Analysis: Use of Fresh Donor Eggs in IVF Has Small Advantage in Birth Outcomes

Using freshly donated eggs for women undergoing in-vitro fertilization (IVF) provides a small but statistically significant advantage in birth outcomes compared to frozen donated eggs, according to a new study led by a Duke Health researcher. 

The national study, publishing online Feb. 6 in the journal Obstetrics & Gynecology, was the largest head-to-head comparison of the two IFV approaches, measuring the likelihood of a good perinatal outcome, defined as a single baby without prematurity and with a healthy birth weight.

“Our study found that the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference,” said lead author Jennifer L. Eaton, M.D., medical director of Assisted Reproductive Technology and director of the Oocyte Donation Program at the Duke Fertility Center.

“From a clinical standpoint, given that frozen eggs have many benefits such as ease, cost, and speed, the decision to use fresh or frozen donor eggs should be made on an individual basis after consultation with a physician,” Eaton said.

While statistically significant, the benefit over frozen eggs should be weighed among numerous factors

Eaton and colleagues, including senior author Alex Polotsky, M.D., of the University of Colorado Advanced Reproductive Medicine, studied three years of data from the Society for Assisted Reproductive Technology. Nearly 37,000 IVF attempts were analyzed, including 8,381 (22.7%) that used frozen eggs and 28,544 (77.3%) using fresh.   

Controlling for factors such as the quality of fertilized eggs and the age of both mother and donor, the researchers found that fresh eggs resulted in a good perinatal outcome in 24% of fertility attempts compared to 22% of the attempts with frozen eggs. Implantation, clinical pregnancy, and live birth rates were all significantly higher among the women using fresh eggs vs. frozen.

“As IVF with donor oocytes has become standard treatment for women with decreased egg supply or advanced reproductive age, there has been an increased demand for donor oocytes, making frozen eggs an attractive option,” Eaton said. “In general, IVF with frozen donor eggs is cheaper and faster than with fresh donor eggs.

“It’s important for physicians and their patients to understand the risks and benefits of using either fresh or frozen eggs,” Eaton said. “This study provides the best data to date, showing a slight advantage to using fresh eggs. Physicians should weigh this new finding against the known advantages of frozen eggs when counseling their patients.”
In addition to Eaton and Polotsky, study authors include Tracy Truong and Yi-Ju Li. 

The study received support from the Clinical Research/Reproductive Scientist Training Program (CREST), National Institute of Child Health and Human Development (R25HD075737), National Institutes of Health, Clinical Research Training Program at Duke University, The American Society for Reproductive Medicine, and The Society for Assisted Reproductive Technology.

Study authors reported no conflicts.

This article was originally published in Duke Health News