Larry Hand

October 17, 2013

BOSTON — The number of donor eggs used for in vitro fertilization (IVF) increased almost 70% in a decade in the United States, and birth outcomes from those donor eggs also improved, according to a new study.

Researchers from the Centers for Disease Control and Prevention's National Assisted Reproductive Technology Surveillance System tracked more than 95% of all IVF cycles performed in the United States.

Jennifer Kawwass, MD, from Emory University in Atlanta, presented the findings here at the American Society for Reproductive Medicine 69th Annual Meeting. The results were published online in JAMA to coincide with the presentation.

Dr. Kawwass reports that her team looked at all donor oocyte cycles performed using fresh and frozen embryos from 2000 to 2010 that did not involve a third-party carrier.

 
The finding that recipient age was not independently associated with poor perinatal outcomes is both clinically reassuring and biologically intriguing.
 

After eliminating canceled cycles, they calculated annual percentages for donor oocytes using fresh or frozen embryos, cycles that involved single-embryo transfer, and cycles that resulted in good perinatal outcomes.

The researchers also calculated the mean age of donors and recipients for the years that data were available, and used linear regression analysis to evaluate trends.

They found that the annual number of donor oocyte cycles performed at 443 clinics, representing 93% of all fertility centers in the United States, increased from 10,801 in 2000 to 18,306 in 2010.

The percentage of cycles involving frozen embryos increased, as did the percentage of elective single-embryo transfers relative to multiple embryo transfers.

Table 1. Distribution of Embryo Transfers

Type Percent Confidence Interval
Frozen 26.7 25.8–27.5
Fresh 40.3 39.6–41.1
Single 0.8 0.7–1.0
Multiple 14.5 14.0–15.1

 

Good perinatal outcomes rose over the 10-year study period, and recipient age was not associated with the likelihood of a good outcome (< .001 for all trends), the researchers report.

Table 2. Good Perinatal Outcomes

Year Percent Confidence Interval
2000 18.5 17.7–19.3
2010 24.4 23.8–25.1

 

"The finding that recipient age was not independently associated with poor perinatal outcomes is both clinically reassuring and biologically intriguing," writes Evan Myers, MD, from Duke University in Durham, North Carolina, in an accompanying editorial. "Because the risk of maternal complications increases with age, one would expect an age-related association with earlier gestational age at delivery or smaller birth weight."

The results of this study show that IVF "is a successful and effective approach," William Schlaff, MD, from Jefferson Medical College in Philadelphia, told Medscape Medical News. There are several encouraging trends, he added.

The researchers found that embryo transfer from the lab at 5 days was more effective than at 3 days. "The longer they kept the embryos, the better the outcomes. That could be due to a whole variety of factors, but it could allow them to identify embryos that might be more normal," Dr. Schlaff explained.

"The real goal here is good, and ideally singleton, outcomes," he emphasized.

Dr. Kawwass, Dr. Myers, and Dr. Schlaff have disclosed no relevant financial relationships.

American Society for Reproductive Medicine (ASRM) 69th Annual Meeting: Abstract P1174. Presented October 17, 2013.

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