Outcomes and efficiency of embryo donation: an 8-year retrospective analysis from a Belgian ART centre

The improvements in cryopreservation techniques led to an increasing number of frozen-thawed embryo transfers (FET) and a rise in the number of embryos stored in cryobanks. Embryo donation, even if underutilized, remains one option for unused remaining embryos in Belgium. This study aims to evaluate the management, efficiency, and operating costs of an embryo donation programme.

This is a retrospective single-centre study. Data were extracted from the IVF database of CHC MontLégia in Liège from 2014 to 2022 for the donor population analysis and from 2005 to 2023 for the results of donated FET cycles. The administrative costs are based on the gross hourly wage of the secretarial staff and head biologist. The biological costs are based on the prices applied in 2025 for the different laboratory tests.

Out of 3598 IVF treatments initiated from 2014 to 2022, 429 couples indicated their willingness to donate their surplus embryos, 211 confirmed their decision, and only 92 had surplus frozen embryos available at the time of the study. Among these 92 couples, only 22 met all eligibility requirements for embryo donation (0.61% of all initiated IVF treatments). From 2005 to 2023, a total of 112 FET cycles using donated embryos (DE) were performed, during which 173 embryos were transferred. Double embryo transfers (DETs) were performed in 66 cycles (58.9%), while single embryo transfers (SETs) were performed in 46 cycles (41.1%). The overall clinical pregnancy rate was 45.5% (51/112), and the live birth rate (LBR) was 29.6% (33/112). Blastocyst-stage embryos were transferred in 47 cycles, with a corresponding live birth rate of 31.9% (15/47). The mean age of recipients was 40.5 years. At the time of analysis, 31 recipients had completed their treatment and achieved parenthood, corresponding to a live birth rate per recipient couple of 52.5%. It was estimated that the biological screening and validation of a donor couple amounts to approximately €532.9 (administrative time) + €120.2 (serological screening for both partners) + €1343.7 (genetical screening for both partners) = €1996.8 CONCLUSIONS: Currently facing an increasing demand in gamete donation in Europe and a decrease in availability, embryo donation is an efficient alternative to double gametes donation which is underlined by the observed live birth rate of 31.9% per donated blastocyst transfer cycle in this Belgian embryo donation programme, despite the time-consuming process for its management.