Planned Oocyte Cryopreservation Research Articles

International attitudes towards medical and planned oocyte cryopreservation.

This study aims to better understand the knowledge and attitudes of men and women internationally towards oocyte cryopreservation (OC). An online 25-question survey was distributed internationally via email and social media. Knowledge and attitudes towards OC among different regions and genders were assessed. The study population consisted of adults from North America (NA, 15.7%), Southeastern and Eastern Europe (SE, 34.7%), Central and Western Europe (CWE, 12.7%), Asia (12.7%), and Middle East (ME, 8.9%). A total of 496 respondents initiated the survey and the completion rate was 80.2%. The mean (SD) age was 35.2 (12.1) years. Over 70% were aware of OC, but only 4.8% had previously undergone the procedure. Most considered ages 26-31 as optimal for OC and correctly identified conditions that could impact the chance of spontaneous conception. Significant differences were observed regarding etiologies that would render OC acceptable. Only in NA and ME did solid majorities strongly agree that it is acceptable to proceed with OC to allow more time to find the right partner or for professional opportunities. More similar opinions were observed between genders. When medical conditions existed, large majorities across all nationalities and genders strongly agreed that OC is acceptable. In NA, SE, and ME most respondents would consider or recommend OC for any reason, whereas most respondents in CWE and Asia would do that only for certain social reasons or medical necessity. A good understanding of OC was observed. Nationality appeared to impact opinions on appropriate indications for this procedure, though overall positive attitudes were documented.

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation: a retrospective cohort study

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation: a retrospective cohort study

Planned oocyte cryopreservation: a systematic review and meta-regression analysis.

Awareness of the age-related decline in fertility potential has increased the popularity of planned oocyte cryopreservation (POC). However, data regarding outcomes of POC, including rates of women returning to thaw oocytes, as well as pregnancy and live birth rates, are scarce and based mostly on small case series. POC was defined as cryopreservation exclusively for prevention of future age-related fertility loss. The primary outcome was live birth rate per patient. The secondary outcomes included the return to thaw rate and laboratory outcomes. A meta-regression analysis examining the association between live birth and age above 40 or below 35 was conducted. We conducted a systematic database search from inception to August 2022. The search included PubMed (MEDLINE) and EMBASE. Our search strategies employed a combination of index terms (Mesh) and free text words to compile relevant concepts. The systematic review and meta-regression were undertaken following registration of systematic review (PROSPERO registration number CRD42022361791) and were reported following guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 (PRISMA 2020). The database search yielded 3847 records. After the selection process, 10 studies, conducted from 1999 to 2020, were included. Overall, 8750 women underwent POC, with a mean cryopreservation age of 37.2 (±0.8). Of those, 1517 women returned to use their oocytes with a return rate of 11.1% (± 4.7%). The mean age at the time of cryopreservation for women who returned to use their oocytes was 38.1 (±0.4), with an average of 12.6 (±3.6) cryopreserved oocytes per woman. In a meta-analysis, the oocyte survival rate was 78.5% with a 95% CI of 0.74-0.83 (I2 = 93%). The live birth rate per patient was 28% with a 95% CI of 0.24-0.33 (I2 = 92%). Overall, 447 live births were reported. In a sub-group analysis, women who underwent cryopreservation at age ≥40 achieved a live birth rate per patient of 19% (95% CI 0.13-0.29, I2 = 6%), while women aged ≤35 years old or younger had a higher live birth rate per patient of 52% (95% CI 0.41-0.63, I2 = 7%). POC emerges as a feasible option for women aiming to improve their chances of conceiving at a later reproductive age. Nonetheless, it must be acknowledged that the overall success rates of POC are limited and that the likelihood of successful live birth declines as the age at cryopreservation rises. With increasing interest in POC, the collation of comprehensive and high-quality data is imperative to clearly define the outcomes for various age groups. CRD42022361791.

Decision-making in women considering planned oocyte cryopreservation: decision satisfaction or regret?

Research question: Among women considering planned oocyte cryopreservation (OC), does decision regret differ among those that pursued planned OC vs. those that did not? Design: A survey was emailed to all women seen in consult for planned OC from January 2016–December 2021 using a secure REDCap platform. The survey comprised of questions on demographics, reproductive planning, and a validated decision regret scale (DRS). Univariable and multivariable models were fitted to examine decision regret in the group that pursued vs the group that did not pursue planned OC. A sentiment analysis was employed to characterize respondents’ emotional tone. Results: A total of 338 respondents met eligibility criteria, of which 178 (52.7%) underwent and 160 (47.3%) did not undergo planned OC. The groups were similar in age, race/ethnicity, and education. Respondents who underwent planned OC were more likely to be single, anticipate starting a family ≥39yo, and consider donor sperm acceptable. Those that did not undergo planned OC more frequently reported starting attempts at conception. A higher proportion of respondents that did not undergo planned OC experienced moderate-to-severe regret in their decision compared to those that underwent ≥1 cycle (50% vs. 13%, p<0.001). There was a correlation between decreasing number of cryopreserved oocytes and increasing DRS score (P<0.001). Conclusions: There is substantial decision regret among women considering planned OC who did not proceed with it. DRS score was highest among those that did not proceed with planned OC and those that underwent ≥1 cycle resulting in a low number of oocytes.

Planned oocyte cryopreservation to preserve future reproductive potential: an Ethics Committee opinion

Planned oocyte cryopreservation is an ethically permissible procedure that may help individuals avoid future infertility. Because planned oocyte cryopreservation is new and evolving, it is essential that those considering using it be informed about the uncertainties regarding its efficacy and long-term effects. This replaces the document of the same name, last published in2017.

High prevalence of low prognosis by the POSEIDON criteria in women undergoing planned oocyte cryopreservation

ObjectivePlanned oocyte cryopreservation (OC) is being increasingly utilized worldwide. However, some women cannot accumulate sufficient oocytes because of poor response to stimulation. The POSEIDON classification is a novel system to classify patients with ‘expected’ or ‘unexpected’ inappropriate ovarian response to exogenous gonadotropins. Our study aimed to examine the prevalence of POSEIDON patients among women undergoing planned OC. Study designWe retrospectively reviewed the first cycles of 160 consecutive patients undergoing planned OC. Patients were classified into the four POSEIDON groups or as ‘non-POSEIDON’ based on age, AMH level and the number of oocytes retrieved. The primary outcome measure was the prevalence of POSEIDON patients. ResultsOverall, 63 patients (39.4 %) were classified as POSEIDON patients, 12 in group 1, 12 in group 2, 8 in group 3, and 31 in group 4. Compared to non-POSEIDON patients, POSEIDON patients had increased basal FSH levels and reduced serum AMH levels and antral follicle counts, required higher FSH starting doses and increased gonadotropin requirements and reached lower peak serum estradiol levels. Additionally, POSEIDON patients had a lower number of oocytes retrieved (7.6 ± 3.1 vs.20.2 ± 9.9, p < 0.001) and vitrified (5.8 ± 2.9 vs.14.7 ± 6.8, p < 0.001) than non-POSEIDON counterparts, respectively. ConclusionWe found a high prevalence of patients being classified as low prognosis according to the POSEIDON criteria among patients seeking planned OC. POSEIDON patients had increased gonadotropin requirements and a significantly lower number of oocytes retrieved and vitrified. This novel, unexpected finding adds clinically relevant information for counselling and management of patients undergoing planned OC.

Utilization of Cryopreserved Oocytes in Patients With Poor Ovarian Response After Planned Oocyte Cryopreservation

Poor ovarian response (POR) to stimulation may impact patients' desire or need to utilize cryopreserved oocytes for family building in the future. These findings, captured by Society for Assisted Reproductive Technology (SART) national data, underscore the need for tailored counseling and further research into the decision-making processes influencing oocyte utilization. To examine the association of ovarian response to stimulation and the number of vitrified oocytes with the likelihood and timing of patients returning for oocyte utilization following planned oocyte cryopreservation (OC). This cohort study used data in the SART Clinical Outcome Reporting System for patients in US fertility clinics and data was used for eligible patients who underwent planned OC from January 2014 through December 2020. Data were analyzed from November 2022 to June 2023. The association between number of oocytes cryopreserved on return rate to utilize cryopreserved oocytes and the time from vitrification to warming. A total of 67 893 autologous oocyte freezing cycles were performed in the US between 2014 and 2020, among 47 363 patients (mean [SD] age, 34.5 [4.7] years). Of these, 6421 (13.5%) were classified as patients with POR, with fewer than 5 oocytes vitrified across all ovarian stimulation cycles. A total of 1203 patients (2.5%) returned for oocyte warming and utilization. The rate of return was significantly higher in the POR group, with 260 (4.0%) returning compared with 943 (2.3%) in the normal responder group (P < .001). This trend was most notable in the age 30 to 34 years (warm cycle, 46 of 275 [16.7%] vs no warm cycle, 982 of 11 743 [8.4%]; P < .001) and age 35 to 39 years groups (warm cycle, 124 of 587 [21.1%] vs no warm cycle, 3433 of 23 012 [14.9%]; P < .001). The time elapsed from vitrification to warming was comparable between patients with POR (mean [SD], 716.1 [156.1] days) and normal responders (803.8 [160.7] days). A multivariate analysis adjusted for age, clinic region in the US, body mass index, and history of endometriosis was conducted to identify factors associated with the utilization of oocytes. The analysis revealed that having fewer than 5 oocytes vitrified was associated with higher odds of utilizing oocytes (OR, 1.52; 95% CI, 1.32-1.76). This cohort study reveals a distinct pattern in the utilization of cryopreserved oocytes among patients undergoing planned OC in the US. Despite the increase in number of patients pursuing OC, there is a notably low rate of return to utilize previously vitrified oocytes; notably, patients with POR are more likely to return, although the time to return is similar to those with normal ovarian response.

Impact of employer-covered planned oocyte cryopreservation on decision-making for medical training.

To characterize how employer coverage of planned oocyte cryopreservation (POC) might impact medical career decision-making. A cross-sectional survey was distributed to all medical students at two large academic programs in December 2022 to better understand attitudes towards childbearing, POC, and how employer coverage of POC might influence future career decisions. Of the 630/1933 (32.6%) medical students who participated, 71.8% identified as women and 28.1% as men. More women (89.2%) than men (75.1%, P < 0.001) felt pressure to delay childbearing. Regarding childbearing, women more than men were concerned about the physical demand of residency (76.5% vs. 50.8%, P < 0.001), stigma in residency hiring practices (41.2% vs. 9.0%, P < 0.001), and parental leave interfering with team dynamics (49.6% vs. 20.9%, P < 0.001). Respondents were more likely to pursue POC if it were covered by residency employer health insurance (60.0% vs. 11.6%, P < 0.001). Women were more likely than men to state that employer-sponsored POC would influence their residency ranking (46.0% vs. 23.7%, P < 0.001), pursuit of additional degrees (50.9% vs. 30.5%, P < 0.001), and pursuit of fellowship training (50.9% vs. 30.5%, P < 0.001). Additionally, 25.4% of women and 19.8% of men felt their choice in medical specialty would be impacted by employer-sponsored POC. Medical students, particularly women, feel pressure to delay childbearing during medical training and are concerned about future fertility. Both male and female students were interested in employer-sponsored POC and more likely to pursue it with financial coverage. Further research is needed to determine the full impact of employer-sponsored POC on medical career decision-making.

P-414 Trends in patient age at planned oocyte cryopreservation

Abstract Study question Did the age of women who underwent Planned Oocyte Cryopreservation (POC) change in the last decade? Summary answer Mean age of women presenting for POC decreased from 38.2±2.8 to 35.6±2.7. Proportion of women &amp;lt;36 increased from 13% in 2011 to 51% in 2022. What is known already Mean age of women who had POC reported in the literature to date is 37-8. Given that efficacy of POC is strongly related to age, some clinicians advice women considering POC to complete the procedure before age 35. Study design, size, duration Retrospective, observational multicenter study of all POC cycles from January 2011 to October 2022. Women who had oocyte cryopreservation for other indications were excluded. Participants/materials, setting, methods In all, 4021 women had at least one POC cycle in two large private IVF units belonging to the same medical organization in Israel. The main outcome measure was age at first cycle. Total number of women who underwent POC at each year and age at first cycle of every woman were recorded. Data was analyzed using SPSS version 23. ANOVA was used to test whether mean age differed significantly throughout the years. Main results and the role of chance Since 2011, when POC was first approved in Israel, until the end of October 2022, 4021 women underwent at least one cycle of POC in our units. The number of women who had POC per year increased gradually from 62 in 2011 to 979 in 2021 (last year with full data). Mean age declined with each year, from 38.2±2.8 in 2011 to 35.6±2.7 in 2022. The proportion of women aged &amp;lt; 36 increased gradually from 13% in 2011 to 35% in 2019 and further to 51% in 2022 (R = 0.20, p value&amp;lt;0.01). Limitations, reasons for caution This study was performed in a high-socioeconomic catchment area of one country. This may limit the generalizability of our findings to other populations. In addition, the usage rate and delivery rates of these patients are not known yet. Wider implications of the findings The significant decrease in age of women presenting for POC and the increased proportion of women&amp;lt;36 may present a growing awareness for age related infertility and possibly increased efficacy of POC in younger women. Trial registration number not applicable

P-402 What is the efficacy of planned oocyte cryopreservation? A systematic review and meta-regression analysis

Abstract Study question What are the chances of achieving a live birth after planned oocyte cryopreservation (POC)? Summary answer The mean thawing rate is 11.9% (± 4.9). Among women who thawed their oocytes, the mean live birth per patient is 28.1% (± 13.0). What is known already Trends of delayed childbearing have become increasingly common. The age-related decline in fertility potential increased the popularity of planned oocyte cryopreservation. However, Data on the outcomes of planned oocyte cryopreservation including a return for a thaw, pregnancy, and live-birth rates are scarce, being based mostly on small case series. Study design, size, duration A systematic review and meta-regression followed the PRISMA and MOOSE guidelines. A systematic search was conducted in Medline, Embase, and the Cochrane Library. The search strategies incorporated index terms (Mesh) and free text words for the search concepts. The first domain contained terms on indication the second domain related to oocytes cryopreservation. The detailed protocol is documented online in the International Prospective Register of Systematic Reviews registry. Participants/materials, setting, methods POC was defined as cryopreservation for future age-related fertility loss exclusively. All studies that reported primary data on POC were considered eligible for screening. Observational and non-observational studies were included. The primary outcome was the live birth rate per woman. The secondary outcomes included the thawing rate and other laboratory outcomes. Meta-regression analyses regarding the association between oocyte survival after thawing and live birth and age above 40 or method of freezing were conducted. Main results and the role of chance A systematic search from inception to October 2022 yielded 3847 citations. After the selection process, 9 studies, conducted from 1999 to 2020, were included. In total, 8059 women underwent POC, and 1463 returned to use their oocytes. The mean thawing rate was 11.9% (±4.9). The mean age at thawing was 41.9 years (±0.8) with a mean time from freezing to thawing of 4.0 years (±- 0.4). 68.3% (± 18.4 ) of patients returned with a partner while the others used donor sperm. Five studies used vitrification exclusively while the others included both slow-freezing and vitrification. The oocytes survival rate after thawing was 79.0% (±5.4 ) and the mean live birth per patient was 28.1% (± 13.0). A meta-regression analysis revealed an association between age above 40 years and decreased live birth (R2=0.08) and oocyte survival (R2=0.16). No statistically significant association was found between the method of cryopreservation to oocyte survival rate or live-birth Limitations, reasons for caution Variations in expertise and technical experience between different centers may yield different results. In addition, most data reports outcomes for women who underwent POC aged 35-40, while information on women who had this procedure at younger or older ages is scarce. Wider implications of the findings Data presented here may be valuable for consultation and informed decision-making of women considering POC Trial registration number CRD42022361791 02/10/2022

What do female medical students know about planned oocyte cryopreservation and what are their personal attitudes?

This study aimed to assess medical student knowledge and attitudes regarding oocyte cryopreservation, as well as attitudes regarding future intentions of utilizing this procedure. This cross-sectional web-based survey study was distributed to 873 medical students at the University of Kansas from July through September 2018. The survey was self-reported and female medical student responses were analyzed. Students were surveyed through a variety of multiple-choice questions on demographics, knowledge of oocyte cryopreservation, and factors and attitudes that would impact personal and professional use of oocyte cryopreservation. A total of 122 female responses were collected (30%). A majority of female medical students were aware of oocyte cryopreservation, less than half correctly identified a dramatic drop in female fertility as well as oocyte cryopreservation success and cost-effectiveness. Three-quarters felt pressure to delay childbearing and nearly two-thirds would consider freezing their oocytes. Several factors were found to alter their decision toward oocyte cryopreservation including personal factors, procedure complexity and availability, and outcomes. A majority of female medical students are amenable to the possibility of using oocyte cryopreservation to delay childbearing. Though nearly all knew of oocyte cryopreservation, knowledge regarding fertility and oocyte cryopreservation was low.

Information and decision support needs: A survey of women interested in receiving planned oocyte cryopreservation information

PurposeIdentifying the information and decision support needs of women interested in receiving planned oocyte cryopreservation (POC) information.MethodsAn online survey of Australian women, aged 18-45, interested in receiving POC information, proficient in English, with internet access. The survey covered POC information sources, information delivery preferences, POC and age-related infertility knowledge (study-specific scale), Decisional Conflict Scale (DCS), and time spent considering POC. Target sample size (n=120) was determined using a precision-based method.ResultsOf 332 participants, 249 (75%) had considered POC, whilst 83 (25%) had not. Over half (54%) had searched for POC information. Fertility clinic websites were predominately used (70%). Most (73%) believed women should receive POC information between ages 19-30 years. Preferred information providers were fertility specialists (85%) and primary care physicians (81%). Other methods rated most useful to deliver POC information were online. Mean knowledge score was 8.9/14 (SD:2.3). For participants who had considered POC, mean DCS score was 57.1/100 (SD:27.2) and 78% had high decisional conflict (score >37.5). In regression, lower DCS scores were associated with every 1-point increase in knowledge score (-2.4; 95% CI [-3.9, -0.8]), consulting an IVF specialist (-17.5; [-28.0, -7.1]), and making a POC decision (-18.4; [-27.5, -9.3]). Median time to decision was 24-months (IQR: 12.0-36.0) (n=53).ConclusionWomen interested in receiving POC information had knowledge gaps, and wanted to be informed about the option by age 30 years from healthcare professionals and online resources. Most women who considered using POC had high decisional conflict indicating a need for decision support.

Decision regret among women considering planned oocyte cryopreservation: a prospective cohort study.

To (1) prospectively characterize the incidence of decision regret among women considering planned oocyte cryopreservation (planned OC), comparing those who pursued treatment vs those who did not freeze eggs, and (2) to identify baseline predictors for future decision regret. A total of 173 women seen in consultation for planned OC were followed prospectively. Surveys were administered at (1) baseline (< 1week after initial consultation) and (2) follow-up, 6months after planned OC among participants who froze eggs or 6months following consultation in the absence of further communication to pursue treatment. The primary outcome was the incidence of moderate-to-severe decision regret, indicated by a Decision Regret Scale score > 25. We also examined predictors of regret. The incidence of moderate-to-severe regret over the decision to freeze eggs was 9% compared to 51% over the decision not to pursue treatment. Among women who froze eggs, adequacy of information at baseline to decide about treatment (aOR 0.16, 95% CI 0.03, 0.87) and emphasis on future parenthood (aOR 0.80, 95% CI 0.66, 0.99) were associated with reduced odds of regret. Forty-six percent of women who froze eggs regretted not doing so earlier. Among women who did not freeze eggs, the primary reasons were financial and time constraints, correlating with increased odds of decision regret in an exploratory analysis. Among women undergoing planned OC, the incidence of decision regret is low compared to the regret confronting women seen in consultation for planned OC but who do not pursue treatment. Provider counseling is key to offset the regret risk.

Knowledge and attitude of reproductive-aged women towards planned oocyte cryopreservation in the United Arab Emirates.

Delayed conception is associated with a decline in oocyte number and quality. Oocyte cryopreservation techniques are used for medical or non-medical (elective) reasons. We aim to assess the knowledge and attitudes towards planned oocyte cryopreservation (POC) among reproductive-aged women in the United Arab Emirates (UAE) and to investigate the factors interfering with their decisions. A cross-sectional study on 422 women (18-38years) living in the UAE, using an online questionnaire with three sections: sociodemographic, knowledge, and attitudes towards POC. 91.2% of participants have heard of POC, 84.1% hold a bachelor's degree or higher, 65.4% with medical background, 54.3% employed, and 79.2% live in Sharjah and Dubai. Consideration of POC was significantly associated with age (p = 0.011), employment (p = 0.002), the Emirates they live (p < 0.001), and if they have heard of POC (p = 0.036). Mean knowledge score was 44.44%, which was significantly higher among those considering POC (49.66% vs. 40.55%), and social media was their main source of information. About 57% will not consider POC, mainly due to cost, cultural issues, and safety. Determinants of knowledge score were marital status (B = 0.44; 95%CI: 0.09-0.79; p value = 0.014) and education level (B = 0.35; 95%CI: 0.13-0.58; p value = 0.002), and after adjustment, only the education level remained significantly associated with knowledge score (B = 0.24; 95%CI: 0.01-0.47; p value = 0.042). Despite many participants being motivated to undergo POC, majority had poor knowledge, and cost was the main barrier. The main determinant of the knowledge score was education level. Awareness among couples of consequences of delaying childbearing and comprehensive information from medical practitioners are highly needed.

COUNTING EGGS BEFORE THEY HATCH: UTILIZATION OF OOCYTES AFTER PLANNED OOCYTE CRYOPRESERVATION

Women are increasingly electing to cryopreserve oocytes in order to delay childbearing. Planned oocyte cryopreservation often requires significant investment, yet there is a paucity of data to guide patients on their likelihood of obtaining significant returns. In addition, the prediction of live birth rates after using cryopreserved oocytes remains an area of active investigation.

Clinical outcome of planned oocyte cryopreservation at advanced age.

To report outcome of planned oocyte cryopreservation (POC) in the first 8years of this treatment in our center. A retrospective study in a university-affiliated medical center. A total of 446 women underwent POC during 2011-2018. Fifty-seven (13%) women presented to use these oocytes during the study period (until June 2021). POC was performed at a mean age of 37.9 ± 2.0 (range 33-41). Age at thawing was 43.3 ± 2.1 (range 38-49). A total of 34 (60%) women transferred their oocytes for thawing at other units. Oocyte survival after thawing was significantly higher at our center than following shipping to ancillary sites (78 vs. 63%, p = 0.047). Forty-nine women completed their treatment, either depleting their cryopreserved oocytes without conceiving (36) or attaining a live birth (13)-27% live birth rate per woman. Only one of eleven women who cryopreserved oocytes aged 40 and older had a live birth using thawed oocytes. Women should be advised to complete planned oocyte cryopreservation before age 40, given low success rates in women who underwent cryopreservation at advanced reproductive age. In this study, oocyte shipping was associated with lower survival rate. These findings may be relevant for women considering POC and utilization of cryopreserved oocytes.

DOES RACIAL DISPARITY EXIST IN PLANNED OOCYTE CRYOPRESERVATION CYCLES? A SART DATABASE ANALYSIS OF 15,806 CYCLES

To determine if FSH treatment dosage, number of mature oocytes, and treatment duration differ by race/ethnicity in planned oocyte cryopreservation (OC) cycles.

HOW MANY EGGS WILL I GET AND HOW MUCH MEDICATION DO I NEED? A SART DATABASE PREDICTOR MODEL FOR EGG FREEZING

To develop a model for predicting individualized gonadotropin starting dose and estimating number of retrieved mature oocytes in planned oocyte cryopreservation (OC) cycles.

A SART data cost-effectiveness analysis of planned oocyte cryopreservation versus in vitro fertilization with preimplantation genetic testing for aneuploidy considering ideal family size

To determine the cost-effectiveness of planned oocyte cryopreservation (OC) as a strategy for delayed childbearing to achieve 1 or 2 live births (LB) compared with invitro fertilization (IVF) and preimplantation genetic testing for aneuploidy (PGT-A) at advanced reproductive age. Decision tree model with sensitivity analyses using data from the Society for Assisted Reproductive Technology Clinical Outcome Reporting System and other clinical sources. Not applicable. A data-driven simulated cohort of patients desiring delayed childbearing with an ideal family size of 1 or 2 LB. Not applicable. Probability of achieving ≥1 or 2 LB, average and maximum cost per patient, cost per percentage point increase in chance of LB, and population-level cost/LB. For those desiring 1 LB, planned OC at age 33 with warming at age 43 decreased the average total cost per patient from $62,308 to $30,333 and increased the likelihood of LB from 50% to 73% when compared with no OC with up to 3 cycles of IVF/PGT-A at age 43. For those desiring 2 LB, 2 cycles of OC at age 33 and warming at age 40 yielded the lowest cost per patient and highest likelihood of achieving 2 LB ($51,250 and 77%, respectively) when compared withpursuing only 1 cycle of OC ($75,373 and 61%, respectively), no OC and IVF/PGT-A with embryo banking ($79,728 and 48%, respectively), or no OC and IVF/PGT-A without embryo banking ($79,057 and 19%, respectively). Sensitivity analyses showed that OC remained cost-effective across a wide range of ages at cryopreservation. For 1 LB, OC achieved the highest likelihood of success when pursued before age 32 and remained more effective than IVF/PGT-A when pursued before age 39, and for 2 LB, 2 cycles of OC achieved the highest likelihood of success when pursued before age 31 and remained more effective than IVF/PGT-A when pursued before age39. Among patients planning to postpone childbearing, OC is cost-effective and increases the odds of achieving 1 or 2 LB when compared with IVF/PGT-A at a more advanced reproductive age.

Planned oocyte cryopreservation for fertility preservation

Background: Oocyte cryopreservation opens up opportunities for women to preserve fertility when it is necessary to postpone pregnancy. After the advent of vitrification, the results of oocyte cryopreservation were significantly improved compared to conventional slow-freezing. Through these improvements, oocyte cryopreservation was introduced to overcome a decline in fecundity due to an increase in age, and this modality is defined as planned oocyte cryopreservation.Current Concepts: Oocytes cryopreserved through vitrification appear to result in similar clinical pregnancy rates and live birth rates compared to fresh oocytes, though the evidence is still limited. It has been reported that the live birth rate increases when the planned oocyte cryopreservation is performed at a younger age. Obstetrical and neonatal outcomes appear similar between vitrified and fresh oocytes.Discussion and Conclusion: Preliminary data supports planned oocyte cryopreservation as a feasible modality resulting in fertility preservation and subsequent live births. The fact that performing the procedure at a younger age can increase the oocyte yield, oocyte efficacy, and live birth rate can be discussed along with patient consultation. However, as there is still a lack of data on the standardized live birth rate, the number of oocytes to be collected, and the long-term effect on the children; more well-designed studies are needed to improve counseling and decision-making in patients seeking this treatment.