG following FET), clinical pregnancy, pregnancy loss (early [at gestation <13 weeks] and late [loss between ≥13 and <20 weeks]), preterm (<37 weeks), term (≥37 weeks) and live birth. Covariates adjusted for included age, BMI, AMH, infertility diagnosis and smoking history. Results79,416 FET cycles met the eligibility criteria. Information on race and ethnicity was specified for 50,820 (64.0%) and was not known in 28, 723 (36%) of the cycles . The population was predominantly non-Hispanic White (NHW, 44%). Non-Hispanic Black [NHB] comprised 2.7%, Asian 12.3%, Hispanic 3.4%, American Indian, Pacific Islander, Hawaiian and Alaskan [AI_AL_PI_H] 0.2%. Nearly 1.0 % self-identified with more than one race. On multivariable analyses, pregnancies in NHB and in Hispanic women (compared to NHWs) were significantly more likely to result in in preterm birth (p<0.001). Compared to NHW women, the likelihood of live birth was significantly lower in NHBs (p<0.01), Asian (p=0.04), Hispanic (<0.01) and AI_AL_PI_H women (p<0.01). . The likelihood for delivery by Cesarean was also disproportionately higher in the NHB (p=0.047), Hispanic (p=0.007) and in women identifying with more than one race (0.023)compared to NHWs . ConclusionRacial and ethnic differentials are apparent in the outcomes of FET conceived pregnancies resulting from the transfer of single genetically tested embryos.

Embryo Donation Law in Iran and Some Challenges in Determining the Rights of Donated Children: A Review

Islamic Republic of Iran has provided a legal framework for embryo transfer so that fertility becomes possible with third party intervention. The use of this method of fertility as well as its effects and rules are subject to cultural, social and religious factors. The brief nature of the embryo donation law indicates the lack of adequate measures for the child’s future. The present study aimed to review the embryo donation law in Iran and some challenges in determining the rights of the child. This study employed a library, descriptive and analytical method and is based on Shia jurisprudence and law books. By using the keywords of “Donation, Alimony, Custody, and Inheritance”, various aspects of the embryo donation law have been investigated. Article 3 of the Embryo Donation Law considers the duties and responsibilities of the couples who donate the embryo and the born child in terms of maintenance, alimony and being mahram[1], similar to the duties and responsibilities of children and parents. However, the important issues of lineage and inheritance are not considered. Neither it elaborates compliance with the principle of confidentiality and the non-identification of the genetic parents, the coercive guardianship of the father, and the prohibition of marriage (being mahram). There is neither enough clarity about the method of evaluating the recipient couple’s moral competence, the limit of the number of gamete donations, alimony, or custody. It is necessary to explain the kinship and genetic inheritance, amend birth certificate registration law, specify the rejection of anonymity to prevent the phenomenon of mixing lineage based on Shia jurisprudence, or to add new materials to this law.

A Child's Right to Identity in the Context of Embryo Donation: Part 1

This article investigates the extent to which the South African Legislature and the international community recognise the right to identity of a child born through embryo donation. A distinction is drawn between embryo donation, gamete donation and surrogacy. Thereafter, the article discusses the multiple aspects which the right to identity comprises, namely: personal, biological, family and siblingship identity. An assessment is made of how these various aspects are impacted by national and cross-border embryo donation arrangements. The Children's Act 38 of 2005, the Constitution of the Republic of South Africa, 1996, the National Health Act 61 of 2003 and the Regulations Relating to Artificial Fertilisation of Persons, in addition to the Convention on the Rights of the Child (CRC) and the African Charter on the Rights and Welfare of the Child (ACRWC) are critically examined to the extent that may be applicable to children born through embryo donation. The article concludes that neither the South African legislative framework, nor the CRC or the ACRWC explicitly upholds the child's right to identity

A Child's Right to Identity in the Context of Embryo Donation: Lessons from Australia and New Zealand, Part 2

In part 1 of this article, the current level of protection for the right to identity both at the national and international levels were considered in the case of embryo donation. It was concluded that at a national level the NHA, its accompanying regulations and the Children’s Act fail to protect this right. The constitutional provisions on children’s rights are further unhelpful in providing the requisite level of protection. At an international level it was further found that neither the CRC or the ACRWC explicitly uphold the child’s right to identity in the case of embryo donation. In an attempt to address this defect, this article draws comparisons on the legal protection provided for the right to identity of children born through embryo donation in Australia and New Zealand. A number of lessons can be drawn from this comparative analysis. At a national level, the article submits that the birth certificate should indicate the child’s true origins and in addition to a register which holds the particulars of the child’s donor parents, a separate donor sibling register is also suggested. Legislative amendments are also suggested to Parliament. At an international level, the following recommendations are made: a new UN Convention which is centred around Assisted Reproductive Technology, a General Comment drafted by the Convention on the Rights of the Child to cover specific issues and interests of children, ratification of a Convention by the Hague Conference, and an investigation into the concerns raised by international embryo donation to be carried out by the International Social Service Network. Further, the article concludes that an African based instrument would not be as effective as a UN proposed solution given the cultural and religious concerns in traditional African societies.

Too many embryos: a critical perspective on a global challenge.

Over the past decade, significant endeavors have been directed toward establishing an optimal oocyte number to maximize the chances for successful in vitro fertilization outcomes. The effectiveness of assisted reproductive technologies has greatly improved, and more good-quality embryos are being created in each cycle. However, many of these embryos remain unused. Notably, in Europe, approximately one-third of couples did not use their surplus cryopreserved embryos. Surplus embryos pose a challenge for patients and clinics. Embryo disposal practices are not the same all over the continent, with embryo donation and embryo discharge not allowed in several countries. In this scenario, limiting the number of surplus embryos by reducing the number of inseminated oocytes, according to couple clinical history, could be a strategy.

One size does not fit all: the personal nature of completed embryo donation.

To assess factors associated with embryo donation among individuals interested in donation in the United States. An invitation to complete the 123-item survey was emailed from June to September 2022 to patients at a private practice fertility clinic with interest in donation at the time of IVF. Survey questions included disposition decision, attitudes about embryo status and genetic relatedness, donation disclosure, ideal donation arrangement, and decision satisfaction. Three hundred thirty-seven completed the survey. Two hundred thirty donated to another person(s), 75 discarded embryos, 25 remained undecided, and disposition was unknown for 7 respondents. There were no demographic differences between groups based on final disposition or use of donor gametes. Few gamete recipients were interested in donation due to biological attachment to embryos. Final embryo disposition was associated with religious factors, not wanting to waste embryos, and storage fee concerns. Final disposition was also significantly associated with concern about donor-conceived children's (DCP) welfare, being denied the ability to complete donation, personal IVF outcomes, financial or legal issues, future contact with DCP, cognitive appraisal of disposition, beliefs about embryos, someone else raising their genetic child, anonymity, and beliefs about DCP not knowing genetic relationships (p < .001). Donation to others was associated with less regret and greater satisfaction with the emotional/medical aspects of donation and counseling compared to those who discarded embryos (p < .001). The decision to donate embryos to another person(s) is complex. Counseling that considers individual circumstances, values, and evolving dynamics may facilitate informed decision-making for those navigating infertility treatment, family building, and embryo disposition.

A systematic review of assisted and third-party reproduction guidelines regarding management and care of donors

BackgroundGamete and embryo donors face complex challenges affecting their health and quality of life. Healthcare providers need access to well-structured, evidence-based, and needs-based guidance to care for gamete and embryo donors. Therefore, this systematic review aimed to synthesize current assisted and third-party reproduction guidelines regarding management and care of donors.MethodsThe databases of ISI, PubMed, Scopus, and websites of organizations related to the assisted reproduction were searched using the keywords of “third party reproduction”, “gamete donation”, “embryo donation”, “guidelines”, “committee opinion”, and “best practice”, without time limit up to July 2023. All the clinical or ethical guidelines and best practice statements regarding management and care for gamete and embryo donors written in the English language were included in the study. Quality assessment was carried using AGREE II tool. Included documents were reviewed and extracted data were narratively synthesized.ResultsIn this systematic review 14 related documents were reviewed of which eight were guidelines, three were practice codes and three were committee opinions. Five documents were developed in the United States, three in Canada, two in the United Kingdom, one in Australia, and one in Australia and New Zealand. Also, two guidelines developed by the European Society of Human Reproduction and Embryology were found. Management and care provided for donors were classified into four categories including screening, counseling, information provision, and ethical considerations.ConclusionWhile the current guidelines include some recommendations regarding the management and care of gamete/embryo donors in screening, counseling, information provision, and ethical considerations, nevertheless some shortcomings need to be addressed including donors’ psychosocial needs, long-term effects of donation, donors’ follow-up cares, and legal and human rights aspects of donation. Therefore, it is needed to conduct robust and well-designed research studies to fill the knowledge gap about gamete and embryo donors’ needs, to inform current practices by developing evidence-based guidelines.

In vitro fertilization and perinatal outcomes of patients with advanced maternal age after single frozen euploid embryo transfer: a propensity score-matched analysis of autologous and donor cycles

ObjectiveTo evaluate in vitro fertilization (IVF) and perinatal outcomes of donor egg and autologous cycles in advanced reproductive-aged patients after undergoing single, frozen euploid embryo transfer (SET/FET). DesignA retrospective, multicenter cohort study. SettingUniversity-affiliated and private IVF centers. Patient(s)Patients between 39-46 years old undergoing IVF with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A) using whole-chromosome sequencing with donor (n=278) or autologous (n=278) oocytes between October 2017 and October 2021. Intervention(s)SET/FET with donor or autologous euploid embryo Main outcome measure(s)The live birth rate after the first embryo transfer, calculated per embryo transfer. Secondary outcomes included implantation rate, ectopic pregnancy rate, miscarriage rate, and gestational age and birthweight at the time of delivery. Result(s)Patients using donor or autologous oocytes had a similar likelihood of implantation57.91% (51.87-63.78) versus 57.19% (51.15-63.09), p=0.93 and live birth rate 41.01% (95% CI:35.17-47.04) versus 42.45% (95% CI:36.56-48.49), p=0.86. Furthermore, there were no significant differences in ectopic pregnancy rate [0.72% (0.09-2.57) versus 0.36% (0.01-1.99), p=1] or miscarriage rate [16.19% (12.06-21.05) versus 14.39% (95% CI:10.48-19.08), p=0.98], gestational age [38.50 weeks (38.08-38.92) versus 39.16 weeks (38.25-40.07), p=0.19], or birthweight of infants [2982.25 kg (2606.69-3357.81) versus 3128.24 kg (2962.30-3294.17), p=0.95]. The univariate analysis showed no association of advanced maternal age on the live birth rate [risk relative (RR) 1.03 (IC95%: 0.84-1.25); p=0.79]. Multivariate analysis using putative confounders for embryo competency found no associations with live birth rate [adjusted risk relative (aRR) 1.22 (IC95%: 0.75-1.98); p=0.42] Conclusion(s)Patients with euploid blastocysts derived from donor or autologous oocytes did not reveal statistically significant differences in live birth rate, implantation rate, ectopic pregnancy rate, miscarriage rate, duration of gestation, or infant birthweight. These findings suggest that age-related reproductive decline and/or poor IVF outcomes associated with advanced reproductive-aged women undergoing IVF are heavily driven by embryonic aneuploidy.

Post-cooling semen processing and sperm re-suspension as an alternative method to circumvent poor semen cooling in stallions.

Artificial insemination with cooled-shipped semen is the primary method used in the equine breeding industry; yet, sperm quality and fertility can be suboptimal for some stallions when standard techniques are used. Therefore, there is a critical need to develop alternative approaches for these stallions. To assess sperm quality parameters and fertility of cooled-stored stallion semen processed by SpermFilter® or centrifugation and resuspended in three extenders. Controlled and field study. In Experiment 1, semen was collected from 21 stallions classified as having good ('Good-coolers', n = 8) or poor ('Bad-coolers', n = 13) semen cooling. The semen was extended at 30 million spermatozoa/mL in a skimmed milk-based (SM) diluent, and refrigerated for 24 h. Then, the cooled-stored semen was processed through SpermFilter® or centrifugation, and the resulting sperm pellets were resuspended in SM, SM containing pentoxifylline (SM-P), or an egg yolk-based (EY) extender. Unprocessed cooled-stored semen served as control. Sperm motility parameters, plasma membrane integrity (PMI), and mitochondrial membrane potential (HMMP) were assessed in cooled-semen pre- and post-processing. Experiment 2, cooled semen from 9 stallions classified as Bad-coolers was used to inseminate 18 embryo donor mares at 66 cycles (Unprocessed, n = 22; SpermFilter®/SM-P, n = 16; or SpermFilter®/EY, n = 28). Data were analysed with a mixed model and Tukey's as posthoc, and logistic regression. Processed semen resuspended in EY had superior sperm motility compared to unprocessed, SM and SM-P (p < 0.0001). Semen processed by SpermFilter® resuspended in SM-P was similar to EY (p > 0.05). Pellet resuspension with EY and SM-P improved the HMMP of Bad-cooler stallions (p = 0.0010). Semen processed by SpermFilter® had superior PMI to centrifuged semen (p < 0.0001). Mares inseminated with SpermFilter®/SM-P (50%, 8/16) or SpermFilter®/-EY (68%, 9/28) had higher pregnancy rates than mares bred with unprocessed semen (14%, 3/22) (p < 0.001). Low number of mares in the fertility trial. Sperm quality and fertility of Bad-cooler stallions can be enhanced by SpermFilter® and pellet resuspension with either EY or SM-P.

Clinical and experimental substantiation of the use of reduced concentrations of FSH during superovulation in highly productive cows

The purpose of the studies was to substantiate the use of reduced concentrations of follicle-stimulating hormone to induce superovulation in highly productive cows and heifers. The research was carried out in one of the farms in the Leningrad region. After analyzing breeding cards and based on ultrasound visualization of the reproductive organs, promising animal embryo donors were selected - cows after the first calving and heifers that had reached physiological maturity, Holstein breed. According to the principle of analogues, groups of experimental animals Ⅰ and Ⅱ were formed, which included cows, and groups Ⅲ and Ⅳ, which included heifers, eight and six animals each, respectively. To induce multiple ovulation, hormonal treatment regimens were used, presented in Table 1. Hormonal treatment regimens were compiled in accordance with methodological recommendations on the procedure and conditions for applying the method of cattle embryo transplantation, as well as in accordance with the results of previously conducted studies and analysis of literary sources. As a result of the studies, it was established that all experimental animals responded equally to the hormonal regimen recommended by the manufacturer of exogenous gonadotropins and the experimental regimen, with a reduced concentration of the latter. It was revealed that there were no significant differences in the number of corpora lutea in the groups of cows and heifers when using a standard scheme for stimulating polyovulation and with a reduced content of follicle-stimulating hormone. There was also no difference between the experimental groups of cows and heifers in the number of embryos obtained. Analyzing the data obtained, we can conclude that it is advisable to use reduced concentrations of pituitary gonadotropins to stimulate multiple ovulation in highly productive cows and heifers.

Awareness and acceptability of embryo adoption among African women with fertility challenges in Umuahia, South East Nigeria

Objective: In African culture, a large premium is attached to procreation. An African woman who has not given birth to a child lacks fulfillment and marital security. Embryo adoption though an uncommon procedure is currently becoming an option for infertile African women. Methods: A study questionnaire was randomly administered to 220 infertile women at the fertility clinic. Data collated was analyzed using the EPI info version. Results: Most of the women were married (85.7%) and the majority were Pentecostals (71%). The most common source of awareness was social media (40.8%) and friends (34.7%). Most respondents were aware of embryo adoption (82.8%). All respondents most importantly, understand embryo adoption to mean fusion of male and female gametes (100%). For the majority of the respondents, their culture (94.4%) and religion (92.5%) do not prohibit embryo adoption. Conclusion: This study demonstrates that embryo adoption is widely accepted as a treatment for infertility among women in Umuahia, South-East Nigeria; a typical African society. Religion and culture in Africa are not barriers to the utilization of embryo adoption in Africa.