Oocyte vitrification for elective fertility preservation: the past, present, and future

Gunnala, V.; Schattman, Glenn

doi:10.1097/gco.0000000000000339

Cited by 39 publications

(24 citation statements)

References 29 publications

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“…Egg freezing: Egg freezing is no longer considered an experimental cryopreservation method for female fertility preservation since ASRM declaration in 2012 [77]. It involves cryopreservation of mature oocytes via slow freezing or vitrification which is now more preferred due to a better post-thaw survival rate [78][79][80][81]. Egg freezing requires prior ovarian stimulation and mature oocyte retrieval without the need for sperm or IVF.…”

Section: Fertility Preservation and Restoration Options In Female Patmentioning

confidence: 99%

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

2019

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Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.

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Section: Fertility Preservation and Restoration Options In Female Patmentioning

confidence: 99%

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

2019

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“…Elective oocyte cryopreservation via vitrification-or Belective egg freezing^(EEF), as women themselves prefer to call it [1,2]-for healthy women who are hoping to preserve their reproductive potential is gaining increasing international acceptance [3][4][5][6][7][8][9]. Although EEF has been considered a key way for reproductive-age women to defer or delay childbearing while pursuing their educations and careers [10][11][12], the emerging empirical evidence strongly suggests that the primary users of EEF are women reaching the end of their reproductive lifespans (i.e., late 30s to early 40s) who would like to pursue childbearing, but find themselves without a male partner. Five major surveys conducted in urban centers around the globe foreground the single status of most EEF patients, who are pursuing EEF at an average age of 36-38 [13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Patient-centered elective egg freezing: a binational qualitative study of best practices for women’s quality of care

Inhorn

Birenbaum‐Carmeli

Westphal

et al. 2019

J Assist Reprod Genet

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Purpose How can elective egg freezing (EEF) be made patient centered? This study asked women to reflect on their experiences of EEF, which included their insights and recommendations on the optimal delivery of patient-centered care. Methods In this binational, qualitative study, 150 women (114 in the USA, 36 in Israel) who had completed at least one cycle of EEF were recruited from four American IVF clinics (two academic, two private) and three in Israel (one academic, two private) over a two-year period (June 2014-August 2016). Women who volunteered for the study were interviewed by two medical anthropologists. Interviews were audio recorded, transcribed, and entered into a qualitative data management program (Dedoose) for analysis. Results The majority (85%) of women were without partners at the time of EEF, and thus were undertaking EEF alone in mostly couples-oriented IVF clinics. Following the conceptual framework known as Bpatient-centered infertility care,^we identified two broad categories and eleven specific dimensions of patient-centered EEF care, including (1) system factors: information, competence of clinic and staff, coordination and integration, accessibility, physical comfort, continuity and transition, and cost and (2) human factors: attitude and relationship with staff, communication, patient involvement and privacy, and emotional support. Cost was a unique factor of importance in both countries, despite their different healthcare delivery systems.

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“…Most recent reviews of oocyte cryopreservation suggest that women are undertaking EEF primarily to “delay,” “defer,” or “postpone” their fertility for educational and career purposes, thereby achieving reproductive autonomy [ 8 ], and forestalling age-related fertility decline [ 9 – 12 ]. However, it is unclear from these recent overviews whether postponement of fertility through EEF is intentional and planned, and whether the achievement of career advancement or reproductive autonomy are women’s primary EEF goals.…”

Section: Introductionmentioning

confidence: 99%

Elective egg freezing and its underlying socio-demography: a binational analysis with global implications

Inhorn

Birenbaum‐Carmeli

Birger³

et al. 2018

Reprod Biol Endocrinol

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BackgroundWhat are the underlying socio-demographic factors that lead healthy women to preserve their fertility through elective egg freezing (EEF)? Many recent reviews suggest that women are intentionally postponing fertility through EEF to pursue careers and achieve reproductive autonomy. However, emerging empirical evidence suggests that women may be resorting to EEF for other reasons, primarily the lack of a partner with whom to pursue childbearing. The aim of this study is thus to understand what socio-demographic factors may underlie women’s use of EEF.MethodsA binational qualitative study was conducted from June 2014 to August 2016 to assess the socio-demographic characteristics and life circumstances of 150 healthy women who had undertaken at least one cycle of elective egg freezing (EEF) in the United States and Israel, two countries where EEF has been offered in IVF clinics over the past 7–8 years. One hundred fourteen American women who completed EEF were recruited from 4 IVF clinics in the US (2 academic, 2 private) and 36 women from 3 IVF clinics in Israel (1 academic, 2 private). In-depth, audio-recorded interviews lasting from 0.5 to 2 h were undertaken and later transcribed verbatim for qualitative data analysis.ResultsWomen in both countries were educated professionals (100%), and 85% undertook EEF because they lacked a partner. This “lack of a partner” problem was reflected in women’s own assessments of why they were single in their late 30s, despite their desires for marriage and childbearing. Women themselves assessed partnership problems from four perspectives: 1) women’s higher expectations; 2) men’s lower commitments; 3) skewed gender demography; and 4) self-blame.DiscussionThe “lack of a partner” problem reflects growing, but little discussed international socio-demographic disparities in educational achievement. University-educated women now significantly outnumber university-educated men in the US, Israel, and nearly 75 other societies around the globe, according to World Bank data. Thus, educated women increasingly face a deficit of educated men with whom to pursue childbearing.ConclusionAmong healthy women, EEF is a technological concession to gender-based socio-demographic disparities, which leave many highly educated women without partners during their prime childbearing years. This information is important for reproductive specialists who counsel single EEF patients, and for future research on EEF in diverse national settings.

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Oocyte vitrification for elective fertility preservation: the past, present, and future

Cited by 39 publications

References 29 publications

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach

Patient-centered elective egg freezing: a binational qualitative study of best practices for women’s quality of care

Elective egg freezing and its underlying socio-demography: a binational analysis with global implications

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