The changing of IVF clinics business: international embryo migration does not affect clinical outcome

Abstract

Purpose: The regulated transportation of cryopreserved human embryos resulting from assisted reproduction treatments offers opportunities for patients to undergo embryo transfer in other regions/countries. However, with this new business for fertility clinics comes the concern of maintaining unaltered embryo quality to assure satisfactory clinical outcomes. The goal of this study was therefore to evaluate the efficacy of the transportation process by comparing the survival rate and competence of the transported embryos to embryos produced on-site. Methods:This retrospective study assessed the pregnancy outcomes of 608 single frozen embryo transfers at IVI Rome (Italy) between March 2021 and March 2022. Autologous or donated oocytes that were fertilized in vitro, cultured to the blastocyst stage, and cryopreserved in IVI Rome (Group A, n=440), were compared to embryos generated in Spanish IVI clinics and transferred to IVI Rome (Group B, n=168). Results: Groups A and B respectively showed no significant difference in embryo survival rates after thawing (N= 430/440, 97.7% vs. N=165/168, 98.21%, p=0.71), pregnancy rate (N=221/440, 50.23% vs. N=77/168, 45.83%, p=0.33), clinical pregnancy rate (N=200/440, 45.45% vs. N=62/168, 36.90%, p=0.06), and cumulative miscarriage rate (N=42/221, 19,00% vs. 22/77, 28.57%, p=0.07), even after taking into account embryos screened with preimplantation genetic testing. Conclusion: The regulated transport of cryopreserved embryos did not affect embryo survival rate or pregnancy outcomes. Our results support the safety of embryo cryopreservation and security of rapid medical shipping services, encouraging clinics and patients to transport their embryos with no significant risk to their competence.