Compassionate embryo transfer: physician practices and perspectives

Objective: To assess reproductive endocrinology and infertility (REI) physicians’ basic knowledge of compassionate embryo transfer, current practices, and perceived barriers to offering compassionate transfer. Design: Cross-sectional survey study. Setting: Not applicable. Patients: Not applicable. Intervention: None. Main Outcome Measures: Number of physicians offering and performing compassionate transfer, barriers, beliefs and demographics of physicians. Results: A total of 744 members of the Society for Reproductive Endocrinology and Infertility were sent the survey, and 202 (27.1%) responded. Of the 168 (83.2%) physicians who had heard of compassionate transfer, 75 (44.6%) had offered it. In all, 130 physicians stated that they would offer compassionate transfer if there was patient demand, and 74 would offer it if there were American Society for Reproductive Medicine guidelines. Among physicians who did not offer compassionate transfer, 97 cited lack of patient interest as a barrier. In all, 55 physicians had performed compassionate transfer (range 0−8) performed within the past 2 years. The majority of physicians (76.4%) placed embryos in the endometrium, and there was no consensus on timing. Of the physicians, 27 restricted the number of embryos transferred. Three physicians reported pregnancies following compassionate transfer; none were ectopic. Conclusion: Data from this survey suggest that REI physicians have a wide range of knowledge and practices concerning compassionate transfer. Individual practices should be encouraged to develop written protocols regarding the use of embryos for nonreproductive purposes. American Society for Reproductive Medicine should develop recommendations to standardize the practice of compassionate transfer for those physicians who plan to offer this procedure.