FAQs & Regulations & Policies

Egg Retrieval

The Egg Yield vs. Quality Hypothesis

Researchers have investigated the hypothesis that a higher number of eggs, or oocyte yield, leads to more high-quality, chromosomally normal embryos. The study found that statistically, the more eggs retrieved, the more chromosomally normal embryos were available for transfer. The researchers found that it was a numbers game for all intents and purposes; the more chromosomally normal embryos available, the higher the cumulative chance of a live birth after that IVF cycle. This is because chromosomally normal embryos have the most significant potential for pregnancy.

However, the study found that the benefit of high egg yield decreased with age. Researchers found that to produce between 1 and 2 chromosomally normal embryos, between 5 and 14 eggs would be required if the patient was under 35. Therefore, if you’re under 35 and ask yourself, “I had eight eggs retrieved in IVF – is this good?” the answer is yes, it is. However, if you’re over 35, between 10 and 24 is arguably a more desirable yield.

This particular study also suggested that higher egg yields due to ovarian stimulation did not affect egg quality. However, this is a controversial debate; other studies have found that intense ovarian stimulation can negatively affect egg quality.

I Had 8 Eggs Retrieved in IVF – Is This Good? Is There an Optimum Number of Eggs?

While the debate about whether or not egg yield affects egg quality continues, several factors will impact the optimum egg yield depending on the individual case. For instance, age and ovarian reserve is an important variable. Equally, whether or not the embryo is transferred fresh or frozen can affect the outcome. There are also non-medical factors, such as laboratory procedures and, of course, the patient’s wishes.

While the evidence suggests that aiming for a high egg yield increases the risk of ovarian hyperstimulation syndrome (OHSS) is compelling, new methods can reduce this risk. Previously, an egg yield of any more than 15 was thought to be an indicator of OHSS. Therefore, if you’re thinking to yourself, “I had eight eggs retrieved in IVF – is this good?” then you can be confident you’re unlikely to be experiencing OHSS. However, fertility specialists are constantly working towards streamlining the IVF process. If patients can get pregnant in one IVF cycle, it can reduce the financial, physical, and emotional cost of fertility treatment.

What is the Average Number of Eggs Retrieved in IVF?

In vitro fertilization (IVF) treatment is different for everyone. Therefore, the average number of eggs retrieved in IVF depends on several factors. Every woman’s body will respond differently to the ovarian stimulation injections, which means that everyone will have a different number of eggs harvested during the egg retrieval procedure.

Generally speaking, the more eggs the fertility specialist has to work with, the greater the chances of success. This is because the more significant the yield, the more likely there will be a selection of high-quality fertilized eggs. However, there are nuances to this process. Below, we discuss the relationship between egg yield and live births.

Age and the Average Number of Eggs Retrieved in IVF

IVF success rates, egg yield, and age have a significant relationship. According to research, women aged under 35 have the highest success rates regardless of the number of eggs retrieved, with the proportion of live births increasing with the egg yield. However, this does not mean that women older than 35 do not have successful pregnancies. Women aged between 36–38 have a success rate of approximately 35%, with only 3–6 eggs. Nonetheless, the more eggs that the fertility specialist retrieves, the better the statistics. This is especially the case for older age groups, where if more than ten eggs are harvested, success rates jump by approximately 15%.

Is 15 the Magic Number?

However, according to a 2011 study, the optimal number of eggs to retrieve was 15. These results were based on data from women undergoing IVF in the UK. Researchers created a model that compared age, the number of eggs, and live births from 400,135 IVF cycles between April 1991 and June 2008. According to the data, for women under 34, the live birth rate with 15 eggs was 40%; however, with five eggs, the live birth rate dropped to 30%. These results confirmed that more is always better; however, when the study progressed, the researchers made an important discovery. Interestingly, when 40 eggs were harvested, the live birth rate was just 33%.

They found that retrieving too many eggs put women at risk of ovarian hyperstimulation. This condition causes weight gain, pain to the abdomen, and leaking fluids into the stomach and chest. Ovarian hyperstimulation negatively affects egg quality, thus impacting a woman’s chance of successful conception. As such, more isn’t always better. In every case, the average number of eggs retrieved in IVF will depend on numerous factors, including age and hormone levels.

Everyone's Journey is Different

Although further research into what impacts IVF success rates is vital, it is essential to remember that everyone’s fertility journey is different. The average number of eggs retrieved in IVF depends on many highly individual factors and is not necessarily a concrete indication of your success chances. If you have any questions or doubts about your IVF case, consult with your fertility specialist. They’ll have a detailed insight into your case’s nuances and will be able to give advice and guidance.

Governing Regulations & Policies

CDC Policy Documents
These policy documents cover, ‘The Fertility Clinic Success Rate and Certification Act. The Fertility Clinic Success Rate and Certification Act (FCSRCA) of 1992 mandates that clinics performing ART annually provide data for all procedures performed to the Centers for Disease Control and Prevention (CDC) and sets forth definitions and reporting requirements, specifically sections 2(a), 2(b), 2(c), 6 and 8. CDC is required to use these data to report and publish clinic-specific success rates and certification of embryo laboratories. The details on who and how needs to report in order to be compliant with the law are described in Federal Register Notices published following the FCSRCA enactment. Content source: National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health
FDA regulation of tissue donation (includes eggs and sperm)

FDA regulation of tissue donation (includes eggs and sperm:) This piece from the FDA offers insight on what you should know when it comes to reproductive tissue donation. The FDA regulates human reproductive tissue, which includes donated eggs (oocytes) and sperm (semen). Contained is information that you may want to know before becoming a recipient of donated sperm. Content Source: U.S. FOOD & DRUG ADMINISTRATION ‘What You Should Know – Reproductive Tissue Donation’.

Information on CAP (College of American Pathologists) IVF Lab accreditation

This resource explores the Reproductive Accreditation Program. Designed for the unique needs of reproductive laboratories in collaboration with the American Society for Reproductive Medicine, the CAP’s program promotes the quality and safety of laboratory services to give your physicians and patients confidence in the services it provides. Our program is recognized by the Society for Assisted Reproductive Technologies (SART) to meet membership requirements for in vitro fertilization facilities. Content Source: College of American Pathologists ‘ Reproductive Accreditation Program’.

Joint Commission Certification

In this certification information, they share why pursuing certification as it relates to clinical care at your fertility clinic is valuable. Achieving certification provides you with a framework to standardize your disease-specific program to help you reduce variation and risk and improve care. Based on evidence-based standards, The Joint Commission offers many certifications, ranging from stroke and cardiac to orthopedic and rehabilitation, with many options for various disease-specific programs. Find out about available certifications, the review process, and gain access to valuable resources to help you get started. Content Source: The Joint Commission on Accreditation & Certification

IVF regulation in Europe

This study explores the evolution of legislation in the field of medically assisted reproduction and embryo stem cell research in European union members. Although medically assisted reproduction (MAR), involving in vitro fertilization (IVF), has created an expectation for many people affected by infertility, it has generated a surplus of laws and ethical and social debates. Content Source: NCBI, Journal ListBiomed Res Intv.2014; 2014PMC4134786

IVF Embryo Regulations in Germany, the US, and UK

IVF Embryo Regulations in Germany, the US, and UK: Sage Journals shares information on everything having to do with science, technology, and human values. In this particular abstract, they look at “Borderlands of Life: IVF Embryos and the law in the United States, United Kingdom, and Germany. Content Source: Sage Journals, ‘Borderlands of Life: IVF Embryos and the Law in the United States, United Kingdom, and Germany,’ Published January 29, 2018

Cryostorage of Reproductive Tissues in the In vitro Fertilization Laboratory - A Committee Opinion

This document from ASRM is designed to help fertility clinics better manage cryopreserved reproductive tissues stored in cryogenic storage (cryostorage) tanks. These recommendations are based upon scientific principles and laboratory experience related to best practices for safe and reliable cryopreserved reproductive tissue storage. Embryology and andrology laboratories provide storage of often irreplaceable reproductive tissues such as oocytes, embryos, sperm, and ovarian and testicular tissues, including tissues from cancer patients. All of these reproductive tissues must be maintained under stringent conditions. Content Source: Fertility and Sterility® Vol. -, No. -, – 2020 0015-0282/$36.00 Copyright ©2020 American Society for Reproductive Medicine, Published by Elsevier Inc.

IVF Policy history

This Volume of Science Direct shares a global history of IVF in the United States. The USA has played, and continues to play, a distinctive and significant part in the history of IVF and assisted reproductive technology worldwide. American IVF emerged in the scientific context of contraceptive and fertility research, in the social context of a wealthy nation without universal healthcare, and in the political context of the abortion debate and its impact on federal versus state funding and regulation. IVF had its first clinical success in the USA in 1981. Since then, IVF in the USA has become known for procedures involving third, fourth, and fifth parties as gamete donors and surrogates. The USA has also been one of the pioneers in domestic and transnational deployment of IVF for lesbian, gay, bisexual, transgender (LGBT) parenthood, and a pioneer of the social egg-freezing revolution. Content Source: Reproductive Biomedicine & Society Online, Volume 2, June 2016, Pages 128-135

Canada

This journal walks you through a brief history of regulating assisted human reproduction in Canada. In 1989, in response to increasing public demand, the federal government established the Royal Commission on New Reproductive Technologies to study the social, ethical, legal, health, and economic implications of ART. In 1993—after four years, $28 million dollars, and consultations with roughly 40,000 Canadians—the Royal Commission issued its final report Proceed with Care. The report contained 293 recommendations on what policies and safeguards Canada should adopt to balance the benefits of ART with its issues, including dangerous and discriminatory practices. The report concluded that there was an urgent need for federal legislation to limit the use of ART and a body to oversee, license, and monitor the use of ART. Content Source: Institute of Health Policy, Management and Evaluation / University of Toronto, January 2019

IVF Regulation in the United States 2002

There is a widely perceived notion that assisted reproductive technology (ART) is not regulated in the United States. This current perception has developed for a number of reasons. In the United States, ART has been characterized by the absence of a socialized healthcare system, lack of centralized government or financial oversight, and the proliferation of a large number of clinics to meet market demand. Although some of these clinics are based in universities, which are operated under state oversight, and some are in private academic centers, many function as private medical practices. Second, there is no statutory national body, such as the Reproductive Technology Accreditation Committee (RTAC) in Australia, or the Human Fertilization and Embryology Authority (HFEA) in England, to oversee these programs. Content Source: FERTILITY AND STERILITY, VOL. 78, NO. 5, NOVEMBER 2002

State by state IVF regulation in the US, 2014

In this abstract, they look at the regulation of assisted reproductive technologies as a contested area. Some jurisdictions, such as the UK and a number of Australian states, have comprehensive regulation of most aspects of assisted reproductive technologies; others, such as the USA, have taken a more piecemeal approach and rely on professional guidelines and the general regulation of medical practice to govern this area. It will be argued that such a laissez-faire approach is inadequate for regulating the complex area of assisted reproductive technologies. Two key examples, reducing multiple births and registers of donors and offspring, will be considered to illustrate the effects of the regulatory structure of assisted reproductive technologies in the USA on practice. It will be concluded that the regulatory structure in the USA fails to provide an adequate mechanism for ensuring the ethical and safe conduct of ART services and that more comprehensive regulation is required. Content Source: Reproductive BioMedicine Online (2014) 29, 516–523