Storing Frozen Embryos From First IVF Treatment May Be an Advantage

Women Have Good Chances of a Second IVF Pregnancy

May 8, 2020/ Source: Amanda D’Ambrosio, MedPage Today – Women who conceived their first child via assisted reproductive technology (ART) and returned for a second baby had better than even probability of getting pregnant again, according to a large population-based study.

After six complete cycles, women who recommenced ART treatment with previously frozen embryos had a cumulative live birth rate of 61% to 88%, depending on assumptions made about the likelihood of success in women who dropped out of treatment, reported Georgina Chambers, PhD, of the University of New South Wales in Sydney, Australia, and colleagues.

As shown in the team’s study online in Human Reproduction, for women who started in vitro fertilization (IVF) for their second baby with fresh embryos, cumulative live birth rates were between 51% and 70%.

Of more than 35,000 women in Australia and New Zealand who conceived a child via ART, 43% returned to treatment for a subsequent pregnancy, the researchers said.
“This is the first time that the estimates for the chances of having a second baby using IVF have been calculated,” Chambers told MedPage Today via email. “This is important because most couples want more than one child. And those that had to use IVF to achieve their first baby are likely to need IVF again.”

Alan Penzias, MD, director of the Fellowship Program in Reproductive Endocrinology and Infertility at Harvard Medical School in Boston, who was not involved with the study, commented that it reflects a shift in thinking about treatment for infertility.

“In the early days of IVF when success rates were low, the focus was getting to ‘the baby,'” he told MedPage Today. “Having a second child was rarely considered. Nowadays, we ask couples what they see as their ideal family size at the first visit, so understanding how likely a second child is after the first success becomes very relevant.”

Penzias added that the study not only helps physicians quantify the chances of a second IVF success, but also allows them to understand what characteristics lead to that success. “Having this information can help physicians understand who to counsel to persist and who should be counseled to think about other alternatives,” he said.

Around 15% of couples, or 180 million people worldwide, experience infertility, Chambers and colleagues wrote. The aim of their study was to identify factors associated with returning to ART treatment for a second child, and to calculate both cycle-specific and cumulative live birth rates.

The researchers looked at data from the Australian and New Zealand Assisted Reproduction Database for ART cycles performed from 2009 to 2015. The database includes all 90 fertility clinics in these two countries, which are required to report ART cycles for licensing agreements.

The study population included 35,290 women who had an ART-conceived infant, and received treatment from 2009 to 2013. Women were followed up for 2 to 7 years, and all live births up to 2016 were included. The researchers excluded cycles that used donated oocytes or embryos, as well as any treatment for the purpose of long-term oocyte or embryo storage only.
The group adjusted for women’s age, the cause of infertility at the second time of ART treatment, and the time between the first ART-conceived live birth and the second treatment, as well as the parity and characteristics of the first treatment.

More than 15,000 women returned to IVF treatment for their second child. Those who were nulliparous at the time of their first ART-conceived child and those who were younger were more likely to return, and were also more likely to have had a fresh embryo transfer, the researchers reported.

During the second ART treatment, women more likely to have a second live birth were younger, had frozen embryos stored from their first IVF treatment, had a shorter time between the birth of their first child and second treatment, and got pregnant in the first few cycles.

The live birth rate in the first complete cycle was 43.4% for those who used a frozen embryo from the previous treatment, and 31.3% for women who started a new ovarian stimulation cycle. Although cycle-specific live birth rates declined in successive cycles, cumulative live birth rates increased for all age groups up to six cycles.
Among women younger than 30, live birth rates were similar for those who started their second treatment with previously frozen or fresh embryos. Yet for older women, live birth rates were better for those who used frozen embryos.

Regarding the clinical implications, Penzias said: “For those patients who want more than one child, there may be an advantage to having frozen embryos available from the first IVF cycle to use as frozen embryos for the second child.”

Study limitations, Chambers and colleagues said, included that the research does not account for individual prognostic factors that may affect a woman’s chance of IVF success, including the duration of infertility, body mass index, and ovarian reserve. In addition, since use of IVF is high in Australia and since it is included in universal healthcare coverage, the study’s generalizability to other groups may be limited.

Primary Source: Human Reproduction
Source Reference: Paul RC, et al “Cumulative live birth rates for women returning to ART treatment for a second ART-conceived child” Hum Reprod 2020; DOI: 10.1093/humrep/deaa030.

World Record Shattered

August 24, 2012 – World Record for Birth through Cryopreserved Sperm is Broken

As a world record is broken, hope comes alive.

 

Late in August, twin girls were born to a couple who used in vitro fertilization (IVF) to achieve pregnancy. On the surface, this may look like just another of the increasingly common success stories for the IVF industry. But this story has its own unique twist that makes it different from every other IVF pregnancy—the sperm used to fertilize the egg was frozen over 40 years ago, shattering the existing record of 28 years for a successful live birth through cryopreserved sperm.

In the beginning.

In 1971, a Japanese American war hero banked his sperm with a sperm bank where Russ Bierbaum, a young pioneer in reproductive tissue cryopreservation, was the acting laboratory technician. The war hero was the “first born” of a proud Japanese family whose culture dictates the family blood line be carried on through the first born son. Shortly after learning he and his wife would never have children of their own, he discovered none of his siblings were going to be able to preserve the family blood line either. That’s when he started the journey to maintaining his heritage through a surrogate.

Having banked his sperm, he contacted a surrogate agency to find a mother for the child who would save his family’s blood line. In the years that followed, the dream faded—surrogates were hard to find and the few who were willing were unable to achieve successful pregnancies. Yet his hope remained undeterred; as a successful American businessman, he continued to put money into a trust that would one day provide for the child he remained committed to fathering. Ultimately, Family Formation Law Offices of Michelsen and Cohen were able to connect him with a couple who was seeking pregnancy through donor sperm and was eager to become part of a much greater story. In late fall of 2011, a successful pregnancy was announced, followed nearly nine months later with the birth of twin girls.

According to Russ Bierbaum, a pioneer in the human reproductive tissue specialty, the length of time human reproductive tissue can be frozen and successfully used is still unknown. “Cryobiologists [scientists who study ultra-low temperature storage] have calculated that it could be several thousand years…the birth of these twins brings us one step closer to that truth.” Bierbaum, an executive at ReproTech, Ltd.—the nation’s leader in long-term cryostorage—has played a key role in this particular pregnancy from the beginning. As previously mentioned, Bierbaum worked as a lab technician back in 1971 at the sperm bank where the donor’s sperm was first frozen. In the 40 years since, his organizations have handled much of the shipping and storage of the specimen.

“What is gratifying for us,” reports Bierbaum, “is that the systems and processes we’ve built for over 50 years are now proven. The specimen used in this birth was collected and preserved over 40 years ago. Since then it has been transferred across the country four times using our shipping tanks and the procedures we designed as well as our storage facilities. In my mind, the science of long-term storage and its efficacy was never in doubt. However, maintaining the integrity and safety of the specimen through multiple shipments has never been tested to this extent.”

ReproTech, Ltd., is a long-term cryostorage company with four locations throughout the United States. As the leading provider of long-term cryostorage services in the country, ReproTech had a vested interest in seeing the successful birth of these twins. “This is a huge seal of approval for the shipping processes, containers, and storage methods we’ve developed over the years,” said Bierbaum. “Perhaps the biggest reservation we hear among the IVF docs is their concern about the shipping and handling of precious specimens. Even though we successfully ship thousands of specimens a year, these births prove that our systems have been effective all along. It’s additional proof that we are the true leaders in the long-term storage and handling of reproductive tissue.”

The practical application.

Although the birth of these twins from 40 year old sperm is an unusual story, it does have a more immediate and practical application for cancer patients. People like Bierbaum have forever been preaching to oncology professionals that long-term storage is a viable option for children and young men and women to preserve their fertility prior to cancer treatments that will affect their future fertility. “This proves that a young male can effectively store semen and confidently use it 20, 30, or 40 years later to start a family,” said Bierbaum. “We’re hoping this kind of news will convince oncology professionals to be more proactive about discussing future fertility with their patients and begin the necessary steps to assure that their patients have been informed.”

41 Years Ago, A Sperm Donation. Today, Twins.

May 2, 2013 – World Record for Birth through Cryopreserved Sperm is Broken

As a world record is broken, hope comes alive.

 

Late in August, twin girls were born to a couple who used in vitro fertilization (IVF) to achieve pregnancy. On the surface, this may look like just another of the increasingly common success stories for the IVF industry. But this story has its own unique twist that makes it different from every other IVF pregnancy—the sperm used to fertilize the egg was frozen over 40 years ago, shattering the existing record of 28 years for a successful live birth through cryopreserved sperm.

In the beginning.

In 1971, a Japanese American war hero banked his sperm with a sperm bank where Russ Bierbaum, a young pioneer in reproductive tissue cryopreservation, was the acting laboratory technician. The war hero was the “first born” of a proud Japanese family whose culture dictates the family blood line be carried on through the first born son. Shortly after learning he and his wife would never have children of their own, he discovered none of his siblings were going to be able to preserve the family blood line either. That’s when he started the journey to maintaining his heritage through a surrogate.

Having banked his sperm, he contacted a surrogate agency to find a mother for the child who would save his family’s blood line. In the years that followed, the dream faded—surrogates were hard to find and the few who were willing were unable to achieve successful pregnancies. Yet his hope remained undeterred; as a successful American businessman, he continued to put money into a trust that would one day provide for the child he remained committed to fathering. Ultimately, Family Formation Law Offices of Michelsen and Cohen were able to connect him with a couple who was seeking pregnancy through donor sperm and was eager to become part of a much greater story. In late fall of 2011, a successful pregnancy was announced, followed nearly nine months later with the birth of twin girls.

According to Russ Bierbaum, a pioneer in the human reproductive tissue specialty, the length of time human reproductive tissue can be frozen and successfully used is still unknown. “Cryobiologists [scientists who study ultra-low temperature storage] have calculated that it could be several thousand years…the birth of these twins brings us one step closer to that truth.” Bierbaum, an executive at ReproTech, Ltd.—the nation’s leader in long-term cryostorage—has played a key role in this particular pregnancy from the beginning. As previously mentioned, Bierbaum worked as a lab technician back in 1971 at the sperm bank where the donor’s sperm was first frozen. In the 40 years since, his organizations have handled much of the shipping and storage of the specimen.

“What is gratifying for us,” reports Bierbaum, “is that the systems and processes we’ve built for over 50 years are now proven. The specimen used in this birth was collected and preserved over 40 years ago. Since then it has been transferred across the country four times using our shipping tanks and the procedures we designed as well as our storage facilities. In my mind, the science of long-term storage and its efficacy was never in doubt. However, maintaining the integrity and safety of the specimen through multiple shipments has never been tested to this extent.”

ReproTech, Ltd., is a long-term cryostorage company with four locations throughout the United States. As the leading provider of long-term cryostorage services in the country, ReproTech had a vested interest in seeing the successful birth of these twins. “This is a huge seal of approval for the shipping processes, containers, and storage methods we’ve developed over the years,” said Bierbaum. “Perhaps the biggest reservation we hear among the IVF docs is their concern about the shipping and handling of precious specimens. Even though we successfully ship thousands of specimens a year, these births prove that our systems have been effective all along. It’s additional proof that we are the true leaders in the long-term storage and handling of reproductive tissue.”

The practical application.

Although the birth of these twins from 40 year old sperm is an unusual story, it does have a more immediate and practical application for cancer patients. People like Bierbaum have forever been preaching to oncology professionals that long-term storage is a viable option for children and young men and women to preserve their fertility prior to cancer treatments that will affect their future fertility. “This proves that a young male can effectively store semen and confidently use it 20, 30, or 40 years later to start a family,” said Bierbaum. “We’re hoping this kind of news will convince oncology professionals to be more proactive about discussing future fertility with their patients and begin the necessary steps to assure that their patients have been informed.”

The technical article related to this story, “Live births from frozen human semen stored for 40 years” was published in the April online issue of the Journal of Assisted Reproduction and Genetics.  The final publication is available at link.springer.com.

NASA Scientist Gives Birth Using Embryos Frozen for Nearly 19 Years

Source:  Reproductive Science Center of the Bay Area

SAN RAMON, Calif., Aug. 20, 2013 (GLOBE NEWSWIRE) — Kelly Burke – a 45-year-old NASA research scientist – looks upon her babbling baby and ponders the unique reality that his biological siblings, created from the same embryo cycle and born to another family 2,500 miles away, will be of voting age at the time of his first birthday this November. This story could, possibly, only be conceived by a rocket scientist.

Kelly gave birth to Liam James using what her doctor believes to be the second oldest cryopreserved human embryo in history.

Having submitted herself to numerous fertility treatments and years of trying to become pregnant, the Virginia Beach mother says she had finally abandoned the idea of ever using her own eggs. Weighing her waning options, Kelly discovered a couple from Oregon looking to donate four embryos.

“Embryos are not easy to come by and the opportunity came unexpectedly. I was excited by the idea of carrying my child,” says Kelly.

Although embryo adoption is significant in itself, the embryos Kelly would adopt had an even more amazing story.

Nineteen years earlier, a woman donated her eggs at Reproductive Science Center of the Bay Area (RSC). In 1994, the couple from Oregon had been struggling with infertility and decided to use these donated eggs while going through in vitro fertilization (IVF). They transferred two embryos and froze the remaining embryos that had been created during the process. Happily, they delivered fraternal twins from that IVF cycle.

The embryos remained frozen until 2012 when the Oregon couple was put into contact with Kelly who went through a rigorous adoption process. “I think the couple knows more about me than some of my family,” Kelly joked.

Kelly adopted four embryos and flew to RSC for the implantation.

“We were all very excited about the procedure,” recalls Dr. Deborah Wachs, a reproductive endocrinologist at RSC – the fertility clinic recognized for the nation’s second successful birth from a frozen embryo in 1986.

“As was practiced in the early 90s, the embryos had been developed to the day-2 stage and then frozen,” says Dr. Wachs. “Currently, we commonly transfer and freeze embryos at the day-5 stage because it allows us to better select the embryos that are more likely to result in a pregnancy.

“In Kelly’s case, we decided to thaw all four day-2 embryos and culture them in our IVF lab to the day-5 blastocyst stage. We were successful.”

The embryo donors and Kelly agreed to have an open embryo adoption, which means her nine-month-old will one day have the chance to know his siblings.

In 2010 the medical journal Fertility and Sterility reported, “19 years and 7 months […] represents the ‘oldest’ cryopreserved human embryos resulting in a live birth to date.”