Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

Abstract

Introduction Women are postponing childbearing and preventing age‐related fertility decline with oocyte freezing for non‐medical reasons (OFNMR). The objective of this systematic evaluation was to gain an understanding of women's attitudes and knowledge of, and intentions to use OFNMR among users of OFNMR and the general public. Material and methods A systematic search of MEDLINE, EMBASE, and PyschINFO databases was undertaken, for studies that examined the psychosocial attitudes among women toward OFNMR. The search was limited to English language and no time restriction was set for publications. Extracted data were analyzed using thematic analysis and the study was performed according to PRISMA guidelines with prospective PROSPERO registration (CRD4201912578). Results Overall, 35 studies met the inclusion criteria. Studies were broadly categorized into studies investigating users or potential users of OFNMR, and studies examining the views of members of the general public. Users of OFNMR have good knowledge of age‐related fertility decline and awareness of the OFNMR procedure. Lack of partner was identified as the most common motivating factor to undertake OFNMR, with cost as a predominant concern. Knowledge among the general public of OFNMR is highly variable. Underestimation of age‐related fertility decline is common among the general public. Intentions of women to use OFNMR also varied drastically between studies. Conclusions Women are predominantly motivated to freeze eggs by the lack of a suitable partner, but cost is a significant barrier. Increasing the number of women pursuing OFNMR at an earlier stage may positively impact upon the risk of future involuntary childlessness. Better information should be made available to both women and men about their fertility and options to inform their reproductive decision‐making.

Assessing the quality of decision-making for planned oocyte cryopreservation

“…A latest systematic review of 17 psychosocial studies found that over 70% of women were single at the time of POC [21]. In our study, only 7% of respondents were in a committed relationship and 71% were ≥ 35 years old when undergoing their first POC cycle.…”

“…To date, most POC research on women who had undertaken the procedure focuses primarily on evaluating their characteristics, life circumstances, intentions, experience and future utilization plans [17][18][19][20][21]. The influential role of decision regret has only been explored briefly in a few qualitative [23,24] and quantitative [18,24,25] studies, and more in-depth in a US-based single-site follow-up survey study [26].…”

Social Freezing: Pressing Pause on Fertility

“…Hammarberg et al analyzed the reasons for the low usage rate of frozen oocytes, and the most common were found to be single-parent issues, the preference to conceive naturally, and not wanting to use a sperm donor [58], as well as insufficient knowledge and interest of women in the procedure at the optimal age range to perform FP (28-35 years).…”

Oocyte Cryopreservation in Domestic Animals and Humans: Principles, Techniques and Updated Outcomes

“…This was supported by a large randomized clinical trial on oocyte donation that revealed that vitrified oocyte quality was not inferior to fresh oocytes in terms of pregnancy outcomes [21]. Later, oocyte cryopreservation has become a fascinating alternative option for women who attempt in vitro fertilization (IVF) or fertility preservation programs [22]. Benefits of oocyte cryopreservation include increased flexibility to preserve (1) excess oocytes eventually present in each subsequent IVF cycle; (2) fertility in women who are at risk of infertility caused by chemotherapy/radiotherapy/premature ovarian insufficiency (POI) or who prefer to postpone childbearing and prevent age-related fertility decline (>36 years old) [20,22].…”

“…Later, oocyte cryopreservation has become a fascinating alternative option for women who attempt in vitro fertilization (IVF) or fertility preservation programs [22]. Benefits of oocyte cryopreservation include increased flexibility to preserve (1) excess oocytes eventually present in each subsequent IVF cycle; (2) fertility in women who are at risk of infertility caused by chemotherapy/radiotherapy/premature ovarian insufficiency (POI) or who prefer to postpone childbearing and prevent age-related fertility decline (>36 years old) [20,22]. Additionally, oocyte cryopreservation technology could facilitate some advantages in routine IVF programs, such as (1) reducing the number of controlled ovarian stimulation cycles in infertile patients; (2) delaying fresh embryo transfer programs aimed at preventing ovarian hyperstimulation syndrome (OHSS) or to optimize artificial endometrial preparation (AEP) and (3) offering options for infertile couples with religious objections to embryo cryopreservation [5,23].…”