Introduction
Social egg freezing enhances reproductive autonomy by empowering women with the capacity to delay their childbearing years, while preserving the opportunity to maintain biological relation with subsequent offspring. However, age‐related obstetric complications, economic implications and the risk of unsuccessful future treatment make it a controversial option. Despite the upward trend in women electively cryopreserving their eggs, there is limited data about the women’s perceptions, having undergone the process. The aim of this study was to investigate the motivations of women who have undergone social egg freezing, identify their perceptions following treatment, and assess potential feelings of regret.
Material and methods
This cross‐sectional survey, based at a fertility clinic in the UK, used an electronic questionnaire to assess the motivations and perceptions of women who underwent social egg freezing between 1 January 2008 and 31 December 2018.
Results
One hundred questionnaires were distributed, and 85 women responded (85% response rate). The most frequent reason for freezing oocytes was not having a partner with 56 (70%) women saying it “definitely” influenced their decision. The majority of women (83%; n = 68) knew there was a chance of treatment failure in the future and that a live birth could not be guaranteed. More than half (n = 39; 51%) disagreed or strongly disagreed that the 10‐year UK storage limit is fair. One‐third of respondents (n = 17; 33%) felt the storage time should be indefinite and 29% (n = 15) believed it should be up to the age of 50. Twenty percent (n = 15) of the women who underwent social egg freezing have successfully had a baby or are currently pregnant, half (n = 8; 53%) of whom conceived spontaneously and a quarter (n = 4; 26%) used their stored oocytes. In all, 91% (n = 73) had no regrets over their decision to undergo social egg freezing.
Conclusions
We demonstrate herein important and novel insights into the motivations and perceptions of women from a UK population who have undergone social egg freezing. Despite potential physical, psychological, and financial burdens, only a small minority of women experience regret after social egg freezing. We also highlight clear discontent with the Human Fertilisation & Embryology Authority storage limit among social egg freezers in the UK.
Most aneuploid blastocysts diagnosed by PGT-A have complex aneuploidies, showing that aneuploid embryos can develop after genomic activation and reaching high morphological scores. It becomes clear that embryo contraction, despite being a physiological feature during blastulation, is conditioned by the ploidy status of the embryo. Furthermore, the presence of contractions may compromise implantation rates.
Research question
To assess the relationship between the number of oocytes retrieved during elective oocyte cryopreservation (EOC) cycles with various clinical, biochemical, and radiological markers, including age, body mass index (BMI), baseline anti-Müllerian hormone (AMH), antral follicle count (AFC), Oestradiol level (E2) and total number of follicles ≥ 12 mm on the day of trigger. To also report the reproductive outcomes from women who underwent EOC.
Methods
A retrospective cohort of 373 women embarking on EOC and autologous oocyte thaw cycles between 2008 and 2018 from a single London clinic in the United Kingdom.
Results
483 stimulation cycles were undertaken amongst 373 women. The median (range) age at cryopreservation was 38 (26–47) years old. The median numbers of oocytes retrieved per cycle was 8 (0–37) and the median total oocytes cryopreserved per woman was 8 (0–45). BMI, E2 level and number of follicles ≥ 12 mm at trigger were all significant predictors of oocyte yield. Multivariate analysis confirmed there was no significant relationship between AFC or AMH, whilst on univariate analysis statistical significance was proven. Thirty six women returned to use their cryopreserved oocytes, of which there were 41 autologous oocyte thaw cycles undertaken. There were 12 successful livebirths achieved by 11 women. The overall livebirth rate was 26.8% per cycle. No livebirths were achieved in women who underwent EOC ≥ 40 years old, and 82% of all livebirths were achieved in women who had done so between 36 and 39 years old.
Conclusion
Clinical, biochemical and radiological markers can predict oocyte yield in EOC cycles. Reproductive outcomes are more favourable when cryopreservation is performed before the age of 36, with lower success rates of livebirth observed in women aged 40 years and above.
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