MyEggBank Doctor's Blog

MyEggBank at the American Society for Reproductive Medicine (ASRM) and Canadian Infertility and Andrology Society (CIAS) meetings

Posted by Dr. Mitchell-Leef

At the national meetings of the American Society of Reproductive Medicine this October and the Canadian Infertility and Andrology Society in September, MyEggBank made its debut. This was the first time MyEggBank was nationally introduced to reproductive endocrinologists and infertility centers throughout the United States, Canada and countries around the world. Our scientific team and physicians presented papers, posters and discussions regarding our collective work in the area of oocyte (egg) cryopreservation and egg banking methodologies. Our embryologists and physicians were able to showcase the outstanding outcomes of our research and present day practice that has established My Egg Bank as the most successful center of oocyte cryopreservation. This involved not only our donor bank, but the science that has lead to women having the option of fertility cryopreservation.

Vitrification, that is the method used to successfully cryopreserve eggs, has been found to be the best technology for freezing oocytes and embryos. This is a very tedious scientific method that succeeds in excellent preservation and subsequent successful thawing and fertilization of oocytes. Reproductive Biology Associates has led the scientific community in developing and Egg Bank that allows couples an improved outcome for egg donation and successful single embryo transfer rates. The option to accelerate donor selections and to decrease costs have equally been important for patients.

The presentations that were given by our embryologists/physicians include:

Cryopreservation of Oocytes: Advances and Pitfalls Z. Peter Nagy M.D.,Ph.D
Ongoing implantations and baby rate per vitrified oocyte during third party reproduction using gametes from an egg bank: Daniel Shapiro M.D.
Teleophase I oocyte vitrification: D. Shapiro M.D., S. Slayden M.D., P. Nagy M.D.,Ph.D
Oocyte Cryopreservation: From “Science to Practice” Dorothy Mitchell-Leef M.D.

Posters presentations:

Comparison of four different cryoprotectant combinations to obtain optimal oocyte survival and embryo development in a mouse model. Reproductive Biology Associates, University of CT
IVF treatment using intentionally vitrified and transported blastocysts obtained from donor Cryoegg bank may provide an efficient treatment for recipients around the world.

Reproductive Biology Associates, ISIS Fertility Centre, Mississauga, Ontario

High implantation rates following single embryo transfer provide similar pregnancy rates to multiple embryo transfer using vitrified donor oocytes. Reproductive Biology Associates
Results of vitrified/warmed donated oocyte treatment procedures in different donor stimulation cycles where human chorionic gonadotropin or leuprolide was used to trigger ovulation.

Building a nationwide eggbank

Posted by Dr. Shapiro

When RBA started its frozen donor egg bank in 2007/2008, we were doing about 60 -80 IVF cases per year with fresh donor eggs. We never imagined that the vitrification process would lead us to do closer to 300 cases per year with frozen eggs and that fresh egg donations would become uncommon in our practice.

As is stands now, we are doing only 20-30 fresh egg donations/year. A large percentage of these are done with agency donors brought by the intended parents. An equal percentage are actually surrogacies where all the parties are known to each other and the egg ‘donor’ is actually the intended parent and the surrogate is thought of as the ‘recipient’ for the purposes of accounting for CDC and the Society for Assisted Reproductive Technology (S.A.R.T.) Only a handful of cases are done by coordinating an anonymous donor to an equally anonymous recipient. This has the net effect of driving our reported donor egg pregnancy rate DOWN, because the average age of the ‘donors’ in the reported cases is actually close to 35. NEITHER CDC OR SART HAS COUNTED ANY OF THE FRESH TRANSFERS ARISING FROM VITRIFIED EGGS BECAUSE THE PROCEDURE IS STILL CONSIDERED EXPERIMENTAL. Ironically, the pregnancy rate in our frozen egg cycles is now actually higher than the rate we are compelled to report for fresh cycles because of the way in which CDC and SART collects this data. The whole idea that using frozen donor eggs to complete anonymous egg donation cycles would be routine is still not out there in the mainstream media or in the heads of patients seeking egg donation. It certainly is not a point of consideration for our oversight agencies, the CDC and SART. At least not yet.

All that is about to change, probably forever. MyEggBank is growing. A lot. We have already added affiliates in Toronto and Miami, which has made it possible for patients to receive frozen donor eggs or embryos without leaving home or changing doctors.

Within the coming months, we expect to add many more affiliates to our network. To supply the network, MyEggBank will be adding strategic partners who will benefit from learning all our technology and in turn will provide access to an even larger selection of donors. As is true for the patients of affiliates, the patients of the strategic partners will not have to leave home or change doctors to complete a donor egg cycle. Donor eggs produced by a partner center will be available to all the clinics in the network. From what we have seen in terms of response to our offers to other centers, we expect that MyEggBank will be a coast to coast operation with affiliates located no more than few hours drive from North America’s largest population centers.

As the parent center of MyEggBank, RBA will take the lead in training the new centers to achieve the same high rates of successful pregnancy at the low cost our local patients have come to expect. Currently, RBA has been able to achieve on-going pregnancy rates as high as 70% in patients using vitrified donor eggs who choose double embryo transfer. The high pregnancy rate is very attractive but comes with a 30-35% twin risk, which is not so attractive. As a result we are strongly encouraging patients with 2 or more High Quality Embryos (HQE) to undergo single embryo transfer. The ongoing pregnancy rate in this group is lower, but still close to 60%. As a reminder, we do have some patients who are not lucky enough to have 2 HQE. For these patients, a negative pregnancy test means they are entitled to another cycle with frozen eggs at no additional cost. Some patients (about 40%) without 2 HQE are still able to achieve live birth. As a result, our PER PATIENT pregnancy rate is over 80% because patients of MyEggBank and its affiliates have the right to keep cycling until they either have 2 HQE or get pregnant…..whichever comes first.

The RBA team and MyEggBank are very excited to be welcoming new centers onboard. Within months, patients will have broader options available in their quest for pregnancy without having to compromise on cost, convenience, cycle control or success rate. As centers join the network, they will be identified and patients close to those centers will be able to stay home while they are being treated. While we enjoy taking care of patients from all over North America, we realize that most would prefer to remain in familiar surroundings while undergoing treatment. Our national network will make egg donation easy, affordable, successful, safe and commonplace. There is a sea of change underway in fertility medicine and MyEggBank is charting the new course.

Savvy patients use the internet

Posted by Dr. Shapiro

Savvy patients use the internet...a lot! The web has made it possible to get information about health care options with just a few clicks of a computer mouse. Unfortunately, in this era of instant information patients can easily become overwhelmed by the choices.

Using vitrification for egg banking and egg donation is new to the world of IVF. We are the industry leader but realize that many other programs will be instituting their own vitrification systems for egg donation in the months and years to come. Patients will have a harder time figuring out where to go for services as the number of egg banks increases. It is very easy for a clinic to claim they have an egg bank. It is MUCH more difficult to actually deliver the service So what’s a patient to do?

Patients should know what to look for in an egg bank and what questions to ask.

How much experience does the bank have?
- RBA/MyEggBank has been doing this successfully for 5 years.
- RBA/MEB has performed over 500 embryo transfers
How many births has the bank had?
- RBA/MEB has over 330 babies born to date.
- We have nearly 50 more pregnancies ongoing
Does the bank keep inventory of eggs at all times?
- RBA/MEB keeps a widely variable inventory at all times and invests in new donors every day.
What is the on-going pregnancy rate?
- RBA/MEB has delivery rates range between 60-70% depending on embryo quality and the number transferred.
How does the bank back up its technology?
- At RBA/MEB patients who do NOT receive 2 high quality embryos and subsequently fail to become pregnant get a free cycle.
Is there a wait for a donor?
- At RBA/MEB-NO NO NO
Are the donors screened on-site or are the eggs shipped in from another source?
- AT RBA/MEB we screen ALL our donors and reject donor applications at a rate that far exceeds our acceptance rate. All MyEggBank’s eggs are frozen at RBA .
What are the criteria for the donors?
- RBA/MEB donors must be under 30, educated and near ideal body weight. They also must pass FDA mandated testing, genetic screening by direct DNA testing, advanced psych testing and have high quality eggs in large numbers to qualify.
Does the freezing technology allow for high rates of efficiency and ability to refreeze embryos that are not transferred?
- RBA/MEB has a pregnancy rate of 55% when frozen EMBRYOS from frozen eggs are transferred. About 50% of our patients have more than 2 high quality embryos per procedure and are therefore able to freeze extra embryos. We thaw an average of 6 eggs per patient, which means we are capable of offering extremely efficient use of eggs and embryos.

As of now, there are no other egg banks in the USA with our level of experience. We have maintained delivery rates with frozen eggs above the national average for fresh egg donation for more than 5 years. . For more information, call MyEggBank at 1-800-200-EGGS or RBA at 404-257-1900.

2011 Update - First Quarter

Posted by Dr. Shapiro

MyEggBank.com is proud to report that we have completed nearly 450 frozen egg donation cycles. More than 230 of those cycles were completed in 2010 alone and we anticipate about 300 more cycles for 2011. Success rates have been quite consistent with about 62-68% of transfers resulting in live births. We have well over 250 babies born from the process thus far.

Our 2010 experience with frozen egg banking has brought a few unanticipated observations to the forefront. First among these is what we now realize will be a major ‘disconnect’ for patients who read the SART or CDC statistics page for RBA. In 2009, we completed 137 frozen donor egg cycles, yet not one of these cycles was recorded by the SART reporting system. We performed only a handful of anonymous fresh donation cycles in 2009. In fact, we performed more gestational surrogacies and known donations combined than anonymous fresh donation cycles. All these cycles; anonymous fresh, gestational carrier, and directed donations are lumped together by SART as ‘fresh donation’ cycles. For 2009 we showed a 50% live birth rate for this group. We also showed a 55% pregnancy rate for frozen embryo transfers from egg donation for the same time period. At first glance, the untrained reader would wonder how it was possible to have a higher pregnancy rate from cryopreserved donor embryos than from fresh. We also did more embryo thaws (79) from donor eggs in 2009 than we did ‘fresh’ cycles. These numbers make no sense unless one considers the sources of these cycles. As mentioned the ‘fresh’ cycles are the anonymous fresh donations +gestational surrogacies + directed donations while the frozen embryos used for the frozen embryo transfers came from anonymous fresh and frozen eggs. Anonymous donors are younger on average than directed donors so the pregnancy rates from these cycles are higher than the hodgepodge of cycles that include surrogacies and (older) known donors. The uncollected data from 2009 would show about a 63% live birth rate from our frozen egg cycles had SART recorded it. Alas, we have no way to get this data into the CDC registry.

We will be able to report the frozen egg donation cycles with our 2011 data set, but these outcomes won’t be published until 2013. We will therefore have 4 years of egg bank data that is available but unreported by the government agency (CDC) which requires compliant clinics to submit their outcomes.

The other unanticipated observation we made from our 2010 data was that Single Embryo Transfer (SET) will provide statistically similar outcomes to Double Embryo Transfers. From July, 2010 through the present we have been strongly advising patients with excellent embryo quality to transfer a single embryo rather than the more typical 2. During this time period, 68% of the SET cycles resulted in pregnancy while 62% of DET cycles were positive.

It may seem odd that SET has a higher positive test rate than DET. There is a reason for this numerical quirk however. We recommend SET when patients have more than 2 high quality embryos (HQE) at the blast stage. Patients with outcomes this good are more likely to have normal embryos than patients with 2 or fewer HQE. Patients with 2 or less HQE are advised to do DET and so we artificially depress the DET pregnancy rate by directing patients with lesser embryo quality into that group. Of course, we stand behind our guarantee of 2 HQE per cycle so that patients who fail to get pregnant after ET of less than 2 HQE get another cycle at no extra cost.

Given the above finding, we will be continuing to advise patients with 3 or more HQE to do Single Embryo Transfer and freeze the remaining embryos for future use. We love babies but hate high-risk situations for our patients. Twinning is a whole lot riskier than people realize and singleton pregnancy remains our preference.

Medical Tourism

Posted by Dr. Kort

Medical Tourism describes the practice of traveling across state or international borders to obtain health care. The concept of medical tourism is not a new one - thousands of years ago Greek pilgrims travelled from afar to an area called Epidauria the sanctuary of the healing god Asklepsios.

Many factors have led to the increasing popularity of medical tourism. These include long wait times for certain procedures, the ease and affordability of air travel, the high standard of health care in the USA and the availability of certain procedures not available or illegal in some countries. (Such as egg freezing, surrogacy and egg donation).

A significant attraction for “medical tourism” to RBA is convenience, efficiency and the attainment of excellent results. In addition the availability of advanced technology and sophisticated training of US physicians is attractive to many living outside the USA. The quality of care and accountability also are important to certain patients who live in countries where these factors are less defined.

While RBA has always treated patients from around the world there has recently been an unprecedented number of patients seeking infertility services not available in their country of residence. These include patients seeking IVF with donor eggs, patients requiring genetic diagnosis on their embryos and patients with sex linked diseases requiring PGD (preimplantation genetic diagnosis).

Some seek treatment at RBA because they have been unsuccessful elsewhere and are attracted by the consistently high success rates attained at RBA.

The recent success of RBA’s egg bank has resulted in a large number of patients traveling to RBA for treatment. The availability of frozen eggs has significantly reduced the cost of IVF with donor oocytes without compromising our high success rates. The efficiency and virtually no wait time for this treatment has also contributed to its popularity. Patients are able to have their treatment with minimal disruption to their lives and schedules spending the minimal time in Atlanta. RBA is also attracting young women who are freezing their eggs for social fertility preservation.

We are also one of the few centers who have data on babies born after egg freezing. This data indicates egg freezing is safe and babies born from this procedure are no different from babies born from fresh eggs. (Over 250 babies born and counting)!

Although much attention has been given to Americans traveling abroad for health care including infertility services, a McKinsey report in 2008 showed approximately 85,000 medical tourist travel to the USA annually. The decline in the value of the dollar has offered added incentive for travel to the USA. Atlanta is an attractive destination as it is easily accessible from any major world capitol.

(Over 250 babies born from egg freezing and counting)!

While it is believed that medical tourism applies to patients traveling from the US to have treatment, a recent McKinsie study found as many as 87,000 patients travel to the US for medical treatment with increasing numbers seeking infertility related procedures.

myeggbank.com - update

Posted by Dr. Toledo

2010 has been a very good year for our egg bank and for our couples utilizing this unique source of eggs. RBA officially opened our egg bank in February of 2008. The concept was simple. We wanted to make the process of finding and choosing a potential egg donor easier for our patients. Prior to the creation of this unique bank, patients had to wait up to 12 months before an appropriate match was found. Now the wait to find a match has been virtually eliminated for our patients.

As of August, 2010 we now have 58 donors in our egg bank, and over 900 available eggs. Over 360 recipients have had an embryo transfer from eggs procured from our egg bank. (Average age of our recipient is 41 years old.) Our pregnancy rates continue to be excellent at 75% with an ongoing clinical pregnancy rate of 65%.

Earlier this year RBA decided to begin offering more single embryo transfers to our recipients, in an effort to reduce the number of twin pregnancies. Our philosophy was that the goal should be a single pregnancy when possible, since twin pregnancies are still considered high risk by obstetricians. Thus far, our results demonstrate that when properly selected the pregnancy rates do not decrease when a single embryo is transferred to our recipient. As of August, 2010, eggs from our egg bank have resulted in 135 embryo transfers. 89 recipients have had embryo transfer with 2 embryos, and 59 of these recipients have an ongoing pregnancy. (66% pregnancy rate with a twin rate of about 35%). 46 recipients have chosen single embryo transfer, and 32 of these recipients have positive pregnancies. (69% pregnancy rate with an approximate 2-3% twin pregnancy rate, all of which are identical twins.)

In conclusion, our egg bank continues to be incredibly successful. More importantly, our egg bank has helped hundreds of recipients achieve their dream of having a healthy baby. We now have over 300 recipients who have had an embryo transfer from eggs created from this unique egg bank. Today over 200 recipients have had positive pregnancies, and over 190 babies have been born.

RBA will continue to refine our egg bank process. Our goal is simple: to offer our recipients the best possible match in a timely, safe, and affordable fashion.

The Financial Aspects of Donor Egg

Posted by Dr. Straub

Inability to conceive can be one of the most difficult and stressful periods in a relationship that a couple can endure. Many times, this leads to a consultation with a fertility doctor. There are many diagnoses of infertility for men and women. At times both partners are affected. Treatment varies significantly depending upon the diagnosis. Sometimes, the treatment is relatively simple and straight forward. Others are more complex.

One of the most common concerns or complaints about fertility treatment is the cost. In fact many patients often delay making the initial appointment with the reproductive endocrinologist for fear that they will not be able to afford the treatment. Fertility treatment can be costly and we are well aware of that fact.

A very difficult decision a couple faces during the infertility struggle is when they are considering the use of donor eggs. In the past, all donor egg cycles were completed with the use of fresh eggs. Though this process was very successful, it also involved a considerable wait time and came at great expense. Our ability to freeze and thaw eggs has completely altered the way we and patients alike view the use of donor eggs on many levels including cost. Importantly, fresh eggs and frozen eggs provide equal pregnancy rates.

A traditional fresh donor egg cycle involves synchronizing the donor and the recipient such that the eggs are obtained from the donor, fertilized and generally two embryos are transferred into the recipient within the same cycle. The recipient couple receives all of the eggs and generally has excess embryos available for freezing and later use. A fresh donor egg cycle is approximately $25,000.

The donor egg bank allows couples to have a more active role in selecting the donor. Couples planning on using donor eggs are able to review the inventory of donor eggs in the bank. Once a donor is selected, the couple may move forward with their cycle immediately. When using the donor egg bank, a sufficient number of eggs are thawed so that the couple is guaranteed the transfer of two high quality day 5 (blastocyst) embryos. Excess embryos of good quality can be frozen for future use, though this is less likely than a fresh donor cycle due to the limited number of embryos. A donor egg cycle using the frozen egg bank is approximately $16,500, significantly less expensive than a traditional fresh donor egg cycle.

Making the proper decisions regarding fertility treatment can be challenging enough for any couple. When a couple considers the use of donor eggs, the frozen egg bank makes this option more accessible for a greater number of patients due to the decreased cost.

Frozen donor eggs - Bank on it!

Posted by Dr. Shapiro

The use of frozen eggs for egg donation is increasing at a rate of 30-40% per year. At this rate, the egg bank will be accommodating about 500 recipients a year by 2013. It is hard to know if this growth rate is sustainable but one thing we are sure of at this point; patients prefer this route over fresh donation for several reasons. Lower cost, convenience and high success rates are certainly explanations for the bank’s initial growth. Future growth however will depend on the willingness of recipients to trust their own doctor in their home clinic with frozen egg technology.

Why is this so?

RBA can easily handle the reproductive tourists currently coming to Atlanta. We have the ability to handle far more too. Even when the cost of travel to Atlanta is factored in, the egg bank still remains a better deal than staying elsewhere to do a fresh cycle. Still, the greatest degree of economic efficiency from this process will come when partner clinics around the US and throughout the world can receive frozen eggs from the RBA egg bank and achieve equally high pregnancy rates in their own labs. When that happens, patients won’t need to travel to Atlanta at all.

Two models for off-site treatment are currently in development.

The first of these will involve transport of frozen sperm to us from the intended parent couple. We will then thaw the sperm and eggs in Atlanta, create the embryos here and then ship frozen embryos back to the partner clinic. For this model to succeed, the partner clinic will need training from the RBA lab staff on how to properly perform the thaw and transfer. This model will be most beneficial to couples coming from states or countries where egg donation is limited. It should be noted that though RBA has achieved high levels of competence with freezing through the process of vitrification, it takes many months to possibly years for clinic staff to develop adequate skill with the technique. Until partner clinics have reached acceptable competence levels, patients will still be better served by coming to Atlanta.

The second model will involve transport of frozen eggs for use by the receiving clinic on behalf of the intended parent. Clinics that have also been trained by RBA staff and have shown proficiency with frozen eggs and ICSI will be the best partners for this approach. This model allows the eggs to be treated in the receiving clinic, which would also be fully responsible for the patient’s work-up and evaluation. This method has the advantage of immediacy since there is no need to transport sperm to Atlanta for the insemination of the eggs. This method also minimizes the risk of transport (since the embryos won’t be shipped) and avoids the ‘refreezing’ required for method #1.

Both of these options should be readily available within the next 12 months. In the meantime, we encourage prospective recipients to take advantage of our offer of a free phone visit with one of the RBA physicians to discuss the egg bank and how to easily become an out-of town recipient and reproductive tourist to Atlanta.

Improved Patient Convenience

Posted by Dr. Mitchell-Leef

For years, patients who wished to use egg donation to achieve a pregnancy were placed on waiting lists as long as six months to a year before a qualifying match could be made. The anxiety of not being matched for months only added to the patient's stress and concerns about the donor process.

With improved egg cryopreservation, consideration of an Egg Bank to facilitate matches for patients was based on the known concerns our physicians had regarding the waiting process. Our patients not only have to make decisions about using a donor, but having the added stressors or putting the final process on hold because a match might not be available for a considerable amount of time can be devastating.

Now, with our Egg Bank, couples can select a donor online as soon as they have completed their required evaluation. Donors can be chosen at the couples' convenience and they can then choose the timing of their cycle based on their personal timetable. Patients may pick their top choices and have their physicians review their chosen options so that any questions regarding the match can be discussed before the final selection is made.

Allowing more expedited matches has truly been one of the most important aspects of MyEggBank.com. Knowing that the patients do not have to wait or be anxious about time constraints has been a rewarding one.

October Update

Posted by Dr. Elsner

2009 has been a very good year for the egg bank at Reproductive Biology Associates. Our egg bank continues to meet and exceed our expectations for its success. As of the end of September 2009, we have banked eggs from 109 donors (average age 26.1 years). One hundred and eighty (180) cycles have been done for recipients (average age 41 years). The initial pregnancy rate currently is 71.97%. The ongoing pregnancy rate is 66%. Over half of our recipients (58.28%) also have embryos to freeze. We have had 72 women deliver 107 live born children, with no increased risk of problems when compared to naturally conceived pregnancies. The other pregnancies are ongoing. The results of our egg freezing program will be presented in greater detail by our Laboratory Director, Dr. Peter Nagy, at the American Society of Reproductive Medicine (ASRM) in Atlanta this month. To our knowledge, these are the best pregnancy rates in the world from the use of frozen thawed eggs. These pregnancy rates equal the pregnancy rates in our center using fresh donor eggs, which are among the best in the country. Therefore, we believe that our current egg freezing technique does not damage the egg.

Additionally, the recent downturn in the economy has actually been very positive for the egg bank, for a variety of reasons. There has been a dramatic increase in the number of young women seeking to be egg donors this year. This has allowed us to be even more selective than we have been in the past and has allowed us to bank eggs from a large number of high quality donors. All these young women are between 21 and 30 years of age, college educated, many have or are working on advanced degrees. On average we recover 22 mature eggs per donor (only mature eggs can be frozen) which means that one donor may produce enough eggs for more than one recipient. This allows us to lower the cost for a donor egg cycle of treatment if eggs from the egg bank are used. At the moment we have approximately 1000 eggs banked for our recipients to choose from and we are continually adding to our inventory.

What all this means for women who need to use donor egg to become pregnant is that (1) we have a wide choice of excellent quality donor eggs available for use now, (2) there is no wait as there may be at many centers that offer egg donation services. And on top of that, (3) the cost to use frozen banked eggs is approximately half (sometimes less) of what it costs to do donor egg elsewhere. (4) All this comes without sacrificing the outcome (the pregnancy rates and live birth rates are as good as with fresh eggs).

Personally, I am very excited about our egg freezing technology. I believe that this technology is going to revolutionize the way women think and plan for their reproductive future. At the moment we don’t even recognize all of the potential applications for this technology, but there will be many.

Already we have preliminary data on the outcomes of egg freezing in older women than our egg donors and they are good. Of course egg freezing is not the fountain of youth, but it appears that in our hands eggs are not damaged in the freeze thaw process. That means that the pregnancy rates from these cycles are age appropriate for the age of the egg. By that I mean that if you freeze a 35 year old woman’s eggs and use them even years later, her likelihood of becoming pregnant would be the same as if she was still 35. The same applies if the eggs are frozen at age 37; the pregnancy rates would be as if she were still 37, regardless of when the eggs were used, and so on. So egg freezing seems to stop a woman’s reproductive time clock, at least for the eggs that are frozen. This opens a whole new world of possibilities for women.

We are so confident in the egg freezing technology that we have begun to offer egg freezing for fertility preservation for women 38 years of age or younger, if they have good ovarian reserve. This means that women recently diagnosed with cancer can freeze their unfertilized eggs for later use even if they do not have a partner. Women who haven’t chosen a partner yet, or are not ready to have a child at the present, for whatever reason (career-related or for economic reasons, etc.) and who feel their reproductive clock ticking can stop that clock by freezing eggs for potential later use. Egg freezing can take the pressure off a woman so she is free to make the best choice for her, without worrying about declining pregnancy rates with advancing maternal age. Of course freezing eggs is no guarantee of future success, but I tell women to look on the process of egg freezing, if they choose to do it, as an insurance policy. They may never need it because they may find the perfect partner and conceive on their own at the right time. But if she doesn’t find the right partner or situation until later in life, she still has a good chance of success. When a woman’s family is complete, she can always have her unused eggs discarded.

These are just a few of the possible applications of egg freezing technology, but these uses of egg freezing are available to you now, not some time in the distant future. I hope that women will be proactive, learn about these new technologies, and if they might be helpful to them, then investigate further. The future is now!

August Update

Posted by Dr. Slayden

I hope you have enjoyed the information provided in our earlier egg bank donor egg blogs. It nicely sets the stage as to what the egg bank at RBA is about. For my first blog on this site (or anywhere on the web for that matter), I'd like to take a different angle and describe the dynamics of how one couple came to choose this form of reproductive treatment. Last year, a patient of mine referred her friend from another city to me. We contacted each other via e-mail several times and they decided to fly to Atlanta for a consultation. They were a lovely couple and it was a tough case. The woman was in her early 40’s and she and her husband had been trying to conceive for many years. In fact, it had been such a long time that neither of them could keep up with all of the details. However, she had undergone major pelvic surgery in the past, but this was unsuccessful. After the nature of the surgery was revealed, the forgotten details weren’t needed. Her tubes were open but irreparably damaged – IVF was the only reasonable hope. So, we started talking about what to do. We talked about FSH levels, protocols, success rates, cancellation rates, and miscarriage rates. We discussed the genetics of reproductive aging. We talked about cost. It was immediately evident that the couple would barely be able to afford IVF. It would be the dreaded "one shot" IVF cycle- always high-stress, for both doctor and patient. Based on the particulars of this individual case, all signs pointed to a poor outcome. But, there was still a chance- what to do?

Let's stop here and place ourselves in this couple’s shoes. They came to RBA to pursue IVF. Should they pursue the dream of having children through the use of IVF if there is less than a 10% chance of a live-born child? What is "plan-B" if they are unsuccessful? In our couple’s case, continuing to live childless or being foster parents are the only choices after the expenses of IVF are taken into account. Now, place yourself in the physician’s shoes. If we step back and look at this case from the perspective of economic efficiency, traditional egg donation makes a lot of sense. The pregnancy rate is exceptional, miscarriages are infrequent and we have little concern for genetic abnormalities. Thankfully, I practice in perhaps the only clinic in the world where I can provide a more affordable method of egg donation without sacrificing quality or outcome. Nonetheless, “clinical efficiency” doesn’t take into account the emotions of a couple sitting in front of me. Should I avoid the difficult, emotionally-laden conversation about abandoning the use of this woman’s own eggs, when there is still a chance of it working? Ultimately, it is the patient’s choice, and I did offer egg bank IVF to this couple. They wanted to be parents and didn’t want to fail. They had never considered egg donation before, but their sense of relief at finding the best chance of becoming parents, that also met their budget, led them to choose our egg bank without reservation.

The next steps included further analysis of this couple’s unique medical history to prepare them for the best chance egg banking can provide. Her screening tests revealed a fibroid (myoma) within the uterine cavity that I removed surgically. The couple underwent the required psychological and routine medical testing. A follow-up ultrasound revealed perfect uterine healing and we were on our way. The thawed eggs fertilized very well with ICSI (intracytoplasmic sperm injection) and we transferred two beautiful blastocysts. Unfortunately, one additional embryo did not meet our standards for freezing. But all ended well with a nicely positive pregnancy test (β-hCG) that continued spiraling upwards. In two more weeks, we were able to see a single embryo with a beautifully positive heart rate. Our patient is nearing the end of her pregnancy now.

My Egg Bank News

Posted by Dr. Shapiro

The egg bank continues to grow and now has enough eggs to meet the demand of 150 new patients. Our ability to screen high quality donors has also provided us with a steady stream of new donors, so that at this point it appears that we will have no significant wait for the vast majority of patients seeking egg donation.

The convenience and lower cost of egg banking have many important consequences. One emerging result of egg banking is ‘reproductive tourism’. The term was coined many years ago in Europe to describe patients who travel for their IVF care. Reproductive tourism in Europe for egg donation services is the norm. Only a few countries on the continent allow anonymous, compensated egg donation. Patients in the UK, Germany and Italy, for example, must travel to the Czech Republic, Spain or Belgium to find anonymous donation programs.

Some Americans have traveled to Europe for IVF care in general, and some have traveled for egg donation in particular.. In each of these cases, patients can expect the cost of travel, including two or more weeks overseas, to significantly erode any cost savings they may experience by going to Europe for medical treatment. American patients traveling within the US usually do so to seek higher pregnancy rate irrespective of cost or inconvenience.

It is also very important to note that for egg donation, reproductive tourists must have their cycles coordinated with their donor’s cycle. It is not uncommon to invest heavily in an arrangement such as this only to reach Prague or Valencia and discover that the donor’s response is inadequate or her egg quality is not good.

By using a frozen egg bank, patients need not worry about egg quality or supply. High quality eggs are already banked, and back-up eggs are usually available in the event of unforeseen circumstances. Patients traveling for egg donation can trust that their travel dollars are well spent.

At RBA we are hopeful that patients will come to realize that by using our egg bank they can achieve pregnancy rates the same as fresh cycles (65%), for a total cost that is far less than egg donation charges for fresh cycles. For patients in California or metropolitan New York, charges at RBA are about half of the typical fees for fresh cycles. For cycles involving egg donor brokers in other states, the savings at RBA are even greater.
Even after figuring in the cost of travel, patients coming to Atlanta for egg donation can expect to save thousands of dollars without compromising outcome at all.
Additionally, recipients have the ability to direct their care by choosing their donor from our website data base and scheduling their own cycle according to their needs, not the donor’s availability.

There are several high quality hotels within walking distance of our practice and we have made arrangements with several of them for discounted stays. Atlanta is, and will continue to be, America’s busiest airline hub, so flights are plentiful as well. Several discount airlines and Delta fly here and travelers can be in Atlanta from anywhere in the continental US within 4 hours. Europeans coming to Atlanta can travel non-stop on Delta, Lufthansa, BA, Air France Alitalia, KLM and Sabena from many cities on the Continent. Asian patients can also reach us non-stop from Shanghai, Tokyo and Seoul.

If you think travel to Atlanta for egg donation will meet your needs, please call us at 404- 257-1900 or 1-888-722-4483 for more information. You may also e-mail our new patient coordinator at mary.viskup@rba-online.com.

We look forward to hearing from you!

Welcome to the Reproductive Biology Associates Egg Bank

Posted by Dr. Shapiro

Welcome to the Reproductive Biology Associates Egg Bank. Although we are not the only practice freezing eggs, we have become the only egg donor program in the world to make egg freezing routine. The future, as they say, is now.

Since we first started vitrifying donor eggs two years ago, we have consistently had pregnancy rates in excess of 60% and equal to our fresh donor egg statistics. After the initial 12 month trial period, we concluded that we had found the holy grail of egg donation; a method to reliably and efficiently freeze eggs for routine use. Since our egg bank officially opened in February 2008, we have been actively recruiting donors and matching them to our recipients. Our inventory now exceeds 500 eggs from more than 30 donors. We thaw an average of six eggs per recipient to get two high quality blastocysts for transfer. We are capable of meeting the needs of about 70 recipients above and beyond our current patients immediately. We continue to bank eggs from high quality donors and anticipate that most recipients will have little or no wait for a match. We screen about eighty young women for our donor program per month and approve about 10% of the applicants. All our donors meet the criteria set forth by the Food and Drug Administration (FDA).

We are very proud of our donor program and our egg bank. We are unique in how we operate. Our recipients can schedule their IVF procedure at their convenience, knowing that the eggs they will receive will result in at least two high-quality blastocysts for transfer or we will provide another attempt at no additional cost. Furthermore, our recipients can take comfort in knowing that they have come to the egg bank with the world’s highest success rates for frozen eggs. Our overall cost per embryo transfer (about $16,500) is well below the national average for egg donation, making our cost per delivery remarkably low.

With the launch of this website, recipients will be able to select donors themselves and review profiles at their leisure. They will be able to provide us with a first and second choice donor. Most importantly, recipients will be able to do all this knowing that their identities are protected as securely as if they made their choice(s) face to face with their doctor.

Some of you reading this are looking to become donors rather than recipients. If you are under thirty years of age, educated, and think you might qualify for our program, click here to contact us and register for a donor seminar. If you are interested in using frozen donor eggs, please contact our patient registration coordinator, Mary, at 404-459-3515. We look forward to hearing from you!

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AUTHORS

MyEggBank at the American Society for Reproductive Medicine (ASRM) and Canadian Infertility and Andrology Society (CIAS) meetings

Posted by Dr. Mitchell-Leef

Building a nationwide eggbank

Posted by Dr. Shapiro

Savvy patients use the internet

Posted by Dr. Shapiro

Top Frequently Asked Questions about MyEggBank.com

Posted by Dr. Mitchell-Leef

2011 Update - First Quarter

Posted by Dr. Shapiro

Medical Tourism

Posted by Dr. Kort

myeggbank.com - update

Posted by Dr. Toledo

The Financial Aspects of Donor Egg

Posted by Dr. Straub

Frozen donor eggs - Bank on it!

Posted by Dr. Shapiro

Improved Patient Convenience

Posted by Dr. Mitchell-Leef

October Update

Posted by Dr. Elsner

August Update

Posted by Dr. Slayden

My Egg Bank News

Posted by Dr. Shapiro

Welcome to the Reproductive Biology Associates Egg Bank

Posted by Dr. Shapiro