CHOOSING NOT TO USE: EXAMINING THE REASONS BEHIND DISCARDING VITRIFIED EGGS

Abstract

Objective: To assess the reasons why patients discard previously vitrified eggs and determine overall outcomes. Materials and Methods: All women who discarded their cryopreserved eggs after having undergone egg vitrification from 2008-2021 at a large assisted reproductive center were analyzed. Demographics such as age at vitrification and disposal, total number of eggs and outcome from vitrification were collected. The reason for disposal was also analyzed through review of disposal request forms. Statistical analysis was performed using ANOVA, with p<0.05 considered statistically significant. Results: We analyzed 124 patients who underwent autologous egg vitrification and later requested to discard their eggs;17 were onco-fertility preservation. 48 patients (39% of those discarding) eventually became pregnant and therefore requested discard. 13 (10%) had natural conception and the remainder (29%) used fertility treatment. 27 patients (22%) discarded based on personal preference, 14 (11%) discarded their eggs because of worsening cancer, and 3 (2.4%) had eggs discarded because of death. 8 patients (6.4%) discarded due to storage costs and 7 (5.6%) discarded due to low yield from retrieval. Ten (8.0%) patients underwent embryo freezing and discarded their previously-frozen eggs;7 (5.6%) patients discarded due to concern from the physician about the quality of the eggs. The average age at freezing and at discard, length of time and total number of eggs frozen varied significantly based on stated reason for discard (p<0.05) (TABLE). Those undergoing fertility preservation were youngest at freeze. Cancer patients stored their eggs the longest and froze the most eggs overall. Interestingly, 32 (26%) of the discards were requested after the COVID-19 pandemic began. Conclusions: This study provides insight into reasons women choose not to use their vitrified eggs. From our exploratory analysis, women who require fertility preservation for cancer are less likely to discard their eggs. Future, larger studies, including survey studies, are needed to further elucidate factors influencing utilization vs. discard of vitrified eggs. Impact Statement: This study will help guide clinical decision making for fertility preservation through oocyte storage. [Formula presented]