Cryopreserved oocyte versus fresh oocyte assisted reproductive technology cycles, United States, 2013

Abstract

Objective To compare characteristics, explore predictors, and compare assisted reproductive technology (ART) cycle, transfer, and pregnancy outcomes of autologous and donor cryopreserved oocyte cycles with fresh oocyte cycles. Design Retrospective cohort study from the National ART Surveillance System. Setting Fertility treatment centers. Patient(s) Fresh embryo cycles initiated in 2013 utilizing embryos created with fresh and cryopreserved, autologous and donor oocytes. Intervention(s) Cryopreservation of oocytes versus fresh. Main Outcomes Measure(s) Cancellation, implantation, pregnancy, miscarriage, and live birth rates per cycle, transfer, and/or pregnancy. Result(s) There was no evidence of differences in cancellation, implantation, pregnancy, miscarriage, or live birth rates between autologous fresh and cryopreserved oocyte cycles. Donor cryopreserved oocyte cycles had a decreased risk of cancellation before transfer (adjusted risk ratio [aRR] 0.74, 95% confidence interval [CI] 0.57–0.96) as well as decreased likelihood of pregnancy (aRR 0.88, 95% CI 0.81–0.95) and live birth (aRR 0.87, 95% CI 0.80–0.95); however, there was no evidence of differences in implantation, pregnancy, or live birth rates when cycles were restricted to those proceeding to transfer. Donor cryopreserved oocyte cycles proceeding to pregnancy had a decreased risk of miscarriage (aRR 0.75, 95% CI 0.58–0.97) and higher live birth rate (aRR 1.05, 95% CI 1.01–1.09) with the transfer of one embryo, but higher miscarriage rate (aRR 1.28, 95% CI 1.07–1.54) and lower live birth rate (aRR 0.95, 95% CI 0.92–0.99) with the transfer of two or more. Conclusion(s) There was no evidence of differences in ART outcomes between autologous fresh and cryopreserved oocyte cycles. There was evidence of differences in per-cycle and per-pregnancy outcomes between donor cryopreserved and fresh oocyte cycles, but not in per-transfer outcomes.

Perceptions, outcomes, and regret following social egg freezing in the UK; a cross‐sectional survey

“…Following the demonstration of comparable pregnancy and live‐birth rates between vitrified and fresh oocytes, the possibility of electively cryopreserving oocytes at a younger age for use at a more convenient time in the future has become realistic, a concept that has since been referred to as social egg freezing (SEF). Women may choose to defer their childbearing years to focus on career progression, educational attainment, or until they are more secure economically .…”

Early ovarian ageing

“…Increasing success rates associated with oocyte freezing have provided a further option for women not yet ready to start a family. Oocyte cryopreservation is no longer considered an experimental treatment, with success rates in the USA reported to be similar to those achieved using fresh oocytes . Overall, live‐birth rate per treatment cycle using autologous frozen thawed oocytes in the UK is currently around 18%, but is largely dependent on age, and therefore should be undertaken early in the reproductive years to have a reasonable chance of success.…”

Vitrification: the pioneering past to current trends and perspectives of cryopreserving human embryos, gametes and reproductive tissue

“…This phenomenon was recently documented in a 137 and 368 autologous egg banking cycles in Spain and the USA, respectively, with 12-21.2% of the fertilized oocyte warming cycle failing to yield an embryo for transfer. 104,121 It is to be kept in mind that survival rates and normal fertilization events tend to be consistent (75-95% and 65-85%, respectively), with survival failure being a rare event (<2%). 105 Perhaps the greatest concern then is that naive, innocent female consumers (ie, perspective patients) are being misinformed about their risks, by financially motivated programs, that the freeze preservation of their potential fertility based on today's technology does not guarantee that a transferrable embryo will even result, let alone potentially create a healthy baby.…”

“…In contrast, commercial egg banks repeatedly report sub-50% LBRs, as do published IVF programs. 34,58,104,105 Excluding the occasional outlier publishing an impressive data set, 98,106 the average clinical practice is not publishing their variable experience with oocyte cryopreservation that fails to attain the levels reported by commercial propaganda. There is, however, general agreement that blastocysts derived from vitrified oocytes are the same as fresh, 99,107,108 or from vitrified blastocysts for that matter.…”