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Medical and elective fertility preservation: impact of removal of the experimental label from oocyte cryopreservation

  • Fertility Preservation
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Abstract

Purpose

The purpose of this study was to compare baseline characteristics and ovarian stimulation outcomes between patients presenting for medically indicated vs. elective fertility preservation consultation and to determine the impact of the 2013 ASRM guidelines on oocyte cryopreservation on the patient population presenting for fertility preservation consultation.

Methods

Retrospective cohort study conducted at an academic center. Study population included 332 patients presenting for medically indicated fertility preservation consultation and 210 patients presenting for elective consultation.

Results

Patients presenting for elective fertility preservation consultation were more likely to be of advanced age, non-Caucasian, highly educated, single, nulligravid, and meet criteria for diminished ovarian reserve (DOR). Additionally, patients presenting electively were more likely to have fertility insurance benefits. A higher percentage of patients with insurance benefits for oocyte cryopreservation proceeded to stimulation. There were no differences in stimulation parameters or number of retrieved oocytes between the groups when adjusted for age. Following release of the ASRM guidelines on oocyte cryopreservation, there was no difference in the percentage of patients in the medical group who proceeded with stimulation; however, a higher percentage of patients presenting electively underwent ovarian stimulation.

Conclusion

Although the populations presenting for medical compared with elective fertility preservation differ at baseline, ovarian stimulation parameters and outcomes are similar when adjusted for age. Insurance benefits for fertility preservation are not comprehensive and impact the decision to proceed with stimulation in all patients. The publication of the ASRM guidelines on oocyte cryopreservation increased utilization of this technology among patients presenting electively; however, they remained at an advanced age and with decreased ovarian reserve parameters.

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Author information

Authors and Affiliations

  1. Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, University of Pennsylvania, 3701 Market Street, Suite 800, Philadelphia, PA, 19104, USA

    Samantha B. Schon

  2. Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, University of Michigan Medical School, L4000 UH-South, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA

    Samantha B. Schon, Clarisa Gracia & Suneeta Senapati

  3. University of Pennsylvania School of Medicine, 3701 Market Street, Suite 800, Philadelphia, PA, 19104, USA

    Maren Shapiro

  4. Department of Obstetrics & Gynecology, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Maren Shapiro

Authors
  1. Samantha B. Schon
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  2. Maren Shapiro
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  3. Clarisa Gracia
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  4. Suneeta Senapati
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Corresponding author

Correspondence to Samantha B. Schon.

Ethics declarations

The study protocol was approved by the Institutional Review Board at the University of Pennsylvania (IRB #819938). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

Funding sources

NIH T32 HD040135 (SBS), 5K12HD065257-07 (SBS), and 5K12HD001265-14 (SS)

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Schon, S.B., Shapiro, M., Gracia, C. et al. Medical and elective fertility preservation: impact of removal of the experimental label from oocyte cryopreservation. J Assist Reprod Genet 34, 1207–1215 (2017). https://doi.org/10.1007/s10815-017-0968-5

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  • DOI: https://doi.org/10.1007/s10815-017-0968-5

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