Family Building Through Use of DONATED EMBRYOS. Robin L. Poe-Zeigler, MD, FACOG

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1 Family Building Through Use of DONATED EMBRYOS Robin L. Poe-Zeigler, MD, FACOG

2 DONATED EMBRYOS Where do these EMBRYOS come from?... Day 5 Blastocyst Embryos

3 DONATED EMBRYOS Embryos are donated by Couples who struggled with infertility and used Assisted Reproductive Technologies (A.R.T.) to assist in conceiving their children.

4 What is A.R.T.? Scientific techniques used in field of reproductive medicine, which allow us to assist in embryo generation and conception.

5 Terms Associated w/a.r.t. In Vitro Fertilization (I.V.F.) Donor Egg (D.E.) Intra-cytoplasmic Sperm Injection (I.C.S.I.) Assisted Zona Hatching (A.Z.H.) Cryopreservation/Vitrification

6 Terms Associated w/a.r.t. In Vitro Fertilization I.V.F.

7 Terms Associated w/a.r.t. Donor Egg I.V.F. (D.E.)

8 Terms Associated w/a.r.t. Intra-cytoplasmic Sperm Injection I.C.S.I. A single sperm is injected directly into an egg using a fine needle to achieve fertilization.

9 Terms Associated w/a.r.t. Assisted Zona Hatching (A.Z.H.) A small hole is made in the zona pellucida (shell) of the embryo, using a micromanipulator, to increase the chances of embryo implantation and pregnancy.

10 Terms Associated w/a.r.t. Cryopreservation & Vitrification Cryopreservation Fast Freeze

11 Cryopreservation/Vitrification Technology developed to allow additional embryos to be Frozen & Stored for future use. It has resulted in an ever increasing number of embryos.

12 Cryopreservation/Vitrification In 2011, it was estimated there were ~600,000 embryos in storage. Today, that number is thought to be ~ 1,000,000!

13 DONATING OF EMBRYOS

14 EMBRYO DISPOSITION Once a couple has completed their family, they are faced with making a decision regarding the disposition of their remaining embryos

15 EMBRYO DISPOSITION

16 Define DONATION Used in the sense of giving a gift, it offers an emotional separation and is often a preferred term by donors.

17 Recipients of Donated Embryos Who are the Recipients of these gifted /Donated Embryos? Couples who have already attempted conception through use of A.R.T. and have not been successful. Couples who cannot afford to proceed with more expensive treatments such as Donor Eggs.

18 Recipients of Donated Embryos Couples who carry genetic mutation(s) which they do not want to transmit to their children (Cystic Fibrosis, Sickle Cell, Tay Sachs Disease, etc.) Couples considering Adoption but who want the experience of Pregnancy itself.

19 Recipients of Donated Embryos Couples requiring substitution of at least one gamete (egg or sperm) and who want to have an equal contribution to the parenthood of the child.

20 Receiving Donated Embryos How can I become a Recipient of Donated Embryos through The New Hope Center s Donated Embryo Program?

21 NHC s Donated Embryo Program 1. Establish care as a NHC patient. 2. Complete an application & submit. 3. Undergo Preliminary Screening: A. Pelvic Ultrasound B. Uterine Cavity Assessment/Prep C. Psychological Screening

22 NHC s Donated Embryo Program Continued: 4. Obtain & Review Profiles of our currently available sets of Donated Embryos. 5. Select a set (Profile #EMxxxx) of embryos for treatment. 6. Select the Series/month you want to proceed with treatment.

23 NHC s Donated Embryo Program Continued: 7. Baseline Visit = Ultrasound, Sign Consents, Medication Review. 8. Cycle synchronization and endometrial preparation, then 9. Embryo Transfer SEE NEXT SLIDE

24 EMBRYO TRANSFER PROCEDURE

25 QUESTIONS: What screening does the Donating Couple undergo? The FDA dictates the required screening for Couples who Donate their embryos. Both contributors - EGG & SPERM undergo screening. Egg Donor: HIV-1/2 Anti, HTLV-I/II Anti, HCV Anti, HBsAG, HBc Anti, RPR, HIV/HCV/HBV, Chlamydia&Gonorrhea, ABO/RH, Medical Genetic History, Psychological Evaluation Sperm Donor: HIV-1/2 Anti + Repeat, HTLV-I/II Anti, HBsAG, HCV Anti, HBc Anti, CMV Anti, RPR, ABO/RH HIV/HCV/HBV, Chlamydia&Gonorrhea, Medical Genetic History, Psych Eval.

26 QUESTIONS: Is there a waiting list to receive Donated Embryos at NHC? Generally YES, because there are more Couples waiting to adopt embryos, than the number of embryos that are available for adoption. Typically, there is a 3 to 6-month wait to receive a suitable match of embryos.

27 QUESTIONS: Is NHC the only Donated Embryo Program that exists? NO but most others are owned by Agencies (not clinics), and they routinely impose substantial fees onto the Patients/Couples who receive the Donated Embryos. EXAMPLES: 1. NHC requires a Psychological Evaluation (~$200). Other Programs require a home study ($1,500 to $4,000). 2. NHC does not charge agency fees. Other Programs do charge agency fees (~$5,000 to $8,000).

28 QUESTIONS: Are there other differences between NHC and Other Programs? YES All embryos for adoption at NHC were created, frozen, and remain stored at NHC. We have more detailed information on the grades, quality, and potential viability of these embryos. Since they re stored on-site, there is no need to transfer/transport the embryos from one facility to another, or to pay customary shipping fees when doing so (~$150 - $500).