O-082 Patients are requesting to ship their surplus frozen embryos to other countries so that they can be donated to other patients
Authors: Lopez-Teijon M , Garcia-Faura A , Marques B 
Published: June 2022

Abstract

Study question
Can all patients decide on the destination of their frozen embryos?

Summary answer
Patients that don’t have the legal right to donate their surplus embryos, still have the opportunity to ship them to centres in Spain

What is known already
In most European countries the laws do not allow patients to decide on the destination of their surplus vitrified embryos. In Spain, however, all possible options are allowed but certain requirements must be met for each of them: donation, research and destruction. Even though, most couples do not decide on any of them and do not reply to the documents they receive from the Centre. The reasons for this behaviour are not due to an irresponsible attitude but to the fact that it presents them with a difficult situation, which triggers emotional conflicts.

Study design, size, duration
The goal of this study is to communicate that since 2018 we have received embryo shipment requests from people who have stored their surplus embryos in other countries, where they cannot donate them. We have evaluated 47 cases and accepted 17 from Italy, Belgium, Ireland and Greece.
We evaluated the survival rate after thawing and pregnancy rates, and compared them with the results of surplus embryos that have been donated in our Centre.

Participants/materials, setting, methods
We received applications from patients from different countries. Given the legal difficulties, we only evaluated those from European Community countries. In order to accept the transfer, we require that they meet all the requirements to be “donation eligible”: clinical history and phenotypic features of parents and siblings born from that cycle, serology results prior to treatment, age under 35 years, good embryo morphology score, and all the information from the embryology laboratory of the Centre.

Main results and the role of chance
According to our Centre's data, only 3% of patients choose to donate their surplus vitrified embryos to others. In a retrospective review of the informed consents of a total of 5,605 IVF cases in which the patients had frozen supernumerary embryos we found that there are no significant differences in this percentage according to the biological origin of the embryos, neither if a couple or a single woman carried out the treatment. Differences are observed between patients from European countries that are close to each other and which are evidence of the idiosyncrasies of each culture. Donation is chosen by 3% of patients from Spain and the UK, 4% from France, 5.5% from Italy, 6% from Germany, 7% from Ireland.
We surveyed patients about their reasons for choosing the destination of their embryos: the main reason why they rejected the possibility of donating embryos was the fear that in the future, their children might meet their biological siblings.
In these 17 cases that have been shipped from other countries, blastocyst survival rate after thawing was 90% (compared to 97% in donated embryos in our Centre) and pregancy rate was 56% (compared to 59% in our Centre).

Limitations, reasons for caution
We don’t know the percentage of patients that would agree to donate their cross-border embryos, and most of them are not even aware of this possibility. They concur in a high socio-economic-cultural level that allows them to be informed and if they are accepted, they must pay the shipment fees.

Wider implications of the findings
We wonder whether all european patients that are interested in donating their embryos and that won’t resign to abandon them should be informed of this possibility. So far, we have had exquisite cooperation from the centres where they remain vitrified. May globalisation allow them to exercise their generosity!

Trial registration number
Not applicable