Recent trends in embryo disposition choices made by patients following in vitro fertilization
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ASSISTED REPRODUCTION TECHNOLOGIES
Recent trends in embryo disposition choices made by patients following in vitro fertilization Vinita M. Alexander 1
&
Joan K. Riley 1 & Emily S. Jungheim 2
Received: 27 May 2020 / Accepted: 13 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Embryo disposition . Cryopreserved embryos
Introduction In 2016, US fertility clinics performed nearly 200,000 assisted reproductive technology procedures with the intent to transfer at least one embryo [1]. In many of these procedures, excess embryos were produced and cryopreserved. Although patients initially cryopreserve their embryos in the hopes of increasing their chances for a future live birth, up to 40% of cryopreserved embryos are unused [2]. When patients choose to end
* Vinita M. Alexander [email protected] 1
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University, 4444 Forest Park Avenue, St. Louis, MO 63108, USA
2
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
cryostorage for their embryos, fertility clinics customarily ask that patients express their wishes regarding the disposition of embryos. Options include donating them to another patient or couple for reproduction, discarding them, or don
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