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Gestational carrier in assisted reproductive technology.

Gayathree Murugappan1, Leslie V Farland2, Stacey A Missmer3

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Gestational carriers (GCs) improve live birth rates (LBRs) in in vitro fertilization (IVF) cycles compared to non-GC cycles. The highest LBRs were observed in women with uterine-factor infertility using GCs.

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Area of Science:

  • Reproductive Medicine
  • Infertility Treatment
  • Assisted Reproductive Technology

Background:

  • In vitro fertilization (IVF) is a cornerstone of assisted reproductive technology (ART).
  • Gestational carriers (GCs) are increasingly utilized in ART for specific patient populations.
  • Comparing outcomes between cycles with and without GCs is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To compare the clinical outcomes of IVF cycles utilizing gestational carriers (GCs) versus cycles without GCs.
  • To evaluate the impact of GCs on live birth rates (LBRs) and multiple birth rates.
  • To identify patient subgroups that benefit most from GC use.

Main Methods:

  • Retrospective cohort study analyzing ART cycles.
  • Inclusion of cycles with (24,269) and without (1,313,452) GC use.
  • Analysis encompassed autologous and donor oocyte cycles, as well as fresh and cryopreserved embryo transfers.

Main Results:

  • Approximately 2% of embryo transfers involved GCs.
  • GC cycles demonstrated higher pregnancy rates and LBRs compared to non-GC cycles across various IVF types.
  • Women with uterine-factor infertility showed significantly higher odds of live birth with GC use for both fresh autologous and cryopreserved embryos.

Conclusions:

  • Gestational carriers can enhance LBRs for select patients undergoing ART.
  • The most substantial benefits in LBRs were noted when GC use was indicated for uterine-factor infertility.
  • GCs represent a valuable option for improving ART success rates, particularly in cases of uterine pathology.