Embryo donation: national trends and outcomes, 2000 through 2013

BACKGROUND: Limited published data exist detailing outcomes of donor embryo cycles. Patients and clinicians would benefit from information specific to donor embryo cycles to inform fertility treatment options, counselling, and clinical decision-making. OBJECTIVE: We sought to quantify trends in donor embryo cycles in the United States, to characterize donor embryo recipients, and to report transfer, pregnancy, and birth outcomes of donor embryo transfers. STUDY DESIGN: This retrospective cohort study of frozen donor embryo transfers uses data from Centers for Disease Control and Prevention National ART Surveillance System to quantify trends in the use of donor embryos and corresponding rates of pregnancy and live birth from 2000 through 2013. For 2007 through 2013, years reflective of current practice, rates of cancellation, pregnancy, miscarriage, live birth, singleton and twin live birth, and delivery of a full-term singleton infant of normal birthweight (>= 37 weeks, >= 2500 g) are reported. RESULTS: Among all frozen transfers from 2000 through 2013 (n = 391,662), the annual number of donor embryo transfers increased significantly from 332-1374, however the proportion of donor embryo transfers among all frozen transfers did not change significantly (2.3-2.6%). Both overall pregnancy and live birth rates per frozen donor embryo transfer increased significantly (33.3-49.1% and 26.5-40.8%, respectively) (P < .01). Among all initiated donor embryo cycles from 2007 through 2013 (n = 7289), the overall cancellation rate prior to transfer was 7.1%. Among all transfers from 2007 through 2013 (n = 6773), 3193 (47.2%) resulted in pregnancy and 2589 (38.2%) resulted in a live birth. Among all pregnancies, 535 (16.9%) resulted in a miscarriage. Among all live births, 1929 (74.5%) delivered a singleton of which 1482 (76.8%) were full term and normal birthweight. CONCLUSION: The increasing availability of donor embryos, low chance of cancellation, and increasing likelihood of achieving live birth can inform consumers and providers who are considering assisted reproductive technology options. Collection of data surrounding donated embryo formation would allow for additional studies that can elucidate predictors of success among donor embryo transfers.