CT Fertility Goes Global

Update on egg donation and surrogacy choices for international patients from more restrictive countries.

Due to the restrictive laws in many countries concerning egg donation and gestational surrogacy, our egg donation program has seen a large increase in use by both international recipients and intended parents using American surrogates. In 2008, eighteen of the fifty (36%) intended parents who utilized our donor oocyte/surrogacy program resided outside the United States. So we asked … Does the more complicated travel and synchronization arrangements affect pregnancy outcomes for our international patients who use American surrogates? The answer is absolutely not.

We recently launched a retrospective study of our 2008 donor oocyte/surrogacy program at Connecticut Fertility Associates, which included 32 domestic (from the United States) and 18 international(from 8 other different countries) participants. All embryos transferred were the result of the use of either fresh or vitrified (frozen) donor oocytes from our Egg Bank. Due to either personal preference when initially selecting their donor, or subsequent need to cancel their original fresh donor due to unexpectedly low response to ovarian stimulation, 3 of the 18 international subjects (16.7%) utilized thawed donor oocytes from our vitrified oocyte bank, compared to only 2 of the 32 domestic recipients (6.2%). The primary indicator for comparison was confirmed clinical pregnancy, while the ability to cryopreserve for subsequent attempts and/or additional pregnancies was also considered.

Results
The average number of mature oocytes received by the domestic and international clients was 17.4 and 17.3 respectively. Forty three of the fifty transfers (86%) resulted in a viable clinical pregnancy. Twenty eight of thirty two (87.5%) from the domestic group and fifteen of eighteen (83.3%) from the international group achieved clinical pregnancies. There was no significant outcome difference between the two groups. All five transfers arising from the use of frozen eggs resulted in clinical pregnancies. Twenty seven domestic and fifteen international treatment cycles resulted in excess high grade embryos which were vitrified for future use.

Conclusion
The experience of our international donor oocyte/surrogacy program demonstrates that pregnancy outcomes can be just as high (over 85% per treatment cycle) for international patients as they are for Americans. Pregnancy outcome is unaffected by the additional challenges that may occur due to increased distances. Additionally,the use of banked vitrified/thawed oocytes can potentially simplify the process for international recipients and surrogates without compromising the ultimate goal of parenthood.