SAN FRANCISCO – Achieving a pregnancy using frozen oocytes costs nearly $27,000, a survey of U.S. egg banks suggests.
Compared with using fresh oocytes from a matched donor, the frozen-egg route is "not really cost-saving as far as the patient is concerned, but it’s quicker and they don’t have to be matched, necessarily, to another person," Dr. Richard J. Paulson said at the UCLA annual in vitro fertilization and embryo transfer update 2013.
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Achieving a pregnancy using frozen oocytes costs nearly $27,000, a survey of U.S. egg banks suggests.
He and his associates surveyed all seven commercial egg banks that they could find in the United States in April 2012, six of which used vitrification as their freezing technique and one of which used slow-freeze techniques. The cost per oocyte averaged $2,225. The egg banks estimated their "efficiency" – the clinical pregnancy rate per oocyte (calculated as the number of pregnancies divided by the number of oocytes obtained, multiplied by 100) – as 10% using slow freezing or averaging 7.5% using vitrification.
"If efficiency is 7.5% per oocyte, you would need about 12 eggs to make one baby. Twelve eggs at $2,225 brings that to around $27,000 to get a pregnancy from frozen eggs," said Dr. Paulson, professor of obstetrics and gynecology and chief of the division of reproductive endocrinology and infertility at the University of Southern California in Los Angeles.
The efficiency rates are not as high as hoped for, but probably acceptable. "We’re not sure if we’re going to get to 24%. That seems optimistic to me, but even 10% is not bad if you have that kind of reproducibility," he said.
Commercial egg banks came in one of three operational models. A majority are affiliated with a single assisted reproductive technology (ART) clinic and supply oocytes only to that clinic’s patients. Two or three ART clinics may jointly create a shared commercial egg bank. Last, a few commercial egg banks ship cryopreserved oocytes all over the country and all over the world.
In the survey, the egg banks recommended using a minimum of four oocytes (in slow-freeze cryopreservation) or six to seven oocytes (in vitrification) per patient to attempt pregnancy. At the time, the banks reported having 3,130 oocytes from 294 donors in storage, and said 8,780 oocytes had been used for in vitro fertilization (IVF) to achieve 602 pregnancies (Fertil. Steril. 2013;99:827-31).
Dr. Richard Paulson
The survey’s results already are out of date because the field of egg banks is moving so quickly, Dr. Paulson said. For example, the number of pregnancies from frozen eggs probably has increased 10-fold, he said. "I’m guessing that right now there are perhaps 5,000-6,000 pregnancies in the world from egg freezing."
The egg banks in the survey had been in existence for 1-8 years.
Donor screening at all seven egg banks included psychological and medical screening, genetic counseling, estradiol/follicle-stimulating hormone (FSH) testing, antral follicle count testing, and routine CT cancer testing. Four egg banks also screened donors by anti-Müllerian hormone testing, five conducted routine fragile X carrier testing, and two performed routine karyotyping.
Dr. Paulson shared statistics from his institution’s experience with oocyte cryopreservation and embryo transfer. Ten of 18 women who were recipients of their own previously frozen eggs delivered live births (56%), as did three of four women who used frozen eggs that were not their own (75%).
This year is the 30th anniversary of the first oocyte donation for a successful pregnancy, Dr. Paulson said. The American Society for Reproductive Medicine released a guideline in 2013 saying that mature oocyte cryopreservation via vitrification should no longer be considered experimental (Fertil. Steril. 2013;99:37-43).
Advances in the field and the advantages of IVF using cryopreserved oocytes make egg banks the future for egg donations, he said.
Dr. Paulson is a speaker for Ferring Pharmaceuticals and an adviser to Cooper Surgical.
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