Oocyte cryopreservation (OC), or egg freezing, to preserve fertility has increased exponentially from 2014 to 2021, according to study findings published recently in the American Journal of Obstetrics and Gynecology.
Researchers, led by Mabel B. Lee, MD, obstetrician-gynecologist with the University of California, Los Angeles (UCLA), and colleagues performed a retrospective cohort study with data from all patients reported to the Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System who completed cryopreservation only of autologous oocytes for fertility preservation between 2014 and 2021. They also assessed all linked oocyte-warming cycles. The surveillance system collates data on all ART cycles from 90% of ART clinics in the US.
The data show that the number of patients undergoing egg freezing for elective fertility preservation jumped from 4153 in 2014 to 16,436 in 2021 (P < .01).
“That shows that it’s a procedure that’s more accepted, more talked about, and being performed more,” said Shahin Ghadir, MD, obstetrician-gynecologist and reproductive endocrinologist/fertility specialist with HRC Fertility in Beverly Hills, California, who was not part of the study.
Ghadir, also an assistant clinical professor in the Department of Obstetrics and Gynecology at UCLA and University of Southern California, Los Angeles, told Medscape Medical News that the paper reflects what he sees in his practice.
Age of Women Undergoing Egg Freezing Dips
The authors noted the average age of women undergoing egg freezing also decreased slightly from 36 years in 2014 to 34.9 years in 2021 (P < .01). Ghadir said the age decrease has been even more dramatic in his practice and has changed from “women coming in just before their 40th birthday” to women seeking the procedure at age 31 or 32.
They point out that the rate for those who come back to use cryopreserved oocytes within a 5- to 7-year follow-up period from planned OC cycles occurring between 2014 and 2016 was low and decreased with increasing patient age at the time of egg freezing. Only 852 patients (5.7%) returned for oocyte warming. But the outcomes after warming are reassuring.
Most Oocyte Warming Yields Usable Embryo
“Of patients who returned for oocyte warming,” the authors wrote, “78.5% (n = 669) obtained a usable embryo, while 21.5% (n = 183) had no useable embryos.”
Ghadir noted that often lifestyle and careers drive the choice to freeze eggs, and “some of those things don’t go away,” he said. “Trying to find the exact time when to use [the eggs] and how to use are issues. And not every single one of the patients who freeze their eggs say they’re going to come back. They just want to leave options available.”
“I think one of the most important takeaways is that for many people freezing their eggs, their success rates are basically the same as other patients undergoing fertility treatment,” Ghadir said. “In the beginning stages of when we were doing egg freezing, we had to tell people that their success rates were going to be much lower than if you were making embryos and trying to have a baby at that time. But the science has advanced so much that the success rates are by far higher and equivalent to probably the rest of the fertility world.”
Higher Age, Lower Odds of Success
However, the researchers found a significant decrease in the likelihood of obtaining a usable embryo with increasing age (P = .01) and that, Ghadir said, may be the most critical message in counseling patients.
“One thing we can clearly tell people is that the younger you are when you freeze your eggs, the better the chances of having more eggs that are quality eggs with better outcomes. Being proactive at a younger age is much more important than anything during this process,” Ghadir said.
Racial Breakdown Unchanged
Though the number of OC procedures has grown, the racial breakdown for those seeking them has not changed, according to the report.
“Patients pursuing planned OC tend to be single, Caucasian women who are highly educated, from higher socioeconomic backgrounds, and in professional occupations,” the authors wrote. “Our findings show that populations with the least access to ART continue to be the most underrepresented, despite increased access and utilization. Our findings serve as a further call to action to rectify disparities.”
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