Altruistic Donation of Surplus Embryos to Known and Unknown Recipients, The Dutch Approach

BACKGROUND: Previous studies have shown that embryo donation can be a successful treatment for infertile couples, however the willingness of Dutch couples to donate or accept embryos was unknown. The aim of this article is to describe the protocol and results for altruistic embryo donation of the only embryo bank in the Netherlands. MATERIALS AND METHODS: This is a descriptive study. Since 2011, donated cryo-embryos from couples that have undergone in vitro-fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments, are being stored in our embryo bank. The majority of the donated embryos were frozen on day 3 or 4 by slow freezing techniques. We perform a thorough medical and psychological screening of donor couples and recipients, according to the protocol drawn up in close collaboration with the Dutch Ministry of Health. RESULTS: Up to June 2021, 54 women have received embryos from our embryo bank, all single embryo transfers. While the clinical pregnancy rate in ‘unknown’ embryo donations was relatively high (25.3%), the live birth rate shows limited success (12.6%), partly due to high pregnancy loss through miscarriage. In known donation procedures, the recipients tend to undergo more procedures, depending on the number of donated cryo-embryos. Twentyeight women received embryos from known donors, with a clinical pregnancy rate per embryo transfer of 24%, and live birth rate of 14%. In total, 82 recipients were granted donated cryo-embryos, twenty had an ongoing pregnancy (24.4%), nineteen of whom have given birth to a healthy child (23%). CONCLUSION: Altruistic embryo donation of embryos appears to be satisfying for the donors, as they are not obliged to destroy their embryos, but instead help others build a family. Although success rates are still limited, partly due to the relatively high miscarriage rates and inferior freezing techniques, to this date nineteen out of 82 recipients have given birth to a healthy child.