Oocyte Cryopreservation No Longer Experimental

Ricki Lewis, PhD

December 23, 2013

Cryopreservation of oocytes should no longer be considered experimental treatment for certain women, according to a Committee on Gynecologic Practice Opinion from the American College of Obstetricians and Gynecologists. The practice opinion supports a 2013 joint document from the American Society for Reproductive Medicine and the Society for Reproductive Technology. However, all 3 organizations state that insufficient evidence supports the use of cryopreservation of oocytes for healthy women with functioning ovaries, so as to delay parenthood.

The opinion was published in the January 2014 issue of Obstetrics & Gynecology.

Improved methods of vitrification during the past decade have increased fertilization and conception rates for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), using frozen oocytes. Success rates are similar to these assisted reproductive technologies using fresh oocytes.

"Fertility preservation" using frozen oocytes has been best studied in and is used for women whose oocytes are at risk of damage from treatments such as chemotherapy and pelvic radiation for cancer, as well as for women who have primary ovarian insufficiency, such as that resulting from XO syndrome or fragile X syndrome.

Cryopreserved oocytes may also be useful in treating infertility. For infertile patients younger than 35 years, using cryopreserved oocytes in IVF or ICSI is as successful as using fresh oocytes, according to several randomized controlled clinical trials, observational studies, and a meta-analysis. Studies indicate that implantation rates in this group ranged from 17% to 41%, and pregnancy rates per procedure ranged from 36% to 65%.

Maternal age of the oocyte donor appears to be a more meaningful predictor of success than whether the oocyte was fresh or cryopreserved.

Oocyte cryopreservation may be an attractive option to preserve fertility that would involve only the woman compared with freezing embryos. The committee calls it "an appealing option for those women who wish to defer childbearing until later in life."

To date, oocyte cryopreservation has not been associated with damage to the neonate compared with other assisted reproductive techniques, but the committee recommends confirmation of this observation in diverse patient groups.

The committee concludes that data are too sparse "to recommend oocyte cryopreservation for the sole purpose of circumventing reproductive aging in healthy women." They advise counseling patients about this lack of data on oocyte cryopreservation and to discuss alternatives to freezing oocytes.

Obstet Gynecol. 2014;123:221-222.

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