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Embryo Banking for Delayed Child-Bearing and Poor Responders
April 18, 2013
Embryo banking, also known as embryo stockpiling or staggered in vitro fertilization (IVF) is a fertility treatment offered to women who wish to bank embryos to delay child-bearing, anticipate having surgery which may interfere with the timing of an embryo transfer, or women who have demonstrated a poor response to traditional stimulation cycles.
Depending on the number of mature eggs retrieved, a woman could complete one or several cycles of ovarian stimulation with fertility drugs, sometimes back to back. A fertility doctor can then freeze the embryos for future use or allow the pool of embryos to undergo one round of preimplantation genetic diagnosis (PGD) to test for genetic abnormalities. For women with a history of pregnancy loss and poor response to ovarian stimulation drugs (typically those of advanced maternal age or with ovarian reserve issues), this technique is both cost and time efficient and delivers an increased chance of successful pregnancy.
John Orris, M.D. of Main Line Fertility in Bryn Mawr, Pennsylvania, believes embryo banking is a viable option for fertility preservation or women with a history of suboptimal egg retrieval results. “Embryo banking is a good option for women who want to delay childbearing, but also want to use present day embryos. If a woman is a working professional or is about to undergo abdominal myomectomy, she might want to freeze her embryos. Another time a woman might consider embryo banking is if her embryos are subject to PGD. If eight to ten eggs are retrieved in one cycle, she might not have to complete another stimulation cycle, but especially for women over 40, if only a few eggs are retrieved, she might want to do another stimulation cycle to produce more eggs,” he says. The decision to complete back to back stimulation cycles is made by the fertility doctor on a per patient basis.
In addition to cost and time savings, embryo banking gives embryologists greater ability to choose an embryo most likely to develop into a healthy pregnancy. “The benefit of embryo banking is that there are more embryos to observe and examine, and more to biopsy with PGD. In most cases, it is the same price to PGD three embryos or ten embryos,” Orris states. He advises that a patient with low Anti-Mullerian Hormone (AMH), high Follicle Stimulating Hormone (FSH), or history of minimal stimulation response may not be a candidate for embryo banking if it is believed their success rates would be higher with egg donation. It is important to consider the prognosis of embryo banking compared to IVF with donor eggs and to treat the patient accordingly.
Embryo banking provides a sense of reassurance to women who wish to store younger embryos for future use and for those who need to feel as though they have tried all reproductive options with their own eggs before moving on to egg donation.