Utilization of third-party in vitro fertilization in the United States

Published:November 14, 2016DOI:


      The use of in vitro fertilization that includes third-party in vitro fertilization is increasing. However, the relative contribution of third-party in vitro fertilization that includes the use of donor oocytes, sperm, or embryo and a gestational carrier to the birth cohort after in vitro fertilization is unknown.


      The purpose of this study was to examine the contribution of third-party in vitro fertilization to the in vitro fertilization birth cohort over the past decade.

      Study Design

      This retrospective analysis investigated 1,349,874 in vitro fertilization cycles that resulted in 421,525 live births and 549,367 liveborn infants in the United States from 2004–2013. Cycles were self-reported by fertility centers to a national registry: Society for Assisted Reproductive Technologies Clinic Outcome Reporting System.


      Third-party in vitro fertilization accounted for 217,030 (16.1%) of all in vitro fertilization cycles, 86,063 (20.4%) of all live births, and 115,024 (20.9%) of all liveborn infants. Overall, 39.7% of third-party in vitro fertilization cycles resulted in a live birth, compared with 29.6% of autologous in vitro fertilization cycles. Use of third-party in vitro fertilization increased with maternal age and accounted for 42.2% of all in vitro fertilization cycles and 75.3% of all liveborn infants among women >40 years old. Oocyte donation was the most common third-party in vitro fertilization technique, followed by sperm donation. Over the study period, annual cycle volume and live birth rates gradually increased for both autologous in vitro fertilization and third-party in vitro fertilization (P<.0001 for all). Live birth rates were the highest when multiple third-party in vitro fertilization modalities were used, followed by oocyte donation.


      Third-party in vitro fertilization use and efficacy have increased over the past decade, now comprising >20% of the total in vitro fertilization birth cohort. In women who are >40 years old, third-party in vitro fertilization has become the dominant treatment.

      Key words

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        • Gleicher N.
        • Kushnir V.A.
        • Weghofer A.
        • Barad D.H.
        The “graying” of infertility services: an impending revolution nobody is ready for.
        Reprod Biol Endocrinol. 2014; 12: 63
        • Center for Disease Control and Prevention, American Society for Reproductive Medicine, and Society for Assisted Reproductive Technology
        2012 Assisted reproductive technology success rates: national summary and fertility clinic reports.
        US Department of Health and Human Services, Washington (DC)2014
        • Baker V.L.
        • Luke B.
        • Brown M.B.
        • et al.
        Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System.
        Fertil Steril. 2010; 94: 1410-1416
        • Fujimoto V.Y.
        • Luke B.
        • Brown M.B.
        • Jain T.
        • Armstrong A.
        • Grainger D.A.
        • Hornstein M.
        Racial and ethnic disparities in assisted reproductive technology (ART) outcomes in the United States.
        Fertil Steril. 2010; 93: 382-390
        • Yeh J.S.
        • Steward R.G.
        • Dude A.M.
        • Shah A.A.
        • Goldfarb J.M.
        • Muasher S.J.
        Pregnancy outcomes decline in recipients over age 44: an analysis of 27,959 fresh donor oocyte in vitro fertilization cycles from the Society for Assisted Reproductive Technology.
        Fertil Steril. 2014; 101: 1331-1336
        • Luke B.
        • Brown M.B.
        • Wantman E.
        • et al.
        Cumulative birth rates with linked assisted reproductive technology cycles.
        N Engl J Med. 2012; 366: 2483-2491
        • Kawwass J.F.
        • Monsour M.
        • Crawford S.
        • et al.
        Trends and outcomes for donor oocyte cycles in the United States, 2000-2010.
        JAMA. 2013; 310: 2426-2434
        • Perkins K.M.
        • Boulet S.L.
        • Jamieson D.J.
        • Kissin D.M.
        Trends and outcomes of gestational surrogacy in the United States.
        Fertil Steril. 2016; 106: 435-442.e2
        • Seifer D.B.
        • Minkoff H.
        • Merhi Z.
        Putting ‘family’ back in family planning.
        Hum Reprod. 2015; 30: 16-19
        • Kushnir V.A.
        • Barad D.H.
        • Gleicher N.
        Ovarian reserve screening prior to contraception?.
        Reprod Biomed Online. 2014; 29: 527-529
        • Kushnir V.A.
        • Barad D.H.
        • Albertini D.F.
        • Darmon S.K.
        • Gleicher N.
        Outcomes of fresh and cryopreserved oocyte donation.
        JAMA. 2015; 314: 623-624
        • Kushnir V.A.
        • Gleicher N.
        Fresh versus cryopreserved oocyte donation.
        Curr Opin Endocrinol Diabetes Obes. 2016; 23: 451-457
        • Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology
        Repetitive oocyte donation: a committee opinion.
        Fertil Steril. 2014; 102: 964-966
        • Ethics Committee of American Society for Reproductive Medicine
        Informing offspring of their conception by gamete or embryo donation: a committee opinion.
        Fertil Steril. 2013; 100: 45-49