N.I Sesina*, V.R. Aleksandrova, K.V. Krasnopolskaya IVF Programs using Embryos obtained from Vitrified and Native Donor Oocyte N.I Sesina*, V.R. Aleksandrova, K.V. Krasnopolskaya PRIOR Clinic International Clinic”Family” Moscow Regional Institute of Obstetrics and Gynecology RUSSIA MOSCOW

Evolution of reproductive life century ХХI century 35 years Early marriage. Repeated pregnancies, childbirth, lactation → Prolonged amenorrhoea (during life not more than 40 menstrual cycles) → Low probability of gynecological diseases Conscious rejection of pregnancy ("social infertility") → Increase in the number of menstrual cycles in dozens of times (> 400 menstruation) → Increase in the frequency of gynecological diseases

Pregnancy rate in IVF programs depending on age (Prior Clinic 2016)

The frequency of pregnancy on the transfer of embryos Frequency of live births ≤35 35-37 38-40 ≥41 Frequency of pregnancy, % 46,7% 37,8% 29,7% 19,8% Frequency of live births, % 40,7% 31,3% 22,2% 11,8% ASRM, 2014

Patients interested in cryopreservation of oocytes Patients before surgery on the ovaries Patients before gonadotoxic therapy If the patient wishes to preserve her genetic material (in the absence of a sexual partner and planning a pregnancy at a later age

Indications for use of donor oocytes Absence of oocytes due to natural menopause Ovarian depletion syndrome The condition after ovariectomy, radio or chemotherapy, Sheriszewski-Turner Syndrome Low quality oocytes Unsuccessful repeated attempts of IVF with insufficient ovarian response to induction of superovulation (poor response) Repeated reception of embryos of poor quality Multiple undeveloped pregnancies Genetic pathologies making it impossible to have one's own healthy child

Strategies for donor programs Оocyte Vitrification Оocyte thawing Fertilization Embryo transfer Embryo cultivation Embryo cryopreservation

The results of the IVF-OD program. Vitrified DO Thawing embryo from DO Fresh DO Cycles 42 101 188 ET 36 94 169 Pregnancies 9 69 Pregnancy rate 25% 40,8% 44,6% Number of transferred embryos 78 186 405 Sacs 14 47 92 Implantation rate (on embryo) 17,9% 25,3% 22,71%

Program IVF-OD with vitrified oocytes 100% 90,4% 63,2% 25,4%

Reproductive losses 11% 14,3% no statistically significant differences

Сonclusions There are no statistically significant differences in the efficacy of IVF between groups of patients using for the fertilization native oocytes. The use of vitrified oocytes for the fertilization in donor programs significantly reduces the effectiveness of the IVF program. To achieve an increase in the effectiveness of IVF with vitrified donor oocytes is possible with an increase in the number of fertilized oocytes

Vitrified donor oocyte??? BANK OF DONOR OOCYTE 1)Opportunities for the selection of a donor 2) No synchronization needed 3) More simple mangement 4) The possibility of transporting oocytes

In Germany, Norway, Sweden, programs with donors of oocytes are prohibited In Israel, the United Kingdom, Canada, programs with gratuitous donation of oocytes are allowed In Spain, Portugal, Greece, Belgium, Finland and Russia there are no bans, but these programs are not financed by the state, so they are possible both altruistically and on a commercial basis.

Thank you for attention