Fifteen years of autologous oocyte thaw outcomes from a large university-based fertility center

Cascante, Sarah D.; Blakemore, Jennifer K.; DeVore, Shannon; Hodes-Wertz, B.; Fino, Mary Elizabeth; Berkeley, Alan S.; Parra, Carlos M.; McCaffrey, C.; Grifo, James A.

doi:10.1016/j.fertnstert.2022.04.013

Cited by 36 publications

(9 citation statements)

References 33 publications

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“…Additionally, there is no consensus on how POR affects success in ART cycles, complicating counseling for patients with this condition. 21 The unpredictability in the patterns of returning to use stored oocytes, especially among those with POR, adds to the counseling complexity. Furthermore, the ethical and logistical issues arising from the large number of unused cryopreserved oocytes pose significant dilemmas.…”

Section: Discussionmentioning

confidence: 99%

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

Fouks,

Sakkas,

Bortoletto

et al. 2024

JAMA Netw Open

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ImportancePoor 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.ObjectiveTo 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).Design, Setting, and ParticipantsThis 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.Main outcomes and measuresThe association between number of oocytes cryopreserved on return rate to utilize cryopreserved oocytes and the time from vitrification to warming.ResultsA 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 &lt; .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 &lt; .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 &lt; .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).Conclusions and RelevanceThis 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.

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Section: Discussionmentioning

confidence: 99%

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

Fouks,

Sakkas,

Bortoletto

et al. 2024

JAMA Netw Open

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“…According to a report from New York University, one of the factors contributing to successful childbirth was having “20 or more mature (MII) oocytes” 9 . Cobo et al.…”

Section: Discussionmentioning

confidence: 99%

“…In the report of New York University, one of the factors contributing to successful childbirth was "(oocyte) freezing age below 38 years." 9 Gruhn et al showed the higher rate of chromosomal normalcy of oocytes at between the ages of 20 to 32, 12 and the guidelines of the JSRM (as of 2023) wrote that collection of unfertilized oocytes from women aged 35 or above is not recommended. Additionally, use of vitrified oocytes beyond maternal age 45 is also not recommended, due to increased risk of pregnancy complications.…”

Section: Whether Older Women Can Become Pregnant By Nmocmentioning

confidence: 99%

“…There appears to be a significant difference in the utilization rate of vitrified oocytes at our clinic (15%) and New York University (61%) (Table 2). 9,14,15 There are several reasons for this. First, younger women have fewer opportunities to use their vitrified oocytes, since they are more likely to achieve results through conventional infertility treatments.…”

Section: Future Challengesmentioning

confidence: 99%

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Non‐medical oocyte cryopreservation at a single center in Japan: 8 years of experience

Yoshinaga,

Hashimoto,

Fukuoka

et al. 2023

Reprod Medicine & Biology

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PurposeIncreasing numbers of women are opting to undergo non‐medical oocyte cryopreservation (NMOC). In this report, we present experience at our clinic and discuss NMOC in Japan.MethodsWe followed the progress of 403 women who underwent NMOC at our clinic between 2014 and 2021, totaling 592 reproductive cycles.ResultsIn total, 61 women underwent oocyte warming and fertility treatment. Of these, 13 women gave birth to 14 children. The median age at first oocyte cryopreservation was 38.3 years, and the oldest pregnant woman was 42 years. Most clients (60%) were in their late 30s. The median time between first oocyte cryopreservation and warming was 3.0 years. One woman was able to achieve a live birth with four vitrified oocytes.ConclusionsThis is the first report in Japan documenting pregnancies and childbirths resulting from NMOC. Ideally, women hope to achieve natural pregnancy between 20 and 32 years of age. NMOC is an option for individuals who are unable to pursue pregnancy during optimal reproductive years and wish to preserve their fertility for future attempts. NMOC is recommended in cases with few indications, and it is necessary to continue accumulating data on its long‐term safety and effectiveness.

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“…These evidence-based tools can be adjusted taking into consideration parameters both related to patient characteristics and the unit's expertise. More recently, Cascante et al, (2022) reported a 70% final life birth rate (FLBR) per patient who stored more than 20 mature oocytes before the age of 38, FLBR fell to 33% for women who achieved to store >20 mature eggs at the age of >41 (26).…”

Section: Oocyte Vitrification For Advanced Maternal Age: How Many Ooc...mentioning

confidence: 99%

Improving Oocyte Freezing for Advanced Maternal Age

CHATZIPARASIDOU

2024

Journal of Reproductive Medicine and Embryology

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Recent advancements in reproductive medicine, specifically in cryobiology and oocyte freezing, have opened new possibilities for women seeking fertility preservation to overcome age-related infertility. This Mini Review aims to outline the expected benefits fertility preservation for non-medical reasons offers to women of advanced maternal age. The review will address current challenges, including determining the optimal number of vitrified oocytes for successful outcomes in planned oocyte cryopreservation, and the need for standardization in the vitrification process. Furthermore, this mini-review will explore concerns and ethical dilemmas arising from the increasing trend of women postponing motherhood, emphasizing the importance of aligning women's expectations with available scientific data to prevent misconceptions and false expectations. Additionally, it will touch upon the welfare of parents and children in light of the increasing age gap among them. Lastly, future developments aiming to enhance the efficiency and accessibility of fertility preservation via automation and the use of AI will be presented.

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Fifteen years of autologous oocyte thaw outcomes from a large university-based fertility center

Cited by 36 publications

References 33 publications

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

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

Non‐medical oocyte cryopreservation at a single center in Japan: 8 years of experience

Improving Oocyte Freezing for Advanced Maternal Age

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