Embryo donation: national trends and outcomes, 2000-2013

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 frozen donor embryo transfers. Retrospective cohort study of frozen donor embryo transfers using the National Assisted Reproductive Technology (ART) Surveillance System evaluating trends from 2000 to 2013 and outcomes from 2007-2013. Linear and binomial regression were used to explore trends in the use of donor embryos and corresponding rates of pregnancy and live birth during 2000-2013. We investigated recipient and cycle characteristics and outcomes of frozen donor embryo transfers performed between 2007-2013, years reflective of current practice and for which age of the donor oocyte source was collected. We report rates of cancellation, intrauterine pregnancy, miscarriage, live birth, singleton live birth, twin live birth, and delivery of full term singleton infant of normal birthweight (>37 weeks, weighing >2500 grams) among donor embryo cycles. Among all frozen transfers between 2000 and 2013 (n=391,662), the annual number of donor embryo transfers increased significantly from 332 to 1,374; however, the proportion of donor embryo transfers among all frozen transfers did not change significantly (2.3% to 2.6%). The overall donor embryo cycle cancellation rate prior to transfer between 2007 and 2013 was 7.1%. Among all donor embryo transfers between 2007 and 2013 (n=6,773), 3,193 (47.2%) resulted in pregnancy and 2,589 (38.2%) resulted in a live birth. Both overall pregnancy and live birth rates per frozen donor embryo transfer increased significantly (33.3% to 49.1% and 26.5% to 40.8%, respectively) (P