Clinical outcomes and utilization from over a decade of planned oocyte cryopreservation

Leung, Angela Q.; Baker, Keith; Vaughan, Denis A.; Shah, Jaimin S.; Korkidakis, Ann; Ryley, David A.; Sakkas, Denny; Toth, Thomas L.

doi:10.1016/j.rbmo.2021.06.024

Cited by 32 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are consistent with findings from recent studies which found a strategy of social freezing leads to higher live-birth rates per cycle compared with morphology-based assessment of embryos in older women [ 14 , 20 ]. For example, using a decision tree model,, Devine and colleagues predicted that oocyte cryopreservation would decrease cost per live birth from US$55,060 to US$39,946 (and increase the odds of live birth from 42% to 62%) for women who freeze their oocytes at age 35 years and defer pregnancy attempts until age 40 years [ 20 ].…”

Section: Discussionsupporting

confidence: 93%

“…Social freezing, where autologous oocytes are collected and cryopreserved at a younger age for potential future use, is increasingly used as an option to negate the risk of age-related fertility loss [ 13 ]. In a recent retrospective US study of 921 women who vitrified their oocytes between 2006 and 2020, women who cryopreserved their oocytes before aged 38 achieved a higher cumulative live birth rate (CLBR) (38.9%) than those who planned their oocytes cryopreservation after age 38 (25%) [ 14 ]. This is also shown in a previous study by Cobo and colleagues who reported CLBR increased for every additional oocytes in women below 36 years old but this reached a plateau for older women ≥ age 36 [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Which assisted reproductive technology (ART) treatment strategy is the most clinically and cost-effective for women of advanced maternal age: a Markov model

Lee

Zhang

2022

BMC Health Serv Res

View full text Add to dashboard Cite

Objective To evaluate the clinical and cost-effectiveness of preimplantation genetic testing for aneuploidy, social freezing, donor and autologous assisted reproductive technology (ART) treatment strategies for women aged 35–45 following 6–12 months of infertility. Methods Four Markov decision-analytic models comprising: (i) Preimplantation genetic testing for aneuploidy (PGT-A); (ii) autologous ART from age 40 using oocytes cryopreserved at age 32 (social freezing); (iii) ART using donated oocytes (donor ART); (iv) standard autologous ART treatment (standard care) were developed for a hypothetical cohort of 35 to 45 years old ART naïve women with 6–12 months of infertility. Input probabilities for key parameters including live birth rates were obtained from the available literature. Deterministic and probabilistic sensitivity analyses were conducted to address uncertainty in estimating the parameters and around the model’s assumptions. Cost effectiveness was assessed from both societal and patient perspectives . Result(s) For infertile women at age 40 and above, social freezing is the most cost-saving strategy with the highest chance of a cumulative live birth at a lowest cost from a societal perspective. PGT-A and donor ART were associated with higher treatment costs and cumulative live-birth rates compared with the autologous ART. Among the four ART strategies, standard autologous ART has the lowest cumulative live birth rate of 45% at age 35 and decreasing to 1.6% by age 45 years. At a willingness-to-pay threshold of Australian dollars (A$)50,000, our model shows all alternative treatment strategies –PGT-A, social freezing and donor ART have a higher probability of being cost-effective compared to the standard autologous ART treatment. However, higher out-of-pocket expenditure may impede their access to these alternate strategies. Conclusion Given current evidence, all alternate strategies have a higher probability of being cost-effective compared to the standard autologous ART treatment. Whether this represents value for money depends on societal and individual’s willingness-to-pay for children conceived with ART treatment.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Which assisted reproductive technology (ART) treatment strategy is the most clinically and cost-effective for women of advanced maternal age: a Markov model

Lee

Zhang

2022

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…While not all studies have provided specific time frames for the return rates, some findings suggest conflicting implications regarding the utilization of cryopreserved oocytes based on the age at vitrification. Similar to our results, which showed a constant and gradual increase to utilize with age, Leung et al 20 observed that individuals who eventually utilized their frozen eggs tended to be from older age groups (38 years or older), suggesting a possible preference among women of advanced age to return for thawing and using their cryopreserved oocytes. However, as absolute numbers are small, more research is needed to capture the factors influencing the timing and rates of returning for oocyte thawing and utilization, considering various aspects of fertility preservation and assisted reproductive technologies.…”

Section: Discussionsupporting

confidence: 90%

“…It is important to note that the utilization rate can be influenced by factors such as the patient population, length of follow-up, and potential confounding by indication. In our previous single-center analysis, 20 we found that 7.4% of patients returned to warm in our practice.…”

Section: Discussionmentioning

confidence: 47%

Utilization of Cryopreserved Oocytes in Patients With Poor Ovarian Response After Planned Oocyte Cryopreservation

Fouks,

Sakkas,

Bortoletto

et al. 2024

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportancePoor ovarian response (POR) to stimulation may impact patients’ desire or need to utilize cryopreserved oocytes for family building in the future. These findings, captured by Society for Assisted Reproductive Technology (SART) national data, underscore the need for tailored counseling and further research into the decision-making processes influencing oocyte utilization.ObjectiveTo examine the association of ovarian response to stimulation and the number of vitrified oocytes with the likelihood and timing of patients returning for oocyte utilization following planned oocyte cryopreservation (OC).Design, Setting, and ParticipantsThis cohort study used data in the SART Clinical Outcome Reporting System for patients in US fertility clinics and data was used for eligible patients who underwent planned OC from January 2014 through December 2020. Data were analyzed from November 2022 to June 2023.Main outcomes and measuresThe association between number of oocytes cryopreserved on return rate to utilize cryopreserved oocytes and the time from vitrification to warming.ResultsA total of 67 893 autologous oocyte freezing cycles were performed in the US between 2014 and 2020, among 47 363 patients (mean [SD] age, 34.5 [4.7] years). Of these, 6421 (13.5%) were classified as patients with POR, with fewer than 5 oocytes vitrified across all ovarian stimulation cycles. A total of 1203 patients (2.5%) returned for oocyte warming and utilization. The rate of return was significantly higher in the POR group, with 260 (4.0%) returning compared with 943 (2.3%) in the normal responder group (P &lt; .001). This trend was most notable in the age 30 to 34 years (warm cycle, 46 of 275 [16.7%] vs no warm cycle, 982 of 11 743 [8.4%]; P &lt; .001) and age 35 to 39 years groups (warm cycle, 124 of 587 [21.1%] vs no warm cycle, 3433 of 23 012 [14.9%]; P &lt; .001). The time elapsed from vitrification to warming was comparable between patients with POR (mean [SD], 716.1 [156.1] days) and normal responders (803.8 [160.7] days). A multivariate analysis adjusted for age, clinic region in the US, body mass index, and history of endometriosis was conducted to identify factors associated with the utilization of oocytes. The analysis revealed that having fewer than 5 oocytes vitrified was associated with higher odds of utilizing oocytes (OR, 1.52; 95% CI, 1.32-1.76).Conclusions and RelevanceThis cohort study reveals a distinct pattern in the utilization of cryopreserved oocytes among patients undergoing planned OC in the US. Despite the increase in number of patients pursuing OC, there is a notably low rate of return to utilize previously vitrified oocytes; notably, patients with POR are more likely to return, although the time to return is similar to those with normal ovarian response.

show abstract

“… 12 Besides, the frozen-thaw cycle survival oocyte rate was shown to be around 70%, but the euploid rate was only around 30%, decreasing with maternal age. 13 Although in the latest decade, with the vitrification technology becoming mature and being widely introduced into clinical practice, 14 evidence showed that the clinical pregnancy rate and live birth rate of planned oocyte cryopreservation were more promising, and pregnancies using frozen oocytes had no difference in fertilisation and ongoing pregnancy rate when compared with fresh oocyte pregnancies. 15 16 Still, there is a lack of long-term follow-up studies on children born under this procedure because oocyte cryopreservation has yet not been used for a long time as a non-experimental clinical technique.…”

Section: Discussionmentioning

confidence: 99%

Latent class analysis of Chinese healthcare providers’ attitudes towards oocyte cryopreservation: a cross-sectional study

Lu,

Tian,

Wang

2024

BMJ Open

View full text Add to dashboard Cite

ObjectivesThe present study was designed to examine the attitudes towards oocyte cryopreservation among healthcare providers working in hospitals across specialties and potential influencing factors.DesignA cross-sectional study.SettingThe questionnaire was distributed among Chinese healthcare providers via the Credamo platform.ParticipantsThere were 877 respondents recruited from 8 April to 8 May 2022, among whom 160 were identified as unqualified because of inconsistency between the IP and work addresses.Outcome measuresIndividual attitudes towards oocyte cryopreservation under four different settings, familiarity with oocyte cryopreservation and perceived risks about oocyte cryopreservation of healthcare providers were measured using a self-designed questionnaire.ResultsThere were 877 respondents recruited, and 717 were identified as qualified respondents. Two latent classes of healthcare providers characterised by different attitudes towards oocyte cryopreservation under four different settings were identified, the supportive and reluctant. Familiarity with oocyte cryopreservation had a significant direct effect on perceived risks, with better familiarity predicting lower perceived risks (β=−0.102, p<0.05). Perceived risks showed a significant direct effect on participants’ attitudes towards oocyte cryopreservation, with higher perceived risks predicting a more reluctant attitude (β=0.165, p<0.001).ConclusionsThe majority of healthcare providers held a reluctant attitude towards oocyte cryopreservation of unmarried women for non-medical reasons, which might relate to their worries about the risks to offspring’s health and lack of knowledge about a reproductive technique.

show abstract

Clinical outcomes and utilization from over a decade of planned oocyte cryopreservation

Cited by 32 publications

References 34 publications

Which assisted reproductive technology (ART) treatment strategy is the most clinically and cost-effective for women of advanced maternal age: a Markov model

Which assisted reproductive technology (ART) treatment strategy is the most clinically and cost-effective for women of advanced maternal age: a Markov model

Utilization of Cryopreserved Oocytes in Patients With Poor Ovarian Response After Planned Oocyte Cryopreservation

Latent class analysis of Chinese healthcare providers’ attitudes towards oocyte cryopreservation: a cross-sectional study

Contact Info

Product

Resources

About