Closed vitrification system and egg donation: Predictive factors of oocyte survival and pregnancy

Abstract

Although many studies have demonstrated the superiority of ultra-fast freezing compared with slow freezing, the debate is still ongoing concerning the best type of vitrification method: direct exposure to liquid nitrogen (i.e., open systems), or sterile system without contact with liquid nitrogen (i.e., closed systems). The aims of this study were to share our experience on closed vitrification systems in the framework of our egg donation programme with fully asynchronous cycles, and to identify predictive factors of successful outcome in this context. Logistic regression analysis indicated that the number of vitrified oocytes was the only factor predictive of the oocyte survival rate and of clinical pregnancy. The addition of one vitrified oocyte increased by 15 % the odds of oocyte survival. When the oocyte survival rate was considered as a continuous variable, the following results were obtained: 7 % of clinical pregnancy probability for 50 % survival rate, 15 % for 75 % survival rate, and 32 % for 100 % survival rate. The rates of oocyte survival and fertilization, embryo implantation, and clinical pregnancy were in agreement with the recommended values established by ALPHA Scientists in Reproductive Medicine in 2012. On the basis of these results, and according to the European directives on safety, we validate the routine use of closed oocyte vitrification systems for egg donation programmes. These results must be confirmed in larger samples before extrapolation to all patient types.