A survey of women who cryopreserved oocytes for non-medical indications

Abstract

Objective: What are the expectations, experiences, and fertility awareness status of women who underwent social oocyte cryopreservation? Design: All women who underwent social oocyte cryopreservation between January 2015 and June 2016 were recruited. One hundred thirty three women were invited to participate in a survey at least 6 months after completion of the treatment cycle. Materials and Methods: Eigthy-one patients completed the survey.All women were given personalized counselling before starting the treatment cycle. Counselling included, chances of natural conception at a given age and the concept of ovarian reserve. The questionnaire investigated initial motivation towards freezing, intentions to use cryopreserved oocytes, treatment experience, awareness of fertility and knowledge about chances of having a live birth with their frozen oocytes. Results: The mean (± standard deviation) age at the time of oocyte freezing was 38.5 ± 2.68 years. The average number (min - max) of mature oocytes cryopreserved was 5.48 ± 6.6 (1-16). Two major motivations were absence of a male partner at the time of decision (40%) and an anticipated age-related fertility decline (42%). Majority of women (42%) opted to limit the use of cryopreserved oocytes up to the age of 45, and 51% of bankers wished that they had completed their family by the age of 35. 41% of the women told that they would donate their oocytes for research, 35% discard, and 24% donate to other infertile couples, if they did not use for own reproduction. 54% of patients thought that they did not have an adequate number of stored oocytes, 43 % wanted to do another cycle. 59% of the latter, were not able to undergo another cycle since they couldn’t afford another cycle. 42% and 35% of the women reported anxiety and injections, respectively, as the most challenging factor during treatment. Almost 60% overestimated the chances of natural conception, as well as the success of IVF at the age of 40 years. Half of the oocyte bankers reported that fertility declined between ages 35-39 but only 28% of patients estimated the live birth rate per cryopreserved oocyte correctly. Overall 98.8% stated that they would recommend oocyte cryopresevation to a friend and 72% felt more secure in terms of reproductive potential. Conclusions: Despite comprehensive personalized counselling prior to the start of ovarian stimulation, many women, as well as some health care policy makers do not seem to have a realistic understanding of reproductive ageing. Overestimaing effectiveness of assisted reproductive technology and arbitrarily delaying childbearing can lead to future childlessnes. Even though gamete cryopreservation provides some insurance, overestimating the effectiveness of oocyte cryopreservation can also lead to a false sense of security. Increasing awareness and knowledge about reproductive ageing is needed.