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Recent trends in embryo disposition choices made by patients following in vitro fertilization

  • Assisted Reproduction Technologies
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Abstract

Purpose

To assess longitudinal trends in in vitro fertilization (IVF) patients’ choices for disposing of cryopreserved embryos.

Methods

This is a retrospective cohort study of embryo disposition forms submitted between January 2000 and February 2020 at a university-based fertility clinic. Primary outcome was disposition decision. Binary and multivariable logistic regression were performed to determine odds ratios (OR) for decisions according to female age, education, race, religion, state of residence, area deprivation index based on zip code, and IVF pregnancy history. We also assessed disposition year, storage duration, and number of stored embryos.

Results

Forms were reviewed from 615 patients; 50.6% chose to discard embryos, 45.4% donated to research, and 4.1% chose reproductive donation. In the regression model, two factors were significantly associated with donation to research: female listing “no preference” or declining to list religious preference (OR 2.56, 95%CI 1.44–4.54) and live birth of multiples after IVF (OR 1.58, 95%CI 1.05–2.36). Before 2012, females younger than age 30 at storage were equally likely to choose to donate embryos to research as discard them. However, between 2013 and 2020, females younger than 30 were significantly more likely to discard than donate embryos for research (OR 2.87, 95%CI 1.13–7.28).

Conclusion

Since 2013, the majority of patients younger than 30 at storage have chosen to discard cryopreserved embryos. Before then, patients were more likely to donate embryos for research. To ensure sufficient embryos are available for research, young patients, who are most likely to have cryopreserved embryos, should be counseled about options for donation.

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Data availability

The data that support the findings of this study are available from the corresponding author, VMA, upon reasonable request.

References

  1. Sunderam S, Kissin DM, Zhang Y, Folger SG, Boulet SL, Warner L, et al. Assisted Reproductive Technology Surveillance - United States, 2016. MMWR Surveill Summ. 2019;68(4):1–23. https://doi.org/10.15585/mmwr.ss6804a1.

    Article  Google Scholar 

  2. Lyerly AD, Steinhauser K, Voils C, Namey E, Alexander C, Bankowski B, et al. Fertility patients' views about frozen embryo disposition: results of a multi-institutional U.S. survey. Fertil Steril. 2010;93(2):499–509. https://doi.org/10.1016/j.fertnstert.2008.10.015.

    Article  Google Scholar 

  3. Lanzendorf S, Ratts V, Keller S, Odem R. Disposition of cryopreserved embryos by infertility patients desiring to discontinue storage. Fertil Steril. 2010;93(2):486–9. https://doi.org/10.1016/j.fertnstert.2009.02.001.

    Article  Google Scholar 

  4. Nachtigall RD, Mac Dougall K, Harrington J, Duff J, Lee M, Becker G. How couples who have undergone in vitro fertilization decide what to do with surplus frozen embryos. Fertil Steril. 2009;92(6):2094–6. https://doi.org/10.1016/j.fertnstert.2009.06.027.

    Article  Google Scholar 

  5. Provoost V, Pennings G, De Sutter P, Van de Velde A, Dhont M. Trends in embryo disposition decisions: patients’ responses to a 15-year mailing program. Hum Reprod. 2012;27(2):506–14. https://doi.org/10.1093/humrep/der419.

    Article  CAS  Google Scholar 

  6. Hoffman DI, Zellman GL, Fair CC, Mayer JF, Zeitz JG, Gibbons WE, et al. Cryopreserved embryos in the United States and their availability for research. Fertil Steril. 2003;79(5):1063–9. https://doi.org/10.1016/S0015-0282(03)00172-9.

    Article  Google Scholar 

  7. Heitmann RJ, Hill MJ, James AN, Schimmel T, Segars JH, Csokmay JM, et al. Live births achieved via IVF are increased by improvements in air quality and laboratory environment. Reprod BioMed Online. 2015;31(3):364–71. https://doi.org/10.1016/j.rbmo.2015.04.011.

    Article  Google Scholar 

  8. Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Warner L, et al. Assisted reproductive technology surveillance - United States, 2014. MMWR Surveill Summ. 2017;66(6):1–24. https://doi.org/10.15585/mmwr.ss6606a1.

    Article  Google Scholar 

  9. Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update. 2017;23(2):139–55. https://doi.org/10.1093/humupd/dmw038.

    Article  CAS  Google Scholar 

  10. University of Wisconsin School of Medicine and Public Health. 2015 Area Deprivation Index v2.0. 2019. https://www.neighborhoodatlas.medicine.wisc.edu/ Accessed 2019 November 1.

  11. Amato P, Daar J, Francis L, Klipstein S, Ball D, Rinaudo P, et al. Ethics in embryo research: a position statement by the ASRM Ethics in Embryo Research Task Force and the ASRM Ethics Committee. Fertil Steril. 2020;113(2):270–94. https://doi.org/10.1016/j.fertnstert.2019.10.012.

    Article  Google Scholar 

  12. Zweifel JE, Rathert MA, Klock SC, Walaski HP, Pritts EA, Olive DL, et al. Comparative assessment of pre- and post-donation attitudes towards potential oocyte and embryo disposition and management among ovum donors in an oocyte donation programme. Hum Reprod. 2006;21(5):1325–7. https://doi.org/10.1093/humrep/dei468.

    Article  Google Scholar 

  13. Lyerly AD, Faden RR. Embryonic stem cells. Willingness to donate frozen embryos for stem cell research. Science. 2007;317(5834):46–7. https://doi.org/10.1126/science.1145067.

    Article  Google Scholar 

  14. Ethics Committee of American Society for Reproductive M. Informed consent and the use of gametes and embryos for research: a committee opinion. Fertil Steril. 2014;101(2):332–5. https://doi.org/10.1016/j.fertnstert.2013.11.006.

    Article  Google Scholar 

  15. Ethics Committee of American Society for Reproductive M. Donating embryos for human embryonic stem cell (hESC) research: a committee opinion. Fertil Steril. 2013;100(4):935–9. https://doi.org/10.1016/j.fertnstert.2013.08.038.

    Article  Google Scholar 

  16. Marcon AR, Murdoch B, Caulfield T. Fake news portrayals of stem cells and stem cell research. Regen Med. 2017;12(7):765–75. https://doi.org/10.2217/rme-2017-0060.

    Article  CAS  Google Scholar 

  17. Rosemann A, Luo H. Attitudes towards the donation of human embryos for stem cell research among Chinese IVF patients and students. J Bioeth Inq. 2018;15(3):441–57. https://doi.org/10.1007/s11673-018-9862-9.

    Article  Google Scholar 

  18. Burton PJ, Sanders K. Patient attitudes to donation of embryos for research in Western Australia. Med J Aust. 2004;180(11):559–61.

    Article  Google Scholar 

  19. Hug K. Motivation to donate or not donate surplus embryos for stem-cell research: literature review. Fertil Steril. 2008;89(2):263–77. https://doi.org/10.1016/j.fertnstert.2007.09.017.

    Article  Google Scholar 

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Acknowledgments

We thank Dr. Deborah J. Frank for editorial feedback on this article.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University, 4444 Forest Park Avenue, St. Louis, MO, 63108, USA

    Vinita M. Alexander & Joan K. Riley

  2. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Emily S. Jungheim

Authors
  1. Vinita M. Alexander
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  2. Joan K. Riley
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  3. Emily S. Jungheim
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Correspondence to Vinita M. Alexander.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the Washington University School of Medicine in St. Louis Institutional Review Board (IRB). This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Alexander, V.M., Riley, J.K. & Jungheim, E.S. Recent trends in embryo disposition choices made by patients following in vitro fertilization. J Assist Reprod Genet 37, 2797–2804 (2020). https://doi.org/10.1007/s10815-020-01927-y

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