Definitions

• Usable embryo: A day 3, 5 or 6 embryo that is either (i) deemed “usable” by embryology lab if no PGT testing has been performed; or (ii) a euploid embryo if PGT-A testing has been performed.
• Recurrent Pregnancy Loss: A pregnancy that ended unintentionally prior to live birth (e.g. miscarriage, ectopic).

Background

Applies to both autologous and donor eggs (S4016, S4015, S4023, etc.)

Embryo banking is a form of fertility preservation where members may choose to create embryos and cryopreserve them for future use, defined as a year of a year after creation. Embryo production without a concomitant attempt to transfer the embryo is clinically inappropriate after three Usable Embryos have been created.

Embryo Banking Policy

Additional embryo banking cycles will not be authorized once a maximum of three (cleavage, day 5 or day 6 non-PGT screened; PGT-A euploid) embryos have been cryopreserved.

Additional Considerations

1. Additional consideration will be given for requests where embryos are only aneuploid or otherwise abnormal or mosaic embryos.
2. A patient with a history of recurrent pregnancy loss.
3. Patient has undergone 3 or more failed embryo transfers (negative pregnancy test) without an intervening pregnancy.
4. Patient is facing (within the next 12 months) impending permanent infertility due to gonadotoxic therapy for cancer or gonadaectomy for cancer or (within the next 12 months) impending medical/reproductive surgical treatment (ie gonadectomy) for gender dysphoria.

References

1. Mejia RB, Capper EA, Summers KM, Ten Eyck P, Van Voorhis BJ. Elective transfer of one embryo is associated with a higher cumulative live birth rate and improved perinatal outcomes compared to the transfer of two embryos with in vitro fertilization. Fertility and Sterility Reports. November, 2020.
2. Pirtea P, De Ziegler D, Tao X, Sun L, Zhan Y, Ayoubi JM, Seli E, Franasiak JM, Scott RT Jr. Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers. Fertility and Sterility. January, 2021.
3. Munne S, Kaplan B, Frattarelli JL, Child T, Nakhuda G, Shamma FN, Silverberg K, Kalista T, Handyside AH, Katz-Jaffe M, Wells D, Gordon T, Stock-Myer S, Willman S; STAR Study Group. Preimplantation genetic testing for aneuploidy versus morphology as selection criteria for single frozen-thawed embryo transfer in good-prognosis patients: a multicenter randomized clinical trial. Fertility and Sterility. December, 2019.
4. Sordia-Hernandez LH, Morales-Martinez FA, Gonzalez-Colmenero FD, Flores-Rodriguez A, Leyva-Camacho PC, Sordia-Pineyro MO, Valdes-Martinez OH, Garcia-Luna SM, Rodriguez-Guajardo R, Sordia-Pineyro LH. The Effects of Preimplantation Genetic Testing for Aneuploidy (PGT-A) on Patient-Important Outcomes in Embryo Transfer Cases: A Meta-Analysis. Journal of Reproduction and Infertility. October-December, 2022.
5. Sanders KD, Silvestri G, Gordon T, Griffin DK. Analysis of IVF live birth outcomes with and without preimplantation genetic testing for aneuploidy {PGT-A): UK Human Fertilization and Embryology Authority data collection 2016-2018. Journal of Assisted Reproduction and Genetics. December, 2021.
6. Mancuso AC, Boulet SL, Duran E, Munch E, Kissin DM, Van Voorhis BJ. Elective single embryo transfer in women less than age 38 years reduces multiple birth rates, but not live birth rates, in United States fertility clinics. Fertility and Sterility. October, 2016.
7. Mancuso, Abigail, Boulet, Sheree, Duran, E.H., Munch, Erika, Kissin, Dmitry, Voorhis, B.J., Live birth and multiple birth rates in women under age 38 by elective single embryo transfer (ESET) versus double embryo transfer (DET) in United States IVF clinics. Fertility and Sterility. September, 2016.