Likelihood of achieving a 50%, 60%, or 70% estimated live birth rate threshold with 1 or 2 cycles of planned oocyte cryopreservation

• Published in: Journal of assisted reproduction and genetics Vol. 37; no. 7; pp. 1637 - 1643
• Main Authors: Maslow, Bat-Sheva L., Guarnaccia, Michael M., Ramirez, Leslie, Klein, Joshua U.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-07-2020; Springer Nature B.V
• Subjects: Adult; Age; Anti-Mullerian Hormone - blood; Assisted Reproduction Technologies; Birth Rate; Cryopreservation; Cryopreservation - methods; Female; Fertilization in Vitro - methods; Fertilization in Vitro - statistics & numerical data; Gynecology; Human Genetics; Humans; Live Birth; Maternal Age; Medicine; Medicine & Public Health; Oocyte Retrieval - methods; Oocytes; Oocytes - physiology; Pregnancy; Reproductive Medicine; Retrospective Studies; Live birth rate; Fertility preservation; Oocyte cryopreservation
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-020-01791-w

Purpose
To characterize the likelihood of cryopreserving enough oocytes for 50%, 60%, or 70% estimated live birth rate (eLBR) with 1–2 planned oocyte cryopreservation (Pl-OC) cycles.
Methods
We performed a retrospective cohort study utilizing all patients completing ≥ 1 Pl-OC cycle from 2016 to 2018 at a large single-center OC program. Subjects were categorized by age at retrieval and number of cycles. We extrapolated age-based oocyte thresholds for 50%, 60%, or 70% eLBR from previously published data. We calculated the proportion of subjects overall, and for each age group, whose number of frozen oocytes was greater than or equal to their age-based threshold for a 50%, 60%, or 70% eLBR after 1 and 2 cycles. OR for 60% eLBR with one cycle was calculated for age and AMH cutoff values and corroborated with logistic regression.
Results
A total of 1241 subjects, completing 1799 Pl-OC cycles, were included. With one cycle, 66% (819/1241) achieved ≥ 50% eLBR and 51% (634/1241) achieved 70% eLBR. With two cycles, 79.6% (988/1241) attained ≥ 50% eLBR and 65.5% (813/1241) achieved 70% eLBR. Achieving 50%, 60%, or 70% eLBR with 1–2 cycles was significantly associated with both age (
p
 < 0.001) and AMH (
p
 < 0.001). Age < 37.5 and AMH > 1.995 were independently associated with attaining 60% eLBR with one cycle (age: OR 13.73; 95%CI 9.16–20.57,
p
 < 0.001; AMH: OR 7.32; 95% CI 5.50–9.76,
p
 < 0.001).
Conclusions
Younger age and higher AMH were associated with achieving 50%, 60%, or 70% eLBR thresholds with Pl-OC. Nevertheless, almost all subjects were successfully able to preserve enough oocytes for ≥ 50% eLBR in 1–2 cycles.