Objective To estimate the optimal age to pursue elective oocyte cryopreservation. Design A decision tree model was constructed to determine the success and cost-effectiveness of oocyte preservation versus no action when considered at ages 25 to 40 years, assuming an attempt at procreation 3, 5, or 7 years after initial decision. Setting A hypothetical decision analysis model. Patients Hypothetical patients between 25 and 40 years old presenting to discuss elective oocyte cryopreservation. Intervention(s) Decision to cryopreserve oocytes between age 25 and 40 versus taking no action. Main Outcome(s) and Measures Probability of live birth after initial decision whether or not to cryopreserve oocytes. Results Oocyte cryopreservation provided the greatest improvement in probability of live birth compared to no action (51.6% vs. 21.9%) when performed at age 37. The highest probability of live birth was seen when oocyte cryopreservation was performed at ages younger than 34 (>74%), although little benefit over no action was seen at ages 25–30 (2.6%–7.1% increase). Oocyte cryopreservation was most cost-effective at age 37 at $28,759 per each additional live birth in the oocyte cryopreservation group. When the probability of marriage was included, oocyte cryopreservation resulted in little improvement in live birth rates. Conclusion Oocyte cryopreservation can be of great benefit to specific women and has the highest chance of success when performed at an earlier age. At age 37, oocyte cryopreservation has the largest benefit over no action and is most cost effective.

The prevalence of moderately elevated TSH levels consistent with subclinical hypothyroidism (2.5–4.0 μIU/mL) was 23% in a cohort of 1231 women pursuing assisted reproductive technologies. Preconception elevated levels of TSH were associated with diminished ovarian reserve, but were not associated with adverse ART or pregnancy outcomes.

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