Oocytes vitrification as an efficient option for elective fertility preservation
A discussion of how oocyte vitrification is clinically efficient for elective fertility preservation in the largest series reported to date and how the demand for this option is increasing.
Ana Cobo, Ph.D., Juan A. García-Velasco, M.D., Aila Coello, Ph.D., Javier Domingo, M.D., Antonio Pellicer, M.D., José Remohí, M.D.
Volume 105, Issue 3, Pages 755-764
To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP).
Retrospective observational multicenter study.
Private university-affiliated center.
A total of 1,468 women who underwent EFP because of age or having associated a medical condition other than cancer (January 2007 to April 2015).
Main Outcome Measure(s):
Survival and cumulative live birth rate (CLBR) per consumed oocyte.
Mean age was higher with EFP due to age versus having an associated medical reason (37.7 y [95% confidence interval (CI) 36.5–37.9] vs. 35.7 y [95% CI 34.9–36.3]). In total, 137 patients (9.3%) returned to use their oocytes. Overall survival rate was 85.2% (95% CI 83.2–87.2). Live birth rate per patient was higher in women ≤35 years old than ≥36 years old (50% [95% CI 32.7–67.3] vs. 22.9% [95% CI 14.9–30.9]). CLBR was higher and increased faster in younger women. The gain in CLBR was sharp from 5 (15.4%, 95% CI −4.2 to 35.0) to 8 oocytes (40.8%, 95% CI 13.2–68.4), with an 8.4% gain per additional oocyte, in the ≤35-year-old group. The increase was slower with 10–15 oocytes, reaching a plateau CLBR of 85.2%. A milder increase (4.9% gain) was observed in the ≥36-year-old group (from 5.1% [95% CI −0.6 to 10.7] to 19.9% [95% CI 8.7–31.1] when 5–8 oocytes were consumed), reaching the plateau with 11 oocytes (CLBR 35.6%). Forty babies were born.
At least 8–10 metaphase II oocytes are necessary to achieve reasonable success. Numbers should be individualized in women >36 years old. We suggest encouraging women who are motivated exclusively by a desire to postpone childbearing because of age, to come at younger ages to increase success possibilities.