MAJORITY OF WOMEN UNDERGOING ELECTIVE OOCYTE CRYOPRESERVATION DO NOT ATTAIN OPTIMAL NUMBER OF OOCYTES CRYOPRESERVED FOR REASONABLE LIKELIHOOD OF FUTURE LIVE BIRTH

Abstract

This study aimed to evaluate the frequency with which women undergoing planned oocyte cryopreservation (OC) ultimately banked an optimal quantity of eggs. Retrospective cohort study. Subjects included 999 women undergoing planned OC between January 2012 and February 2020. The primary outcome of optimal number of oocytes cryopreserved (OOC) was defined as ≥80% probability of at least one live birth (LB) using a published model accounting for age (Goldman et al., 2017). Baseline factors were compared between those with and without OOC using Student’s t-test, Mann-Whitney U-test, and Chi squared test as appropriate. Logistic regression modeling identified predictors for achieving OOC, controlling for age, race, antral follicle count (AFC), anti-mullerian hormone (AMH), insurance status, and total cycles. 415 women undergoing planned OC (42%) achieved OOC after an average of 1.5 cycles. The majority of women ≤35 years achieved OOC (63%); however, few women ages 39-40 years, and no women ≥41 years, achieved OOC (Table 1). Based on median oocytes frozen, the majority of women ≤38 years achieved >50% probability of at least one LB; however, at >38 years, women achieved much lower chances of LB (Table 1). Average age (34 v 37 years, p<0.001), AFC (12 v 7, p<0.01), AMH (3.1 v 1.5 ng/mL, p<0.01), and total number of cycles (1.5 v 1.4, p=0.01) differed between the cohorts that did and did not achieve OOC, respectively. In the multivariate logistic regression, age (aOR 0.69, p<0.001), AFC (aOR 1.05, p<0.01), AMH (aOR 1.50, p<0.01), total number of cycles (aOR 2.15, p<0.01), and Asian (aOR 0.54, p=0.01) or other non-White (aOR 0.60, p=0.02) race were independent predictors of the primary outcome. Insurance coverage was not associated with odds of achieving OOC. The majority of women (58%) who undergo planned OC do not bank sufficient eggs to yield an 80% chance of LB. Ovarian reserve markers and age predicted failure to achieve OOC and should be weighed when counseling. Asian/other non-white races had lower adjusted odds of achieving OOC compared to white race patients. Future studies should investigate the cause of these racial differences in planned OC outcomes.Table 1Cycle outcomes by age groupAge (years) at first planned OCn≤35472361403713138983963403941304215≥4311Optimal # oocytes for 80% probability of one LB1418232732445570>100Median # oocytes frozenProbability of one LB %17861677156514561245113316361122912# of patients who achieved OOC%298636446312416165713000000Mean # cycles to achieve OOCSD1.40.71.70.91.60.81.50.71.80.840---Mean # cycles in those who did not achieve OOCSD1.30.71.40.71.50.81.40.71.40.71.41.11.60.91.81.42.11.0 Open table in a new tab