Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval

Capsule:
In vitro fertilization using autologous vitrified–warmed oocytes is comparable to treatment using fresh oocytes. Oocyte vitrification is appropriate treatment for indications including unavailability of sperm, limited insemination, and elective fertility preservation.

Authors:
Joseph O. Doyle, M.D., Kevin S. Richter, Ph.D., Joshua Lim, M.S., Robert J. Stillman, M.D., James R. Graham, M.S., Michael J. Tucker, Ph.D.

Volume 105, Issue 2, Pages 459-466

Abstract:

Objective:
To evaluate a single treatment center’s experience with autologous IVF using vitrified and warmed oocytes, including fertilization, embryonic development, pregnancy, and birth outcomes, and to estimate the likelihood of live birth of at least one, two, or three children according to the number of mature oocytes cryopreserved by elective fertility preservation patients.

Design:
Retrospective cohort study.

Setting:
Private practice clinic.

Patient(s):
Women undergoing autologous IVF treatment using vitrified and warmed oocytes. Indications for oocyte vitrification included elective fertility preservation, desire to limit the number of oocytes inseminated and embryos created, and lack of available sperm on the day of oocyte retrieval.

Intervention(s):
Oocyte vitrification, warming, and subsequent IVF treatment.

Main Outcome Measure(s):
Post-warming survival, fertilization, implantation, clinical pregnancy, and live birth rates.

Result(s):
A total of 1,283 vitrified oocytes were warmed for 128 autologous IVF treatment cycles. Postthaw survival, fertilization, implantation, and birth rates were all comparable for the different oocyte cryopreservation indications; fertilization rates were also comparable to fresh autologous intracytoplasmic sperm injection cycles (70% vs. 72%). Implantation rates per embryo transferred (43% vs. 35%) and clinical pregnancy rates per transfer (57% vs. 44%) were significantly higher with vitrified–warmed compared with fresh oocytes. However, there was no statistically significant difference in live birth/ongoing pregnancy (39% vs. 35%). The overall vitrified–warmed oocyte to live born child efficiency was 6.4%.

Conclusion(s):
Treatment outcomes using autologous oocyte vitrification and warming are as good as cycles using fresh oocytes. These results are especially reassuring for infertile patients who must cryopreserve oocytes owing to unavailability of sperm or who wish to limit the number of oocytes inseminated. Age-associated estimates of oocyte to live-born child efficiencies are particularly useful in providing more explicit expectations regarding potential births for elective oocyte cryopreservation.

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