Outcomes of medically-indicated (MED) oocyte cryopreservation (OC) cycles performed for fertility preservation (FP) compare favorably to oc cycles of infertile women who have completed a thaw cycle

Abstract

OBJECTIVE: As more reproductive-age women are diagnosed with and survive cancer, OC use is increasing as a means of FP, particularly in those without a male partner. We compared outcomes of medically-indicated (MED) OC cycles to those of infertile women completing an OC thaw cycle (THAW), including their meiotic spindle evaluation (MSE). All MII oocytes cryopreserved in our lab undergo MSE 2 h post-harvest. DESIGN: Retrospective. MATERIALS AND METHODS: 31 MED (520 retrieved eggs) and 28 THAW (512 retrieved eggs) OC cycles were reviewed. Tumors in the MED group included 13 GYN, 10 breast, 3 leukemia, 2 colon, 2 CNS and 1 sarcoma. All patients underwent standard ovarian hyperstimulation followed by retrieval, MSE 2 h post-harvest, then OC of all MII oocytes. Both slow freezing and vitrification were used. 4 MED pts froze ½ as zygotes. RESULTS: In the THAW cycles, there were 16 (57%) pregnancies: 12 women delivered 17 liveborns (5 twins), 3 have ongoing gestations and 1 miscarried. 90% of eggs survived and there was a 94% pre-cryo to post-THAW MSE correlation. 2 MED thaw cycles resulted in 1 pregnancy. Cycle comparisons for THAW vs. MED are shown in the Table.TableComparison of medically-indicated (MED) OC cycles and OC cycles of infertile women who completed a thaw (THAW).THAWMEDPMean age at retrieval (y)31±1 (range 21-38)31±1 (range 20-40).9Mean E2 day hCG (pg/ml)3086±3001788±176<.001Mean no. eggs retrieved18±2 (range 6-61)17±2 (range 5-38).8Mean no. MII for OC14±211±1.1Mean no. MII with pre-cryo spindle10±19±1.08 Open table in a new tab CONCLUSIONS: The majority of oocytes in both groups were mature (MII) and exhibited a spindle. Women diagnosed with cancer can achieve adequate ovarian stimulation, egg production and MSE despite limited time to complete OC treatment and multiple outside stressors, including their underlying disease and its management. Based on our preliminary THAW data, we believe cancer pts should have a reasonable chance for pregnancy using their frozen eggs.