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

Abstract

Background The previous model-based cost-effectiveness analyses regarding elective oocyte cryopreservation remained debatable, while the usage rate may influence the cost per live birth. The aim of this study is to disclose the usage and cost-effectiveness of the planned cryopreserved oocytes after oocyte thawing in real-world situations. Methods This was a retrospective single-center observational study. Women who electively cryopreserved oocytes and returned to thaw the oocytes were categorized as thawed group. The oocytes were fertilized at our center and the sperm samples for each individual was retrieved from their respective husbands. Clinical outcomes were traced and the cumulative live birth rate per thawed case was calculated. The costs from oocyte freezing cycles to oocyte thawing, and embryo transfer cycles were accordingly estimated. The cumulative cost per live birth was defined by the cumulative cost divided by the live births per thawed case. Results We recruited 645 women with 840 oocyte retrieval cycles for elective oocyte freezing from November 2002 to December 2020. The overall usage rate was 8.4% (54/645). After the storage duration exceeded ten years, the probabilities of thawing oocytes were 10.6%, 26.6%, and 12.7% from women who cryopreserved their oocytes at the age ≤ 35 years, 36–39 years, and ≥ 40 years, respectively (P = 0.304). Among women who thawed their oocytes, 31.5% (17/54) of women achieved at least one live birth. For the age groups of ≤ 35 years, 36–39 years, and ≥ 40 years, the cumulative live birth rates per thawed case were 63.6%, 42.3%, and 17.6%, respectively (P = 0.045), and the cumulative costs for one live birth were $11,704, $17,189, and $35,642, respectively (P < 0.001). Conclusions The overall usage rate was 8.4% in our cohort. The cumulative live birth rate was greatest in the youngest group and the cumulative cost per live birth was highest in the oldest group, which was threefold greater than that in the group aged ≤ 35 years. The findings added to the limited evidence of the usage rate in real-world situations, which could hopefully aid future analysis and decision-making in public health policy and for women willing to preserve fertility. Trial registration None.

Outcomes of Social Egg Freezing: A Cohort Study and a Comprehensive Literature Review

“…We noted that out of 558 women, live births were achieved by 196 women giving an average of 35%. The age-wise distribution was comparable mainly in three studies [ 15 , 16 , 22 ]; the reason being varied age-group distribution. In total, 24/50 (48%) women achieved live birth and on-going pregnancy in the age group less than 38 years and 20/94 (21%) in the age-group 38 years or older.…”

“…To date, studies reporting outcomes in women returning to use their cryopreserved oocytes after social egg freezing are scarce [ 14 , 15 , 16 ]. Hence, we conducted this study with an objective to evaluate the outcomes of egg thaw at Guy’s Hospital, following social egg freezing and to compare our results with a comprehensive literature review of published data in order to provide evidence-based contemporaneous information to help women make an informed decision when planning to embark on social egg freezing.…”

The importance of social oocyte cryopreservation in supporting local municipalities

“…Any explanation should include the facts that some aspects of treatment have not yet been fully clari ed and that this in itself is a limitation at the present. 19 As a result of our municipal lectures on fertility in this study, two participants changed their life plan to suit their fertility and became pregnant spontaneously. We need to be able to de nitively improve the current issue, which is the di culty in obtaining education on fertility.…”

Laparoscopy versus open surgery for the surgical management of tubo-ovarian abscess (TOA). Is there a beneficial impact of early endoscopic intervention in terms of fertility rates?

“…Doganay et al reported an average duration of hospital stay as two days for laparoscopy, 7.4 days for laparotomy, and 11 days antibiotics-only treatment [13]. Similarly, Yang et al [14] also showed a marked decrease in hospital stay (5.4 days vs 8.9 days; p <.001) and wound infections with laparoscopy compared to laparotomy. Regarding the complication rates Carlson et al found that a laparoscopic surgical approach was significantly associated with a lower risk of perioperative complications compared to open surgery [15].…”