There are thousands of cryopreserved embryos being stored at IVF clinics throughout the world. These embryos are for the most part leftover from successful cycles. Couples may come back to use these embryos, continue to store them, discard them or put them up for adoption. At the Florida Institute for Reproductive Medicine we strongly encourage couples who have completed their family to consider adoption. Embryo adoption is an ideal option for many couples, particularly those with severe egg or sperm factors. Costs to do donor embryo IVF are typically much less than donor egg in vitro fertilization and can be comparable to donor sperm insemination given the differences in fecundity.
The process of embryo adoption is relatively simple. Initially a history is obtained focusing on the carrying partner, frequently performed over the phone. This is followed by an assessment of the patient’s uterus, a sono-hysterosalpingogram that can be performed by the patient’s local OB/GYN or Reproductive Endocrinologist. A psychologic screen is performed by a clinical psychologist knowledgeable in reproductive medicine, often by phone. Different programs have different maternal age cut offs – at the Florida Institute for Reproductive Medicine we do not transfer embryos to individuals over 50 years of age. If a patient is 45 or older we strongly recommend an EKG and cardiac stress test, as pregnancy is cardiovascularly very taxing. If a patient has a significant medical issue this will need to be addressed by an appropriate medical specialist and clearance given prior to initiation of pregnancy. Embryo selection can then occur, often this is done from our website. Typically we have anywhere from 20-40 couples who agree to donate embryos. Pregnancy rates are largely a function of the age of the mom who created the embryo as well as whether the embryo has been chromosomally tested and the number of embryos being transferred. Pregnancy rates of approximately 60% can be obtained with the transfer of one genetically normal tested embryo, up to 80% with two tested embryos. In most cases embryo transfer will be performed in a prepared cycle. The patient is on estrogen anywhere from 10-13 days, at which point an ultrasound will be performed to assess the endometrial lining. As long as there is an appropriate lining vaginal progesterone is begun. Typically embryo transfer is performed after five days of progesterone. Estrogen and progesterone will continue for eleven days until pregnancy is determined. If pregnancy has occurred hormone replacement will continue through eleven weeks at which time the placenta takes over hormone production. If the patient is not pregnant hormone replacement will be stopped and the patient will have a timely menses.
Kevin L. Winslow, M.D.
Director for Florida Institute for Reproductive Medicine