Long distance/cross border egg donation: a model to have the best of both worlds

Long distance/cross border egg donation is driven largely by restrictive law, cost, and accessibility of egg donors. Current egg donation methods require that either intended parents travel to clinics where donor eggs are located, or the vitrified donor eggs must be shipped to clinics where intended parents will do IVF and ET. Using a cryo-donor egg bank, donor eggs can be shipped to receiving clinics for long distance/cross border egg donation cases. However, it is not uncommon for there to be no high quality embryos available after a donor egg warming cycle. In order to avoid this frustrating and disappointing situation, we developed a novel model for long distance/cross border egg donation, with the objective being to test whether this model can provide the benefit of remaining at home for intended parents while simultaneously guaranteeing high quality embryo creation. Retrospective study. All donors were submitted to COHS using GnRH antagonist with rFSH and GnRH agonist trigger. Cryopreservation of donor oocytes was performed using minimum volume vitrification. A total of 484 donor oocytes (54 individual donors) from the donor oocyte cryo-bank were matched to 70 recipients (22 recipient clinics) and were included in this study. The frozen sperm specimen of intended parents was delivered from remote clinics for the donor egg warming and insemination. ICSI using thawed sperm was performed after 3 hours of in vitro culture and osmotic equilibration. The fertilized eggs were subsequently cultured to day-5/day-6 and embryos were vitrified at blastocyst stage. Cryopreserved embryos were then shipped to the recipient location for warming and transfer. Tabled 1No. of recipient cycle70No. of egg warmed (mean±sd)484 (6.91±2.10)No. of egg survived / fertilized (% per egg warmed)453 (93.5) / 395 (81.6)No. of day 5 / day 6 blastocyst (% per egg warmed)144 (29.7) / 79 (16.3)No. of blastocyst vitrified (mean±sd)223 (3.18±1.48)No. of Frozen ET cycle(cumulative)88No. of Embryo Transferred (mean±sd)122 (1.38±0.49)No. of Clinical Pregnancy (cumulative) (%)44 (62.8)No. of implantation (%)53 (43.4)No. of recipient delivered25No. of live birth29No. of ongoing pregnancy18 Open table in a new tab The study demonstrates that long distance/cross border egg donation cycles can be operated efficiently by using the combination of the transport of frozen husband/partner sperm to the donor egg bank for fertilization followed by return shipment of resulting embryos to the recipient clinic. Since the embryos are created on-site at the donor egg bank, the quality and quantity of the resulting embryos can be assured before returning them to recipient clinic for subsequent embryo warming and transfer. Long distance/cross border egg donation can be operated by this model without increase in tangible and intangible costs relative to care received in one's own community. By eliminating the need to travel, this model of embryo creation allows intended parents to get a minimum number of high quality embryos guaranteed while concurrently preventing dislocation from local support networks.