title: Utilization of third-party in vitro fertilization in the United States.
abstract: 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.
  
  
  
  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.
authors.affiliation: Center for Human Reproduction, New York, NY; Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: vkushnir@thechr.com.
authors.forename: Vitaly A
authors.initials: VA
authors.lastname: Kushnir
authors.affiliation: Center for Human Reproduction, New York, NY.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Darmon
authors.affiliation: Center for Human Reproduction, New York, NY; Department of Obstetrics, Gynecology & Women's Health, Rutgers New Jersey Medical School, Newark, NJ.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Shapiro
authors.affiliation: Center for Human Reproduction, New York, NY; University of Kansas Medical Center, Kansas City, KS; The Rockefeller University, New York, NY.
authors.forename: David F
authors.initials: DF
authors.lastname: Albertini
authors.affiliation: Center for Human Reproduction, New York, NY; Foundation for Reproductive Medicine, New York, NY.
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
authors.affiliation: Center for Human Reproduction, New York, NY; Foundation for Reproductive Medicine, New York, NY; Department of Obstetrics and Gynecology, University of Vienna School of Medicine, Vienna, Austria; The Rockefeller University, New York, NY.
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
mesh_terms: D000328:Adult; D001723:Birth Rate; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D018587:Oocyte Donation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States
keywords: assisted reproductive technology; donor; embryo; gestational carrier; in vitro fertilization; oocyte; sperm; third-party reproduction