ART Embryo Transfers to Gestational Carriers Increased Chances of Pregnancy

NEW ORLEANS — Assisted reproductive technology (ART) cycles with an embryo transfer to a gestational carrier increased the likelihood of pregnancy and live birth, an analysis of national data from 2014 to 2020 showed.

In over 1 million ART cycles with an embryo transfer, those with a gestational carrier were more likely to result in pregnancy, clinical pregnancy, and live birth compared with those without a gestational carrier, reported Lisa M. Shandley MD, MSc, of the Emory Reproductive Center in Atlanta, during the American Society for Reproductive Medicine annual meeting:

Pregnancy: 73% vs 63.4% (adjusted relative risk [RR] 1.06, 95% CI 1.06-1.07)Clinical pregnancy: 63.7% vs 52.9% (aRR 1.09, 95% CI 1.08-1.10)Live birth: 54.3% vs 43.6% (aRR 1.11, 95% CI 1.10-1.12)

The study findings were simultaneously published in a research letter in JAMA.

During her presentation, Shandley defined a gestational carrier as “a person who carries a pregnancy on behalf of intended parents following implantation of an embryo that was created using gametes that originated from the intended parents or a third party.”

All but three U.S. states reported at least one embryo transfer to a carrier, and more than a third of gestational carrier cycles occurred in California.

“Despite several states having laws that deemed surrogacy illegal during the course of the study, many of them still reported embryo transfers to GCs [gestational carriers],” Shandley said.

Over the study period, use of embryo transfers increased, with an exception for 2020, which Shandley noted reflects the impact of COVID pandemic shutdowns on non-emergency medical care, such as ART procedures.

In 2014, the percentage of gestational carrier cycles was 2.7%, which grew to 5.2% in 2019, then decreased in 2020 to 4.6% (P
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