Optimal timing for elective egg freezing

Abstract

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.

Who benefits from putting family life into ice?

“…The optimal timing was studied by Mesen et al. (16), and at the age of 34 years satisfactory numbers of eggs were still obtained. The average age of the women seeking age-related oocyte cryopreservation in an IVF unit in the UK was 36.7 years, which can be regarded as late (17).…”

Let us talk about eggs! Professional resistance to elective egg vitrification and gendered medical paternalism

“…However, it is also worth mentioning that interviewees had a narrow view of efficiency, which was in consonance with their traditional gender views. Other views on rating the efficiency of EVF also exist, for example, Mesen et al (2015) argue based on their decision tree models that although birth rate is maximized if the woman has egg extraction before the age of 34, the relative benefit of EVF compared to not doing anything is maximized at the age of 37 (greatest improvement in the likelihood of birth compared to no action). In contrast, there was little benefit to cryopreserving eggs in the 20s, as probably many women would not need these eggs.…”

The ambiguities of ‘social’ egg freezing and the challenges of informed consent

“…Her investment in egg freezing is less likely to have been a waste of money, even though it is also less likely to work. Mesen et al (2015) calculated that although egg freezing was most likely to work when eggs are frozen before a woman is 34 years old, it was most likely to be cost-effective for women who freeze at the age of 37.…”