Patients opting to Oocyte Cryopreservation have low rate of return for oocyte utilization: JAMA

In a groundbreaking cohort study using data from the Society for Assisted Reproductive Technology (SART) national database, researchers have unveiled intriguing patterns in the utilization of cryopreserved oocytes for family building. The study revealed a low overall rate of return to utilize previously vitrified oocytes despite an increasing number of patients pursuing oocyte cryopreservation.

The study results were published in the journal JAMA Network Open. 

Poor ovarian response (POR) to stimulation has the potential to influence patients' future inclination or necessity to use cryopreserved oocytes for family planning. These insights, gleaned from data provided by the Society for Assisted Reproductive Technology (SART), emphasize the importance of personalized counseling and additional research into the factors that shape decision-making regarding the utilization of oocytes. Hence, researchers conducted a study, spanning from January 2014 to December 2020, that sheds light on the association between ovarian response to stimulation and the likelihood of patients returning for oocyte utilization following planned oocyte cryopreservation (OC) along with the time elapsed from vitrification to warming.

The research, analyzing a staggering 67,893 autologous oocyte freezing cycles among 47,363 patients in US fertility clinics, identifies a subset of individuals experiencing Poor Ovarian Response (POR). This category comprises 13.5% of patients, totaling 6421 individuals, characterized by having fewer than 5 oocytes vitrified across all ovarian stimulation cycles.

Findings:

• Despite an overall low rate of return to utilize previously vitrified oocytes, patients with POR exhibit a significantly higher return rate (4.0%) compared to those with a normal ovarian response (2.3%).
• The age-specific trends are particularly noteworthy, with patients aged 30 to 34 years and 35 to 39 years in the POR group showing a more pronounced inclination to return for oocyte warming and utilization.
• Surprisingly, the time elapsed from vitrification to warming remains consistent between patients with POR and normal responders.
• Both groups exhibit similar average times, challenging the assumption that the delay in utilization is influenced by the ovarian response itself.
• Moreover, a multivariate analysis, adjusting for factors such as age, clinic region, body mass index, and history of endometriosis, identifies a key factor associated with the utilization of oocytes — having fewer than 5 oocytes vitrified.
• Patients falling into this category demonstrated higher odds of utilizing their cryopreserved oocytes.

The findings have implications for the growing number of individuals opting for oocyte cryopreservation. Despite the increased interest in fertility preservation, the study reveals a unique and somewhat unexpected pattern in patient behavior. The distinct trends observed among those with different ovarian responses suggest a complex interplay of factors influencing the decision to return for oocyte utilization. This research not only contributes to the evolving landscape of assisted reproductive technologies but also prompts a reevaluation of counseling strategies for individuals pursuing oocyte cryopreservation.

Further reading: Fouks Y, Sakkas D, Bortoletto PE, Penzias AS, Seidler EA, Vaughan DA. Utilization of Cryopreserved Oocytes in Patients With Poor Ovarian Response After Planned Oocyte Cryopreservation. JAMA Netw Open. 2024;7(1):e2349722.

doi:10.1001/jamanetworkopen.2023.49722