Erez Baron Families Through Surrogacy October 2017

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Myrtle Phyllis Norman
5 years ago
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1 IVF Choices: A Patient s Perspective Erez Baron Families Through Surrogacy October 2017

2 2014 My family through surrogacy Meet Roy, and our twin girls - Daphna and Danielle Born in Portland, in

This is where my family got started Nearly 30 years building families patients from 40 countries team of +125 In the top 5 US clinics for the number of surrogacy and surrogacy + donor egg

3 This is where my family got started Nearly 30 years building families patients from 40 countries team of +125 In the top 5 US clinics for the number of surrogacy and surrogacy + donor egg IVF cycles Consistently high live birth rates top 1-3% of all US clinics in every reported category In-house egg donor program Specialist in surrogacy IVF In-house genetics team and laboratory

4 Choosing a clinic What is important? What to look into? Sometimes gimmicks are just gimmicks

US IVF Clinics Report Their Results www.cdc.gov/art www.sart.org www.

com Two public sources for data on US IVF clinics same dataset but presented

comparisons All US clinics required to report to the CDC only SART members (ca.

1 ½ - 2 year lag on data to allow reporting of live birth rates SART database

5 US IVF Clinics Report Their Results Two public sources for data on US IVF clinics same dataset but presented slightly differently Some sites available to help users make some indicative comparisons All US clinics required to report to the CDC only SART members (ca. 95% of US clinics) report to SART A ca. 1 ½ - 2 year lag on data to allow reporting of live birth rates SART database allows users to filter (to see for example surrogacy only and donor egg + surrogacy cycles; cycles with genetic screening) Live Birth Rate per Transfer and Number of Embryos per Transfer

6 How does the clinic screens the egg donors? How thorough screening? Genetic Screening AND Family Evaluation Ultra Sound, Follicles, AMH etc. Tests are done BEFORE or AFTER the match? Anonymous vs. Known donors

Experience with the Procedure You Need Matters +450 US clinics - 93% do donor egg IVF and 87% do surrogacy IVF However not every clinic is as experienced Cycle Type (Recipient + Egg Origin) Transfers

7 Experience with the Procedure You Need Matters +450 US clinics - 93% do donor egg IVF and 87% do surrogacy IVF However not every clinic is as experienced Cycle Type (Recipient + Egg Origin) Transfers Share Surrogacy IVF Donor Egg IVF International patients Top 5 Clinics (1%) Patient + Patient Egg 118, % 14% Patient + Donor Egg 16, % 16% Surrogate + Patient Egg 2, % 20% Surrogate + Donor Egg 2, % 25% Based on 2014 CDC and SART reported data. Embryo biopsy PGS / PGD; genetics

8 Day 1 ICS I IVF Process is the same. Focus on maximizing success Optimising Egg Quality and Number 60% 8 Day 5 (Blast) Embryology Optimising Laboratory Egg Quality PGS Selecting Normal Embryos 39% Optimising the Transfer and Pregnancy

Chromosomally Normal Embryo Rate and Impact of CCS Egg Donor <35 35-37 38-40 41-42 Normal Embryo Rate* 61% 51% 43% 30% 18% National Ave Success Rate** 40% 45% 40% 35% 30% ORM

9 Chromosomally Normal Embryo Rate and Impact of CCS Egg Donor < Normal Embryo Rate* 61% 51% 43% 30% 18% National Ave Success Rate** 40% 45% 40% 35% 30% ORM CCS-tested Success Rates 75% 64% 73% 68% 63% * Combined data from Reprogenetics and Genesis Genetics up to March ,236 embryos tested ** 2015 data as reported on the CDC website

10 2 method of genetic testing do both! Recessive Carrier Gene Screening Genetic History Evaluation Pre- Embryo Creation Screening for recessive genetic disease genes that could result in a unhealthy baby if both egg and sperm providers are carriers Assessment of the genetic family history for each provider of each egg and sperm to identify any areas that merit particular attention Post- Embryo Creation Pre-implantation Genetic Screening (PGS) Testing embryos to determine normality - the correct number of chromosomes to develop into a healthy pregnancy and baby Pre-implantation Genetic Diagnosis (PGD) Testing embryos to determine whether a patient-specific genetic disorder is present

11 Not all clinics are the same. What to look for? Proven success rates and experience in the type of journey YOU need. Egg donors and surrogates screening standards Genetic testing - pre and post embryo creation Professional, experienced and supportive team (physicians, genetic counselors, coordinators, embryologist etc.)

smooth Release of the embryos The clinic would need to know data of the

12 Shipping Embryos FDA restrictions - Own egg/sperm for own use - Other: need FDA testing before creating Legal advice in advance to insure a smooth Release of the embryos The clinic would need to know data of the embryos (quality, freezing methods, grading etc.) You need to organize your own shipping

13 Final Words of Advice Take the time to get to know your options Ask lots of questions Focus on achieving success the first time Select a team that you trust Enjoy the journey!

14 Thank You

Do it Once, Do it Right

Do it Once, Do it Right Craig Reisser Andrea Speck-Zulak Families Through Surrogacy 2016 Founded in 1989 - more than 25 years building families patients from 40 countries One of the largest IVF clinics