In 2012, ASRM lifted the “experimental” title from the egg freezing procedure when used for medical reasons. This is due to advancements like vitrification and an improved freezing medium. Emerging data shows that pregnancy success rates with frozen donor eggs are comparable to fresh donor eggs. Combined with the added benefit of freedom to cycle at the recipient’s convenience, commercial egg banks are likely to become a popular option for obtaining donor eggs.
A fertility clinic becomes affiliated with a commercial egg bank should their physicians (fertility doctors) agree to be certified according to the commercial egg bank’s receiving and thawing procedures. In addition, the clinic must report the outcome of each frozen donor egg cycle back to the commercial egg bank.
Bruce Campbell, M.D. of the Center for Reproductive Medicine and Advanced Reproductive Technologies in Minneapolis, says that following the thawing guidelines of the egg bank is most essential. “We were contacted by two commercial banks to be a clinic in our area that would be willing to be trained by these commercial banks in their particular thawing techniques and therefore become the clinic patients would use if they wanted to secure eggs from that particular egg bank. So, if a patient at a particular infertility clinic wanted to utilize the services of a commercial egg bank, either her ‘home’ clinic would have to be associated with and trained by the commercial bank, or the patient would have to go to a fertility clinic that was affiliated with that bank,” he states.
Commerical egg banks can service just one fertility clinic, a network of fertility clinics, or can ship frozen eggs to any fertility clinic that agrees to maintain appropriate certification. These affiliations vary depending on the commercial egg bank.
Jack Crain, M.D., a fertility doctor with the Reproductive Endocrinology Associates of Charlotte (REACH) says fertility patients looking to obtain frozen donor eggs from a commercial egg bank should ask questions about success rates and costs before choosing a commercial egg bank. “Questions by prospective patients should include oocyte (egg) survival rate, fertilization rate and delivery rates. Other important items include cost, number of oocytes (eggs) provided and any guaranteed success programs,” he advises. While success rates are comparable to fresh donor egg cycles, the costs of a frozen donor egg cycle are significantly reduced. A pool of eggs can be shared by several recipients to further reduce costs, and funds lost due to a donor’s cycle being cancelled are not an issue.
Commerical egg banks screen egg donors based on medical history, psychological assessment, genetic screening, and the donor’s fertility in accordance with FDA and ASRM guidelines. Ovarian reserve testing via Follicle Stimulating Hormone (FSH) or Anti Mullerian Hormone (AMH) levels is typically performed in conjunction with Antral Follicle Count (AFC) and genetic karyotyping to ensure they meet the criteria for egg donation. Dr. Campbell and Dr. Crain agree that fertility patients should become familiar with the egg bank’s donor screening process.
The future of egg banks is still unknown, though fertility doctors believe the future of frozen egg banks looks promising. Given that vitrification is becoming the standard for egg freezing, fertility clinics will be able to turn to commercial egg banks readily and confidently.
“Time will tell if the convenience, and lower cost of frozen eggs will outweigh the presumably higher pregnancy rates and higher costs to recipients associated with receiving an entire cohort of fresh donor eggs,” states Campbell. Thus far, it seems fertility patients are receptive to the idea of commercial frozen egg banks, largely because of the convenience and lower cost.
Dr. Crain believes that because recipients typically have a greater starting number of donor eggs in a fresh cycle, fresh egg donation will continue to be a strong option. “Until the FDA rules otherwise, patients will have a choice of fresh versus vitrified oocytes,” he says.
Donor egg recipients should consult their fertility doctor to determine whether a fresh donor egg or frozen donor egg cycle is most beneficial to their IVF success.
An article published in the journal, Fertility and Sterility, estimates that with current techniques for egg freezing, frozen donor eggs are becoming widely available for donor egg in vitro fertilization (IVF) cycles through commercial egg banks across the United States.
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