Abstract
BackgroundThe utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations.SummaryOC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high ‘no use’ rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes.ConclusionIt is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.
Highlights
The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building
It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs
With fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation
Summary
The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; it is available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. Oocyte cryopreservation (OC) is used in assisted reproductive technology (ART) to attempt to preserve fertility by freezing gametes for potential future use. A majority of OC was used for patients with upcoming exposure to Walker et al Reproductive Biology and Endocrinology (2022) 20:10 gonadotoxic therapies including chemotherapy and pelvic radiation, and genetic disorders predisposing them to primary ovarian insufficiency (e.g., Fragile X premutation and monosomy X mosaicism). In 2018 the ASRM Ethics Committee opinion stated that planned OC for patients wishing to attempt to protect against future infertility due to reproductive aging was ‘ethically permissible’ [6]. ASRM continues to recommend that providers inform patients about the efficacy, safety, benefits and risks, as well as unknown long-term effects on offspring and potential harms that are still not fully understood [6]
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