The Human Fertilisation and Embryology Authority’s report found a significant trend in the current state of fertility treatments: that being the number of egg donation cycles performed in the UK has increased.
In fact, UK-based egg donation cycles have increased 50-fold, from 27 cycles in 1991 to 1,375 in 2019. Similarly, procedures involving donor eggs and partner sperm have also increased 22-fold, to 3,058 cycles in 2019.
In total, 4,433 egg donation cycles were successfully completed in the UK in 2019.
Why is UK-egg donation on the rise?
The HFEA attributes this increase in part due to the increase in the number of older patients requiring the use of donor eggs. Whilst only 17% of patients aged over 40 used donor eggs in 2019, this rose to 57% for patients aged over 45, therefore there was a noticeable trend where the use of eggs increased with age.
They revealed that 8% of patients aged 40-42 used donor eggs, 21% of patients aged 43-44, and 57% of patients aged 45-50. With all patients, irrespective of age, a live birth rate of over 30% was present.
This is a trend that has already been reported in the USA by the United States Centres for Disease Control Prevention. They discovered that 12% - 25,321 out of 196,454 – of all treatment cycles were egg donation, typically involving older patients.
The shift from treatment abroad
The report would likely also have noted a trend of UK patients undergoing egg donation treatment in clinics overseas. This pattern of cross-border care has already been previously analysed in studies from the European Society of Human Reproduction and Embryology.
The Human Reproduction journal has also confirmed this; noting that a large number of UK patients were travelling abroad for fertility treatments, as well as purchasing donor eggs and sperm that were, in turn, being sent across borders and between countries.
However, this process pulled to a halt in March 2020.
The outbreak of the Covid-19 pandemic undoubtedly impacted the ability of patients to travel overseas for fertility treatment, as well as purchase overseas donations.
With many of the clinics typically visited in countries like Ukraine, Spain, the USA, and Cyprus being out of bounds in 2020 and still heavily restricted in 2021, patients had to turn to clinics at home. However, this proved not to be an issue for those seeking donor eggs, as London Egg Bank has so far engaged with almost 50,000 young women who are interested in becoming egg donors.
As such, we can say with confidence thanks to our observations at London Egg Bank that the UK has now become the primary source of donor eggs for UK patients.
Egg donation has come home.
The ability of frozen eggs to retain the same viability as fresh eggs once warmed has opened up greater possibilities for patients seeking treatment.
The impact of vitrification
What’s more, even when we factor the impacts of Covid-19 into our observations, there is still a significant shift in locations patients are sourcing their donor eggs from; a shift which we predicted in the 2020 journal Reproductive Biomedicine Online.
Writing then, we forecasted that using frozen eggs “will quickly become the default standard practice in egg donation”. This is in contrast to the previous use of ‘fresh’ donor eggs from patients participating in IVF egg collections as egg sharers.
As such, we have found that there is no longer a need for patients to travel abroad or wait long periods of time for a desirable donor to become available.
Now, a greater choice of donors at home, alongside the development of vitrification technology – a technique that allows us to fast-freeze eggs and transform them into a glasslike state – has allowed the UK to compete with the demand from patients that usually would have been fulfilled by overseas clinics.
The UK, home to frozen donor eggs
In our more recent publication in the journal Reproductive Biomedicine Online, we analysed almost 500 egg freezing cycles and subsequent transfers in 705 recipients. This group of patients was sourced from London Egg Bank’s website, social media, and seminars; and found an overall live birth rate of 37.9%. Estimates of cumulative live birth rates after three embryo transfers exceeded 60%.
This study undeniably proves the viability of frozen donor eggs, and the ability of the UK to meet the demand of egg donors from altruistic, UK born donors.
Coinciding with the findings from the HFEA’s report, recipients in this study were found to have a median age of 44 years. Both age and low ovarian reserve were the most common reasons for seeking treatment.
Whilst one study from Spain in a large group of egg donation patients primarily sought to compare the outcomes of frozen and fresh donor eggs, and a USA-based study primarily involved the transfer of multiple embryos, results from our study compare well with the results from these.
Our study, conducted over three years, involved a consecutive group of treatments only with frozen-thawed eggs. A single embryo transfer rate of 87% was reached.
Overall, results from the HFEA’s report and our studies should instil confidence in patients.
Whilst individual predictive factors relating to the donor do have an impact on the outcome, patients should be reassured that a UK-based domestic egg donation programme can achieve the same excellent and desirable outcomes as other cryobanks abroad.
Whilst the Covid-19 pandemic has undoubtedly frustrated cross-border treatments, it’s clear that the UK can more than accommodate patients seeking egg donor treatments.
Frozen egg banking can flourish in the UK, and we are now in a position to meet the demands of patients implicit in the HFEA’s latest review.