Hello clawrence,
Thank you for your interesting question.
As far as I could tell from previous studies, there is about a 42%
overall rate of implantation in surrogates using fresh donated eggs.
There is a much higher live birth rate for certain ages of egg donors,
outlined below, but it is not separated into categories of surrogate
vs. non-surrogate. Surrogates usually have a higher rate of pregnancy
(by about 8-10%) than non-surrogates, depending on the age of the
surrogate. Egg donors and surrogates with previous success have
higher rates of pregnancy than those who do not have previous success.
Sperm donation also increases these chances. There is not a study
that has been done to put all these factors together specifically for
your circumstances, but a 45-50% success rate could be feasible,
considering all these additional positive factors (young, proven donor
and young, proven surrogate), but cannot be assumed. These studies are
all provided for your perusal.
It is possible that the clinic you are looking at does have success
rates of 75%, but it is highly unlikely. Keep in mind that a "success
rate" is only a successful insemination-- the baby still has to be
born and the "live birth rate" is the only statistic applicable for
that data. I assume that all you care about is a live birth, so this
is really the only statistic that you want. Also, are they referring
you to data for just IVF or for other ART technologies as well? I
detail these findings later. 75% seems like an off-the-wall number.
You really need to look long and hard at their data and what factors
they are using to get to those success rates. If they don't want to
give you data to back up that claim, I would be suspicious of them. (I
show you a way to independently check their data yourself later in my
answer.)
Here is the study I found that addressed your specific concerns. All
these surrogates were implanted with donated embryos, either fresh or
frozen.
"Gestational Surrogacy Enhances Implantation Rates In Egg Donation Cases"
This research at the American Society for Reproductive Medicine
(ASRM), San Antonio, Texas, 2003.
CA Adams, LS Anderson and SH Wood. The Reproductive Sciences Center,
La Jolla, CA, USA.
http://www.fertile.com/gestational_egg.html
'"Implantation rates following fresh embryo transfers were
significantly higher for surrogates (42%) than for non-surrogates
(33%, p<. 05). Surrogates also had a higher implantation rate (28%)
than non-surrogates (15%, p<. 01) in FET [frozen embryo transfer]
cycles. Although there were no significant differences in clinical
pregnancy rates between the surrogate (73%) and non-surrogate (65%)
groups for fresh embryo transfer cycles, surrogates had a
significantly higher pregnancy rate (74%) than non-surrogates (43%,
p<. 025) in FET cycles. There were no significant differences in
miscarriage rates between these groups."'
Other factors concern your situation, however, that this study does
not focus on, including the age of the egg donor and age of the
surrogate and their past success rates.
In 1992, Congress passed the Fertility Clinic Success Rate and
Certification Act, which requires the Centers for Disease Control
(CDC) to publish success rates of ART (Assisted Reproductive
Technology) annually. The ART study also includes other procedures
involving ART besides IVF in its calculations, so afterwards I have
included data on IVF only. Since the CDC has to follow up and see if
the pregnancies resulted in live births, there is a lag in data and
the latest report concerns 2003 levels of success.
Here is the ART annual report's website:
http://www.cdc.gov/ART/ART2003/index.htm
Success of IVF cycles
What are the success rates for different kinds of procedures?
http://www.cdc.gov/ART/ART02/section2c.htm
From this data, you may want to look into ICSI (injecting the embryo
directly with the sperm) as that shows higher fertility rates for
couples with a low male fertility rate.
"In every age group, success rates for the IVF with ICSI group were
similar to the success rates for the groups that used standard IVF
without ICSI. These results show that when ICSI was used for couples
diagnosed with male factor infertility, their success rates were close
to those achieved by couples who were not diagnosed with male factor
infertility."
CDC success of different procedures
http://www.cdc.gov/ART/ART02/sect2_fig25-32.htm#Figure%2026
* IVF without ICSI (intracytoplasmic sperm injection), 34.0%
* IVF with ICSI, 31.9%
* GIFT 25.4%
* ZIFT 26.3%
* Combination of IVF with or without ICSI and either GIFT or ZIFT, 22.9%
Gestational Pregnancies
http://www.cdc.gov/ART/ART02/sect2_fig25-32.htm#Figure%2030
" (Note: Age categories reflect the age of the ART patient, not the
age of the gestational carrier.)
As you can see, the rates of success go down as a woman gets older,
but that is because of the quality of her eggs, so a person using
donor eggs would have a higher success rate. Go by the age of your
egg donor and that might give you an idea of how much more successful
the procedure would be with a proven surrogate.
It can safely be said that these stats are most likely consistent with
just IVF and surrogacy, because I can't foresee a reason why a doctor
would put a surrogate through GIFT or ZIFT. Keep in mind that GIFT and
ZIFT may have been used, though.
* Age <35 Live births per transfer, did not use gestational carrier, 42.9%
* Age <35 Live births per transfer, used gestational carrier, 55.3%
* Age 35?37 Live births per transfer, did not use gestational carrier, 37.0%
* Age 35?37 Live births per transfer, used gestational carrier, 47.3%
* Age 38?40 Live births per transfer, did not use gestational carrier, 26.4%
* Age 38?40 Live births per transfer, used gestational carrier, 28.1%
* Age >40 Live births per transfer, did not use gestational carrier, 12.1%
* Age >40 Live births per transfer, used gestational carrier, 26.3%"
ART Cycles Using Donor Eggs:
http://www.cdc.gov/ART/ART2003/section4.htm
Here is a chart that graphs the success of ART cycles when using donor eggs:
CDC ART Figure 39
http://www.cdc.gov/ART/ART2003/sect4_fig38-42.htm#Figure%2039
Here are the results year-by-year, comparing using a woman's own eggs
to using donor eggs:
(Comparing live birth rates)
CDC Art Results
http://www.cdc.gov/ART/ART2003/sect4_fig38-42.htm#Figure%2039
Age 25, Own eggs 49.2%, Donor eggs 65.2%
Age 26, Own eggs 43.6%, Donor eggs 50.0%
Age 27, Own eggs 44.2%, Donor eggs 37.0%
Age 28, Own eggs 45.0%, Donor eggs 48.1%
Age 29, Own eggs 46.7%, Donor eggs 61.4%
Age 30, Own eggs 44.8%, Donor eggs 52.9%
Age 31, Own eggs 44.6%, Donor eggs 59.8%
Age 32, Own eggs 42.5%, Donor eggs 49.5%
Age 33, Own eggs 40.4%, Donor eggs 54.0%
Age 34, Own eggs 40.7%, Donor eggs 51.7%
Age 35, Own eggs 38.8%, Donor eggs 58.3%
Age 36, Own eggs 36.6%, Donor eggs 54.0%
Age 37, Own eggs 34.1%, Donor eggs 51.7%
Age 38, Own eggs 29.1%, Donor eggs 54.5%
Age 39, Own eggs 27.4%, Donor eggs 47.9%
Age 40, Own eggs 20.7%, Donor eggs 50.7%
Age 41, Own eggs 17.0%, Donor eggs 51.2%
Age 42, Own eggs 12.4%, Donor eggs 49.5%
Age 43, Own eggs 7.6%, Donor eggs 54.9%
Age 44, Own eggs 4.2%, Donor eggs 50.9%
Age 45, Own eggs 3.0%, Donor eggs 48.7%
Age 46, Own eggs 4.6%, Donor eggs 45.7%
Age 47, Own eggs 4.2%, Donor eggs 44.6%
These all are stats of people using fresh donor eggs, live births once
they have been inseminated:
# Age 25, Live births 65.2%, Singleton Live births 26.1%
# Age 26, Live births 50.0%, Singleton Live births 40.9%
# Age 27, Live births 37.0%, Singleton Live births 26.1%
# Age 28, Live births 48.1%, Singleton Live births 19.2%
# Age 29, Live births 61.4%, Singleton Live births 40.4%
# Age 30, Live births 52.9%, Singleton Live births 34.1%
# Age 31, Live births 59.8%, Singleton Live births 29.5%
# Age 32, Live births 49.5%, Singleton Live births 26.9%
# Age 33, Live births 54.0%, Singleton Live births 33.7%
# Age 34, Live births 51.7%, Singleton Live births 29.2%
# Age 35, Live births 58.3%, Singleton Live births 34.4%
# Age 36, Live births 54.0%, Singleton Live births 32.7%
# Age 37, Live births 51.7%, Singleton Live births 29.7%
# Age 38, Live births 54.5%, Singleton Live births 31.9%
# Age 39, Live births 47.9%, Singleton Live births 28.8%
# Age 40, Live births 50.7%, Singleton Live births 29.0%
# Age 41, Live births 51.2%, Singleton Live births 31.2%
# Age 42, Live births 49.5%, Singleton Live births 30.3%
# Age 43, Live births 54.9%, Singleton Live births 32.9%
# Age 44, Live births 50.9%, Singleton Live births 33.2%
# Age 45, Live births 48.7%, Singleton Live births 27.9%
# Age 46, Live births 45.7%, Singleton Live births 25.1%
# Age 47, Live births 44.6%, Singleton Live births 27.0%
(As you can see, using this method also substantially increases the
number of muliple births!)
Now, after the clinic you want to use gives you their data, you can
check for them on this CDC website and see if their numbers check out:
Fertility Clinics-- California
http://apps.nccd.cdc.gov/ART2003/clinlist03.asp?State=CA
Here are all the American fertility clinics in case you want to browse
some others. Just click on the state and you'll see a list like the CA
one above.
American Fertility Clinics
http://apps.nccd.cdc.gov/ART2003/clinics03.asp
Here is a guide to reading the fertility clinics' data:
How to Read the CDC Fertility Clinic Charts
http://infertility.suite101.com/article.cfm/ivf_cdc_tables
Here is a summary of the ART report results. Fresh donor eggs resulted
in a 51% live birth rate.
"Assisted reproductive technology surveillance--United States, 2003."
* Wright VC,
* Chang J,
* Jeng G,
* Macaluso M.
Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Atlanta, GA 30341, USA.
vwright@cdc.gov
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16723970&query_hl=1&itool=pubmed_docsum
"Nationwide, 74% of ART procedures used freshly fertilized embryos
from the patient's eggs; 14% used thawed embryos from the patient's
eggs; 8% used freshly fertilized embryos from donor eggs; and 4% used
thawed embryos from donor eggs. Overall, 42% of ART transfer
procedures resulted in a pregnancy, and 35% resulted in a live-birth
delivery (delivery of one or more live-born infants). The highest
live-birth rates were observed among ART procedures using freshly
fertilized embryos from donor eggs (51%)."
"Of 48,756 infants born through ART, 51% were born in multiple-birth
deliveries. The multiple-birth risk was highest for women who
underwent ART transfer procedures using freshly fertilized embryos
from either donor eggs (40%) or their own eggs (34%)."
"ART poses a major risk for multiple births. This risk varied
according to the patient's age, the type of ART procedure performed,
the number of embryos transferred, and embryo availability (an
indicator of embryo quality). PUBLIC HEALTH ACTIONS: ART-related
multiple births represent a sizable proportion of all multiple births
nationwide and in selected states. Efforts should be made to limit the
number of embryos transferred for patients undergoing ART. In
addition, adverse infant health outcomes (e.g., low birthweight and
preterm delivery) should be considered when assessing the efficacy and
safety of ART."
(Keep in mind that infants with a low birth weight, as multiple birth
infants usually are, are at risk for many more health problems and
dangers than if they had a normal birth weight; this accounts for that
warning.)
The fact that both the donor and the surrogate mother have had
previous successful pregnancies/live births bodes well for the
success, too. Women who have previously been successful are more
successful than others.
"Factors Affecting IVF Success Rate"
http://www.ivf-infertility.com/ivf/standard/factors/couples.php
"Woman has never been pregnant 12.5%
Woman conceived naturally but no live birth 13.7%
Woman conceived naturally and has a live birth 15.3%
Woman conceived by IVF but no live birth 16.6%
Woman conceived by IVF and has a live birth 23.2%"
According to that same page, you would have a higher success rate for
IVF with donor eggs, and also with donor sperm.
"Own eggs and sperm 15.4%
Own eggs and donor sperm 19.9%
Own sperm and donated eggs 21.9%
Donated eggs and donor sperm 22.2%"
-----------
Considering the severity of this decision, I recommend that you write
or call the CDC and ask them for more information about their
statistics involving egg donors and if they have any information on
success rates of egg donors combined with gestational carriers. I
would ask what percentage of the egg donors participated in IVF and
what percentage participated in ZIFT and GIFT and what those
individual rates of success were.
Sources:
Reproductive Sciences Center
http://www.fertile.com/research.html
"Surrogacy: Practical Medical Aspects"
http://www.surrogacy.com/medres/article/aspects.html
Search terms:
(on Pubmed)
CDC assisted reproductive technology
(on Google)
surrogacy success rate
art statistics American Society for Reproductive Medicine
sart report
ivf live birth rate cdc
donor egg ivf gestational study
If you need any additional clarification of my answer before rating,
let me know and I'll be happy to assist you.
--keystroke-ga |
