Advertisement

Clinical outcomes and utilization from over a decade of planned oocyte cryopreservation

  • Angela Q. Leung
    Correspondence
    Corresponding author.
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA

    Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA

    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
    Search for articles by this author
  • Katherine Baker
    Affiliations
    Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA

    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
    Search for articles by this author
  • Denis Vaughan
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA

    Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA

    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
    Search for articles by this author
  • Jaimin S. Shah
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA

    Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA

    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
    Search for articles by this author
  • Ann Korkidakis
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA

    Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA

    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
    Search for articles by this author
  • David A. Ryley
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA

    Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA
    Search for articles by this author
  • Denny Sakkas
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA
    Search for articles by this author
  • Thomas L. Toth
    Affiliations
    Boston IVF, 130 2nd Avenue, Waltham Massachusetts 02451, USA

    Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston Massachusetts 02215, USA

    Harvard Medical School, 25 Shattuck Street, Boston MA 02115, USA
    Search for articles by this author

      Highlights

      • Only 7.4% of patients returned to use their cryopreserved oocytes
      • One-third of patients achieved a live birth using cryopreserved oocytes
      • No patient age 40 or older had a live birth with their cryopreserved oocytes

      Abstract

      Research question

      What is the clinical experience of patients who have undergone planned oocyte cryopreservation and oocyte thawing and warming?

      Design

      Retrospective observational cohort study. All women who completed planned oocyte cryopreservation at a single large university-affiliated fertility centre between June 2006 and October 2020 were identified, including the subset who returned to use their oocytes. Patients who underwent oocyte cryopreservation for medical reasons were excluded. Baseline demographics, oocyte cryopreservation and thawing–warming cycle parameters, and clinical outcomes, were extracted from the electronic medical record. The primary outcome was cumulative live birth rate (LBR), and secondary outcomes were cumulative clinical pregnancy rate (CPR), and CPR and LBR per transfer. Results were stratified by age at time of cryopreservation (<38 and ≥38 years).

      Results

      Of 921 patients who underwent planned oocyte cryopreservation, 68 (7.4%) returned to use their oocytes. Forty-six patients (67.6%) completed at least one embryo transfer. The CPR per transfer was 47.5% and LBR was 39.3%. The cumulative LBR per patient who initiated thawing–warming was 32.4%. Cycle outcomes were not significantly different in patients aged younger than 38 years and those aged 38 years or over. No patient aged 40 years or older (n = 6) was successful with their cryopreserved oocytes. Ten patients (14.7%) who were unsuccessful with their cryopreserved oocytes achieved a live birth using donor oocytes, with most (7/10) of these patients aged 38 years and older.

      Conclusion

      Only a small percentage of patients returned to use their oocytes, and 32% of those were able to achieve a live birth.

      KEYWORDS

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Reproductive BioMedicine Online
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. 2021 Survey on Fertility Benefits, 2021. Mercer.

        • ACOG ASRM
        Female age-related fertility decline. Committee Opinion No. 589.
        Fertil. Steril. 2014; 101 (https://doi.org/): 633-634https://doi.org/10.1016/j.fertnstert.2013.12.032
        • Baldwin K.
        • Culley L.
        • Hudson N.
        • Mitchell H.
        • Lavery S.
        Oocyte cryopreservation for social reasons: Demographic profile and disposal intentions of UK users.
        Reproductive BioMedicine Online. 2015; 31 (https://doi.org/): 239-245https://doi.org/10.1016/j.rbmo.2015.04.010
        • Baylis F.
        Left Out in the Cold: Arguments Against Non-Medical Oocyte Cryopreservation.
        COMMENTARY. 2015; (https://doi.org/)https://doi.org/10.1016/S1701-2163(15)30365-0
        • Benagiano G.
        • Gianaroli L.
        The new Italian IVF legislation.
        Reproductive BioMedicine Online. 2004; (https://doi.org/)https://doi.org/10.1016/S1472-6483(10)62118-9
        • Ben-Rafael Z.
        The dilemma of social oocyte freezing: usage rate is too low to make it cost-effective.
        Reprod. Biomed. Online. 2018; 37 (https://doi.org/): 443-448https://doi.org/10.1016/j.rbmo.2018.06.024
        • Bernard A.
        • Fuller B.J.
        Cryopreservation of human oocytes: a review of current problems and perspectives.
        Human Reproduction Update. 1996;
        • Blakemore J.K.
        • Grifo J.A.
        • Devore S.
        • Hodes-Wertz B.
        • Berkeley A.S.
        PLANNED OOCYTE CYROPRESERVATION –10-15 YEAR FOLLOW-UP: RETURN RATES AND CYCLE OUTCOMES.
        Fertility and Sterility. 2020; 114 (https://doi.org/): e82-e83https://doi.org/10.1016/j.fertnstert.2020.08.253
        • Chen C.
        PREGNANCY AFTER HUMAN OOCYTE CRYOPRESERVATION.
        The Lancet. 1986; 327 (https://doi.org/): 884-886https://doi.org/10.1016/S0140-6736(86)90989-X
        • Cobo A.
        • García-Velasco J.
        • Domingo J.
        • Pellicer A.
        • Remohí J.
        Elective and Onco-fertility preservation: factors related to IVF outcomes.
        Hum. Reprod. 2018; 33 (https://doi.org/): 2222-2231https://doi.org/10.1093/humrep/dey321
        • Cobo A.
        • García-Velasco J.A.
        • Coello A.
        • Domingo J.
        • Pellicer A.
        • Remohí J.
        Oocyte vitrification as an efficient option for elective fertility preservation.
        Fertility and Sterility. 2016; 105 (e8https://doi.org/): 755-764https://doi.org/10.1016/j.fertnstert.2015.11.027
      2. Committee of the American Society for Reproductive Medicine, E., Daar, J.J., Benward MSW, J., Collins, L.J., Davis, J. DO, Davis, O., Francis, L.J., Gates, E., Ginsburg, E., Gitlin, S., Klipstein, S., McCullough, L., Paulson, R., Reindollar, R., Ryan, G., Sauer, M.M., Tipton, S.M., Westphal, L., Zweifel, J., 2018. Planned oocyte cryopreservation for women seeking to preserve future reproductive potential: an Ethics Committee opinion. https://doi.org/ 10.1016/j.fertnstert.2018.08.027

        • De Wiel L.van
        For Whom the Clock Ticks: Reproductive Ageing and Egg Freezing in Dutch and British News Media.
        Studies in the Maternal. 2014; 6 (https://doi.org/)https://doi.org/10.16995/sim.4
        • Devine K.
        • Mumford S.L.
        • Goldman K.N.
        • Hodes-Wertz B.
        • Druckenmiller S.
        • Propst A.M.
        • Noyes N.
        Baby budgeting: oocyte cryopreservation in women delaying reproduction can reduce cost per live birth.
        Fertil. Steril. 2015; 103 (e1–2https://doi.org/): 1446-1453https://doi.org/10.1016/j.fertnstert.2015.02.029
        • Doyle J.O.
        • Richter K.S.
        • Lim J.
        • Stillman R.J.
        • Graham J.R.
        • Tucker M.J.
        Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval.
        Fertility and Sterility. 2016; 105 (e2https://doi.org/): 459-466https://doi.org/10.1016/j.fertnstert.2015.10.026
      3. Egg freezing in fertility treatment, trends and figures: 2010-2016, 2018.

      4. Gardner, D.K., 1999. In-vitro culture of human blastocyst. Towards reproductive certainty : Infertility and genetics beyond 1999 378–388.

        • Ghobara T.
        • Gelbaya T.A.
        • Ayeleke R.O.
        Cycle regimens for frozen-thawed embryo transfer.
        Cochrane Database of Systematic Reviews. 2017; (https://doi.org/)https://doi.org/10.1002/14651858.CD003414.pub3
        • Goldman R.H.
        • Racowsky C.
        • Farland L.V.
        • Munné S.
        • Ribustello L.
        • Fox J.H.
        Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients.
        Hum. Reprod. 2017; 32 (https://doi.org/): 853-859https://doi.org/10.1093/humrep/dex008
        • Goold I.
        • Savulescu J.
        In favour of freezing eggs for non-medical reasons.
        Bioethics. 2009; (https://doi.org/)https://doi.org/10.1111/j.1467-8519.2008.00679.x
        • Gürtin Z.B.
        • Morgan L.
        • O'Rourke D.
        • Wang J.
        • Ahuja K.
        For whom the egg thaws: insights from an analysis of 10 years of frozen egg thaw data from two UK clinics, 2008–2017.
        Journal of Assisted Reproduction and Genetics. 2019; 36 (https://doi.org/): 1069-1080https://doi.org/10.1007/s10815-019-01429-6
        • Habbema J.D.F.
        • Eijkemans M.J.C.
        • Leridon H.
        • Te Velde E.R.
        Realizing a desired family size: When should couples start?.
        Human Reproduction. 2015; 30 (https://doi.org/): 2215-2221https://doi.org/10.1093/humrep/dev148
        • Hodes-Wertz B.
        • Druckenmiller S.
        • Smith M.
        • Noyes N.
        What do reproductive-age women who undergo oocyte cryopreservation think about the process as a means to preserve fertility?.
        Fertility and Sterility. 2013; 100 (https://doi.org/)https://doi.org/10.1016/j.fertnstert.2013.07.201
        • Johnston M.
        • Richings N.M.
        • Leung A.
        • Sakkas D.
        • Catt S.
        A major increase in oocyte cryopreservation cycles in the USA, Australia and New Zealand since 2010 is highlighted by younger women but a need for standardised data collection.
        Human Reproduction In press, 2020https://doi.org/10.1093/humrep/deaa320 (https://doi.org/)
        • Kneale D.
        • Joshi H.
        Postponement and childlessness: Evidence from two British cohorts.
        Demographic Research. 2008; 19 (https://doi.org/): 1935-1964https://doi.org/10.4054/DemRes.2008.19.58
        • Leridon H.
        Can assisted reproduction technology compensate for the natural decline in fertility with age? A model assessment.
        Human Reproduction. 2004; 19 (https://doi.org/): 1548-1553https://doi.org/10.1093/humrep/deh304
        • Lewis E.I.
        • Missmer S.A.
        • Farland L.V.
        • Ginsburg E.S.
        Public support in the United States for elective oocyte cryopreservation.
        Fertility and Sterility. 2016; 106 (https://doi.org/): 1183-1189https://doi.org/10.1016/j.fertnstert.2016.07.004
        • Lockwood G.M.
        Social egg freezing: The prospect of reproductive “immortality” or a dangerous delusion? in: Reproductive BioMedicine Online.
        Reprod. Biomed. Online. 2011; (https://doi.org/): 334-340https://doi.org/10.1016/j.rbmo.2011.05.010
      5. Martin, J.A., Hamilton, B.E., Osterman, M.J.K., Driscoll, A.K., 2019. Births: Final Data for 2018 Figure 1. Number and rate of triplet and higher-order multiple births: United States, 1980-2018.

        • Mature oocyte cryopreservation: A guideline
        Fertility and Sterility. 2013; 99 (https://doi.org/): 37-43https://doi.org/10.1016/j.fertnstert.2012.09.028
        • Mesen T.B.
        • Mersereau J.E.
        • Kane J.B.
        • Steiner A.Z.
        Optimal timing for elective egg freezing.
        Fertil. Steril. 2015; 103 (e4https://doi.org/): 1551-1556https://doi.org/10.1016/j.fertnstert.2015.03.002
        • Miner S.A.
        • Miller W.K.
        • Grady C.
        • Berkman B.E.
        It's Just Another Added Benefit”: Women's Experiences with Employment-Based Egg Freezing Programs.
        AJOB Empir. Bioeth. 2020; (https://doi.org/): 1-12https://doi.org/10.1080/23294515.2020.1823908
      6. OECD Family Database - OECD [WWW Document], 2019. URLhttp://www.oecd.org/els/family/database.htm (accessed 1.15.21).

        • Patrizio P.
        • Sakkas D.
        From oocyte to baby: a clinical evaluation of the biological efficiency of in vitro fertilization.
        Fertil. Steril. 2009; 91 (https://doi.org/): 1061-1066https://doi.org/10.1016/j.fertnstert.2008.01.003
      7. SART National Summary Report 2017 [WWW Document], n.d. . SART. URLhttps://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?reportingYear=2017 (accessed 12.3.20).

        • Smith G.D.
        • Serafini P.C.
        • Fioravanti J.
        • Yadid I.
        • Coslovsky M.
        • Hassun P.
        • Alegretti J.R.
        • Motta E.L.
        Prospective randomized comparison of human oocyte cryopreservation with slow-rate freezing or vitrification.
        Fertility and Sterility. 2010; 94 (https://doi.org/): 2088-2095https://doi.org/10.1016/j.fertnstert.2009.12.065
        • Spandorfer S.D.
        • Chung P.H.
        Relationship between maternal age and aneuploidy in in vitro fertilization pregnancy loss.
        Fertility and Sterility. 2004; 81: 5
        • Stoop D.
        • Maes E.
        • Polyzos N.P.
        • Verheyen G.
        • Tournaye H.
        • Nekkebroeck J.
        Does oocyte banking for anticipated gamete exhaustion influence future relational and reproductive choices? A follow-up of bankers and non-bankers.
        Human Reproduction. 2015; 30 (https://doi.org/): 338-344https://doi.org/10.1093/humrep/deu317
        • van Loendersloot L.L.
        • Moolenaar L.M.
        • Mol B.W.J.
        • Repping S.
        • van der Veen F.
        • Goddijn M.
        Expanding reproductive lifespan: a cost-effectiveness study on oocyte freezing.
        Hum. Reprod. 2011; 26 (https://doi.org/): 3054-3060https://doi.org/10.1093/humrep/der284
        • Wennberg A.L.
        • Schildauer K.
        • Brännström M.
        Elective oocyte freezing for nonmedical reasons: a 6-year report on utilization and in vitro fertilization results from a Swedish center.
        Acta Obstetricia et Gynecologica Scandinavica. 2019; 98 (https://doi.org/): 1429-1434https://doi.org/10.1111/aogs.13673
        • Wise J.
        UK lifts ban on frozen eggs.
        BMJ (Clinical research ed.). 2000; 320 (https://doi.org/): 334https://doi.org/10.1136/bmj.320.7231.334/a

      Biography

      Angela Leung, MD, is a Reproductive Endocrinology and Infertility fellow at Beth Israel Deaconess Medical Center/Harvard Medical School and Boston IVF. She has a special interest in fertility preservation.
      Key message
      One-third of patients who used oocytes from planned oocyte cryopreservation cycles achieved an ongoing pregnancy or live birth. No patient who cryopreserved gametes at age 40 years or over was successful. Planned oocyte cryopreservation results in reasonable success at younger ages.