PLANNED OOCYTE CRYOPRESERVATION (PL-OC) IN WOMEN AGE 40-45

Abstract

Women 40-45, particularly if unpartnered, consider Pl-OC to preserve opportunity for a genetic child in the future. According to SART, IVF live birth rates for women >40 are <12% and cycle cancellation rates are as high as 20%. Limited data exist on Pl-OC process and outcomes in this age group, particularly for women 43+. This study aimed to identify rates of Pl-OC in women age 40-45 following appropriate evidence-based counseling. We hypothesized that women 43+ and those with lower AMH would be less likely to proceed with Pl-OC. Retrospective cohort study. All women age 40-45 presenting for a complimentary Pl-OC assessment (consisting of AMH/AFC) and physician consultation at Extend Fertility Medical Practice, a large single-center oocyte cryopreservation program from 1/1/18-5/25/20 were included. Counseling included specific evidence-based algorithms for oocyte yield based on age and AMH, as well as estimated live birth outcomes based on published aneuploidy data, and where relevant, discussion of the lack of live birth data for women 43+. Median AMH levels were calculated overall and by age, for the entire cohort and those who chose Pl-OC. Mean number of MII oocytes cryopreserved per cycle and mean number of cycles per patient were also calculated. Comparisons were made using Kruskal-Wallis, t-test, and X2 where appropriate. 474 women age 40-45 presented for complementary consultation and were included in the study. Following their consultation, 117/474 (24.6%) proceeded with Pl-OC.Tabled 1TABLE 1: Demonstrates data for the entire cohort and those who chose Pl-OC (cycling cohort)AgeTotal CohortAMHMedian±IQRCycling CohortAMHMedian±IQRFrozen MII/CycleMean±SD# of Cycles/PatientMean±SDNN(%)401561.22±1.7847 (30.2)1.80±2.217.14±5.281.77±1.21411220.75±1.6627 (22.1)1.37±2.136.61±5.982.08±1.9042870.58±1.1827 (31.0)1.01±1.707.57±5.641.33±0.6143470.58±1.046 (12.8)1.81±2.455.50±4.641.79±0.9844370.50±0.906 (16.2)0.85±1.205.07±5.091.80±0.9445250.35±0.554 (16.0)0.81±0.653.33±1.632.33±1.21Total4740.77±1.35117 (24.6)1.34±1.896.68±5.451.83±1.38Women who chose not to cycle had lower Median AMH (0.62±1.20 vs 1.34±1.89, p<0.001) and were more likely to be 43+ (OR 0.45 CI 0.25-0.80; 16/109 vs. 101/365 p=0.005) compared to those who cycled. Of those who cycled, only 8/117 (6.8%) had a cycle cancelled for poor response or 0 oocytes cryopreserved. Open table in a new tab Women who chose not to cycle had lower Median AMH (0.62±1.20 vs 1.34±1.89, p<0.001) and were more likely to be 43+ (OR 0.45 CI 0.25-0.80; 16/109 vs. 101/365 p=0.005) compared to those who cycled. Of those who cycled, only 8/117 (6.8%) had a cycle cancelled for poor response or 0 oocytes cryopreserved. With effective counseling, even in this low efficacy group, women with the highest chances of success can have the opportunity to attempt Pl-OC with a low cycle cancellation rate.