FROZEN EGGS

Fresh donor eggs appear to be better for IVF than frozen

Fresh donor eggs appear to be better for IVF than frozen

Donor eggs provide the best chance of success for many women undergoing IVF. But it wasn’t clear whether using fresh or frozen donor eggs in IVF improves the chances of success, so a team from the University of Colorado and Duke University analyzed nearly 37,000 IVF cycles using donor eggs over three years.

According to the largest comparison of donor egg IVF cycles to date, using fresh donated eggs for IVF leads to slightly better birth outcomes than frozen.

Data from nearly 37,000 IVF cycles in the US between 2012 and 2015 showed that fresh eggs resulted in a slightly greater chance of a good birth outcome, which the researchers defined as a single, non-premature baby delivered at a healthy birth weight.

‘Our study found that the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference’, says lead author Dr Jennifer Eaton, of Duke Fertility Centre in North Carolina.

When the quality of fertilised eggs and the age of both mother and donor were taken into account, the team found that fresh eggs led to good birth outcomes in 24 percent of cycles compared to 22 percent of the cycles with frozen eggs.

Fresh eggs had a much higher likelihood of implantation and birth than frozen eggs, the study found. Compared to frozen eggs, fresh eggs were associated with almost 25% better chance of live birth and a 10% higher odds for good outcomes.

The rates of embryo implantation, pregnancy and live birth were all significantly higher among the women using fresh eggs compared to frozen, but fresh eggs also led to a 37 percent higher chance of multiple births, which could pose greater risk for both mothers and babies.

Donor eggs are often used for older women or women who have a decreased egg supply. This has led to an increased demand for frozen donor eggs which are a cheaper and faster option than fresh donor eggs. But it was previously unknown which type provides the best birth outcomes.

Although this study is the first to show an advantage of fresh donor eggs over frozen, the researchers say that doctors should take the other benefits of using frozen eggs into account when discussing the best option with patients.

‘Given that frozen eggs have many benefits such as ease, cost, and speed, the decision to use fresh or frozen donor eggs should be made on an individual basis after consultation with a physician’, said Dr Eaton.

In Greece, we do not have egg banks. Therefore, the fresh donor eggs are fertilised by the husband’s sperm. We then proceed to either fresh embryo transfer if the recipient is synchronised with the donor. Otherwise, we perform embryo transfer after thawing the frozen embryos in the future, once the recipient is ready. Success rates are similar in both cases.

The study was published in the journal Obstetrics and Gynaecology: https://journals.lww.com/greenjournal/Abstract/2020/03000/Prevalence_of_a_Good_Perinatal_Outcome_With.27.aspx

Ten-year storage of eggs, sperm and embryos may be extended in the UK

Ten-year storage of eggs, sperm and embryos may be extended in the UK

The period of time for which eggs, sperm and embryos can be frozen could be extended, as the UK government calls for views on the current 10-year limit.

It said women’s choices on when to have children were being restricted, despite advances in freezing technology.

Only the eggs of people whose fertility may be affected by disease can be kept for longer – up to 55 years.

Current law generally permits frozen eggs, sperm and embryos to be stored for a maximum of ten years, after which patients must choose either to attempt a pregnancy, destroy the frozen material, or transfer it overseas for fertility treatment abroad.

The regulator said the time was right to consider a “more appropriate” storage limit, so the government has now launched a consultation on the current law.

It will also consider the safety and quality of eggs, embryos and sperm stored for more than 10 years and any additional demand for storage facilities that could result.

“Although this could affect any one of us, I am particularly concerned by the impact of the current law on women’s reproductive choices,” said Caroline Dinenage, a minister in the Department of Health. “A time limit can often mean women are faced with the heart-breaking decision to destroy their frozen eggs or feel pressured to have a child before they are ready.”

A fertility charity has previously said women were being pushed to delay egg freezing later and later, because of the 10-year storage limit.

The number of women choosing to freeze their eggs has more than tripled in the last five years. There were 1,462 egg freezing cycles in 2017 compared with 410 in 2012, and four out of five of these women are freezing their eggs for non-medical reasons, data suggests.

A much smaller number are freezing eggs before having unrelated medical treatment, such as to combat cancer.

For women freezing their eggs, the viability of eggs is at its highest in a woman’s early twenties, therefore eggs frozen at this time will have the best chance of leading to a successful pregnancy.

However, under the current law, these frozen eggs would need to be either used or discarded in a woman’s early to mid-thirties, before she may be ready to become pregnant. The most common age for freezing eggs is now 38.

Sally Cheshire, who chairs the Human Fertilisation and Embryology Authority, said the regulator had heard the voices of patients and doctors.

“While any change to the 10-year storage limit would be a matter for Parliament, as it requires a change in law, we believe the time is right to consider what a more appropriate storage limit could be that recognises both changes in science and in the way women are considering their fertility,” she said.

The announcement of the consultation follows the launch of the #ExtendTheLimit campaign, begun by the Progress Educational Trust (PET).

The consultation is available until 5 May 2020.

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