Postponing Childbearing and Fertility Preservation in Young Professional Women

Hurley, Emily G.; Ressler, I.B.; Young, S.L.; Batcheller, A.E.; Thomas, Michael A.; DiPaola, K.B.; Rios, Julie Sroga

doi:10.14423/smj.0000000000000789

Cited by 17 publications

(13 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies reported contradictory findings regarding knowledge of age‐related fertility decline. Five studies reported that the majority of women among the general public had a realistic perception of the decline of fertility with advancing age (51%‐89.4%) 18‐22 . In Milman et al's study involving 1000 women, 40% were considered “fertility knowledgeable” by correctly answering four of six questions to assess general reproduction and age‐related fertility knowledge 23 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

Platts

Trigg

Bracewell‐Milnes

et al. 2020

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction Women are postponing childbearing and preventing age‐related fertility decline with oocyte freezing for non‐medical reasons (OFNMR). The objective of this systematic evaluation was to gain an understanding of women's attitudes and knowledge of, and intentions to use OFNMR among users of OFNMR and the general public. Material and methods A systematic search of MEDLINE, EMBASE, and PyschINFO databases was undertaken, for studies that examined the psychosocial attitudes among women toward OFNMR. The search was limited to English language and no time restriction was set for publications. Extracted data were analyzed using thematic analysis and the study was performed according to PRISMA guidelines with prospective PROSPERO registration (CRD4201912578). Results Overall, 35 studies met the inclusion criteria. Studies were broadly categorized into studies investigating users or potential users of OFNMR, and studies examining the views of members of the general public. Users of OFNMR have good knowledge of age‐related fertility decline and awareness of the OFNMR procedure. Lack of partner was identified as the most common motivating factor to undertake OFNMR, with cost as a predominant concern. Knowledge among the general public of OFNMR is highly variable. Underestimation of age‐related fertility decline is common among the general public. Intentions of women to use OFNMR also varied drastically between studies. Conclusions Women are predominantly motivated to freeze eggs by the lack of a suitable partner, but cost is a significant barrier. Increasing the number of women pursuing OFNMR at an earlier stage may positively impact upon the risk of future involuntary childlessness. Better information should be made available to both women and men about their fertility and options to inform their reproductive decision‐making.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Financial cost was a widely reviewed concern, 20‐22,28,31 with several studies identifying cost as the most important barrier to OFNMR 20,22,31 . In one study, 53% of women perceived £3000 per freezing cycle as too expensive 29 .…”

Section: Resultsmentioning

confidence: 99%

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

Platts

Trigg

Bracewell‐Milnes

et al. 2020

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

“…A total of 26 manuscripts were included in this section of the meta‐analysis 36–61 . Of the general population, 79%, and of healthcare professionals 89% had been aware of planned OC when surveyed (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Planned oocyte cryopreservation (Planned OC): systematic review and meta‐analysis of cost‐efficiency and patients’ perspective

Weizman

Baram

Montbriand

et al. 2020

BJOG

View full text Add to dashboard Cite

Background Advances in vitrification techniques have enabled planned oocyte cryopreservation (‘Planned OC’). Objectives To explore the cost‐efficiency and utilisation of planned OC, as well as patients’ perspectives on the process. Search strategy A systematic search in PubMed/MEDLINE, Embase, Cochrane Database and PsychINFO, for all relevant studies published between January 2007 and December 2019. Selection criteria The protocol followed PRISMA guidelines in PECO format, and was registered with PROSPERO. Data collection and analysis Two independent reviewers evaluated all manuscripts for inclusion eligibility. Authors were contacted for missing data. Included studies were assessed for risk of bias and for heterogeneity. Weighted effects were measured and plotted. Main results The search yielded 12 545 records, of which 43 were included. Planned OC is cost‐efficient at 35, assuming 60% utilisation; and at 37 assuming utilising donor sperm when necessary. At 38 it is cost‐efficient to defer planned OC in favour of undergoing 2 IVF cycles. Currently, utilisation of banked‐oocytes within 22–58 months, is up to 15%. Nine percent of warmed banked oocytes result in life births. Online resources and treating physicians are equally important sources of information regarding planned OC. Most patients think planned OC is ideal before age 35 and are not fully aware of what the process entails and tend to overestimate the success rates. The main barrier to wider endorsement of planned OC is being wary of potential health implications or of limited success. Conclusion Planned OC is an adequate method for preserving fertility. However, knowledge gaps result in under‐utilisation leading to reduced cost‐efficiency. Tweetable abstract Identifying facilitators and barriers for wider adoption of banking oocytes can enhance the cost‐efficiency of this modality.

show abstract

“…Sometimes, young women of reproductive age are offered AMH testing for a "personalized fertility assessment" to discuss fertility preservation with the aim of postponing childbearing [19,20]. Anti-Mullerian hormone (AMH) is not a qualitative marker of fertility in healthy young women; spontaneous pregnancies are reported even for women with very low AMH levels [21].…”

Section: Idiopathic Diminished Ovarian Reserve In the Absence Of Gynecologic And Endocrinologic Diseasesmentioning

confidence: 99%

Oocyte Vitrification for Fertility Preservation in Women with Benign Gynecologic Disease: French Clinical Practice Guidelines Developed by a Modified Delphi Consensus Process

Courbière¹,

Roux²,

d’Argent³

et al. 2021

JCM

View full text Add to dashboard Cite

International guidelines are published to provide standardized information and fertility preservation (FP) care for adults and children. The purpose of the study was to conduct a modified Delphi process for generating FP guidelines for BGD. A steering committee identified 42 potential FP practices for BGD. Then 114 key stakeholders were asked to participate in a modified Delphi process via two online survey rounds and a final meeting. Consensus was reached for 28 items. Among them, stakeholders rated age-specific information concerning the risk of diminished ovarian reserve after surgery as important but rejected proposals setting various upper and lower age limits for FP. All women should be informed about the benefit/risk balance of oocyte vitrification—in particular about the likelihood of live birth according to age. FP should not be offered in rASRM stages I and II endometriosis without endometriomas. These guidelines could be useful for gynecologists to identify situations at risk of infertility and to better inform women with BGDs who might need personalized counseling for FP.

show abstract

Postponing Childbearing and Fertility Preservation in Young Professional Women

Abstract: Women should be counseled regarding reproductive aging and options for fertility preservation. Offering ovarian reserve testing and making OC more affordable may increase the number of women who undergo elective OC.

Cited by 17 publications

References 9 publications

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

Planned oocyte cryopreservation (Planned OC): systematic review and meta‐analysis of cost‐efficiency and patients’ perspective

Oocyte Vitrification for Fertility Preservation in Women with Benign Gynecologic Disease: French Clinical Practice Guidelines Developed by a Modified Delphi Consensus Process

Contact Info

Product

Resources

About