Purpose

To assess longitudinal trends in in vitro fertilization (IVF) patients’ choices for disposing of cryopreserved embryos.

Methods

This is a retrospective cohort study of embryo disposition forms submitted between January 2000 and February 2020 at a university-based fertility clinic. Primary outcome was disposition decision. Binary and multivariable logistic regression were performed to determine odds ratios (OR) for decisions according to female age, education, race, religion, state of residence, area deprivation index based on zip code, and IVF pregnancy history. We also assessed disposition year, storage duration, and number of stored embryos.

Results

Forms were reviewed from 615 patients; 50.6% chose to discard embryos, 45.4% donated to research, and 4.1% chose reproductive donation. In the regression model, two factors were significantly associated with donation to research: female listing “no preference” or declining to list religious preference (OR 2.56, 95%CI 1.44–4.54) and live birth of multiples after IVF (OR 1.58, 95%CI 1.05–2.36). Before 2012, females younger than age 30 at storage were equally likely to choose to donate embryos to research as discard them. However, between 2013 and 2020, females younger than 30 were significantly more likely to discard than donate embryos for research (OR 2.87, 95%CI 1.13–7.28).

Conclusion

Since 2013, the majority of patients younger than 30 at storage have chosen to discard cryopreserved embryos. Before then, patients were more likely to donate embryos for research. To ensure sufficient embryos are available for research, young patients, who are most likely to have cryopreserved embryos, should be counseled about options for donation.

中文翻译：

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患者在体外受精后做出的胚胎处置选择的最新趋势。

目的

评估体外受精 (IVF) 患者处理冷冻保存胚胎的选择的纵向趋势。

方法

这是一项对 2000 年 1 月至 2020 年 2 月在大学生育诊所提交的胚胎处置表格的回顾性队列研究。主要结果是处置决定。执行二元和多变量逻辑回归以确定根据女性年龄、教育、种族、宗教、居住状况、基于邮政编码的地区剥夺指数和试管婴儿妊娠史做出决定的优势比 (OR)。我们还评估了处置年份、储存期限和储存胚胎的数量。

结果

对 615 名患者的表格进行了审查；50.6% 选择丢弃胚胎，45.4% 捐赠给研究，4.1% 选择生殖捐赠。在回归模型中，有两个因素与研究捐赠显着相关：女性列出“无偏好”或拒绝列出宗教偏好 (OR 2.56, 95% CI 1.44–4.54) 和 IVF 后活产多胞胎 (OR 1.58, 95 %CI 1.05–2.36）。在 2012 年之前，30 岁以下的女性在选择捐赠胚胎进行研究和丢弃胚胎的可能性相同。然而，在 2013 年至 2020 年之间，30 岁以下的女性丢弃胚胎的可能性明显高于捐赠胚胎用于研究（OR 2.87，95% CI 1.13–7.28）。

结论

自 2013 年以来，大多数 30 岁以下的患者选择丢弃冷冻保存的胚胎。在此之前，患者更有可能捐赠胚胎进行研究。为了确保有足够的胚胎可用于研究，最有可能拥有冷冻保存胚胎的年轻患者应该被告知捐赠的选择。