Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation

Abstract

Background The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations. Summary OC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high ‘no use’ rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes. Conclusion It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.

Usage and cost-effectiveness of elective oocyte freezing: a retrospective observational study

“…As is well known, freezing the oocytes at a younger age and accumulation of more mature oocytes result in a better success rate of live birth, which was proven in our study and in other previous studies [ 12 – 15 , 27 ]. A decreased percentage of euploid embryos has been reported among individuals with the intent of PGT-A, which were 51.7%, 32.4%, 31.3%, and 0% of women who cryopreserved their oocytes at the age < 35 years, 35–37 years, 38–40 years, and ≥ 41 years of age, respectively [ 14 ].…”

More benefit or harm? Moral contextualism shapes public attitudes towards social egg freezing

“…The objective of cryopreservation is to avoid suffering from involuntary childlessness by widening the fertility span. Therefore, it is not surprising that the dominant view in medical ethics is positive because success rates of subsequent IVF are similar to those without prior cryopreservation (Goold and Savulescu, 2009;Goldman and Grifo, 2016;Walker et al, 2022). In line with moral contextualism, individuals will be more likely to accept cryopreservation for women that would suffer more from involuntary childlessness.…”

“…This involves the possibility that surplus oocytes are discarded after successful IVF. In fact, most vitrified oocytes are not used for IVF (Walker et al, 2022). The prolife position, advocated by Christian churches, considers the destruction of oocytes as harming the unborn life and thus not justifiable (Sallam and Sallam, 2016).…”

“…The eggs are then vitrified and can be stored frozen for a long time. For use, the eggs are thawed and fertilized in-vitro before being transfered into the woman's uterus (Walker et al, 2022).…”

From glass to life: a commentary on the assessment of the reproductive potential of cryopreserved human oocytes

“…1c ). Due to low return rate (< 10%) of women with medical oocyte cryopreservation [ 11 ], the literature on oocyte-to-baby rate in these patients is clearly unbalanced with studies on oocyte donation cycles. This brings additional challenges in building accurate mathematical models predicting success in women with medical oocyte cryopreservation.…”