Abstract Study question Does the length of storage time of cryopreserved samples impact patient response rate and is this influenced by the tissue type stored. Summary answer Patient response rates decline as storage time increases. The decline is faster and higher with sperm and testicular tissue, compared to oocytes and embryos What is known already Clinics are experiencing increasing inventories of cryopreserved samples. While clinics provide storage consents and contracts, an increasing issue has emerged of abandoned/unclaimed samples, even with provision of multiple disposition options. Cryomanagement is labour intensive, both in terms of physical and administrative maintenance, the latter further increasing when communication and payment from the patient inadvertently or deliberately ceases. Full cryomanagement automation including patient billing, education and engagement with disposition decisions reduces the workload for the embryologist and increases consistency. It may also provide data insights allowing clinics to identify issues and implement strategies to improve patient engagement Study design, size, duration Data were retrospectively analysed from an automated cryomanagement platform. In total, 418,895 patient accounts from 122 clinics based in the USA over the period 2015 to 2024 Participants/materials, setting, methods Data was extracted from the automated cryomanagement platform database - a live feed of clinic information – and encrypted. Logic was created to develop calculations utilising the coding language, Structured Query Language (SQL). Revenue collected was compared with collectable charges to generate the collection/response rate. Data was analysed by collection rate by tissue type to identify trends and differences Main results and the role of chance An inverse relationship was identified between storage duration and response rates. Collection rates fell from 97.44% to 68.44% in relation to oocytes, 94.87% to 45.08% for embryos, 87.01% to 29.41% for sperm, and 95.67% to 29.75% for testicular tissue. Patients with stored oocytes are least likely to abandon cryopreserved samples, with 68.44% of storage payments continuing to be received beyond 14yrs. Patients with stored sperm or testicular tissue are the most likely to abandon cryopreserved samples. Collection rates fall below 50% at 6-8yrs and 10-12yrs respectively, and beyond 14yrs storage have fallen to 29.41% and 29.75% Limitations, reasons for caution The storage duration does not necessarily reflect the duration of patient interaction with the automated cryomanagement platform, where freeze date preceeded platform implementation. Further research is necessary to identify if patients exclusively interacting with the platform from freeze date have altered response rates Wider implications of the findings Data held by automated cryomanagement systems allows accurate review and analysis of cryostorage and cryomanagement metrics. Mined data could be used to develop policies based on real-life data. Including patient treatment information and patient engagement with the system from freeze date may help identify and address reasons for abandonment Trial registration number Not Applicable