Optimal timing for elective egg freezing


      To estimate the optimal age to pursue elective oocyte cryopreservation.


      A decision-tree model was constructed to determine the success and cost-effectiveness of oocyte preservation versus no action when considered at ages 25–40 years, assuming an attempt at procreation 3, 5, or 7 years after initial decision.


      Not applicable.


      Hypothetical patients 25–40 years old presenting to discuss elective oocyte cryopreservation.


      Decision to cryopreserve oocytes from age 25 years to age 40 years versus taking no action.

      Main Outcome and Measure(s)

      Probability of live birth after initial decision whether or not to cryopreserve oocytes.


      Oocyte cryopreservation provided the greatest improvement in probability of live birth compared with no action (51.6% vs. 21.9%) when performed at age 37 years. The highest probability of live birth was seen when oocyte cryopreservation was performed at ages <34 years (>74%), although little benefit over no action was seen at ages 25–30 years (2.6%–7.1% increase). Oocyte cryopreservation was most cost-effective at age 37 years, at $28,759 per each additional live birth in the oocyte cryopreservation group. When the probability of marriage was included, oocyte cryopreservation resulted in little improvement in live birth rates.


      Oocyte cryopreservation can be of great benefit to specific women and has the highest chance of success when performed at an earlier age. At age 37 years, oocyte cryopreservation has the largest benefit over no action and is most cost-effective.

      Key Words

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        • Martin J.A.
        • Hamilton B.E.
        • Ventura S.J.
        Births: final data for 2011. National vital statistics reports, vol. 62, no. 1. DHHS publication no. 2014-1120.
        National Center for Health Statistics, Hyattsville, Maryland2012
        • Mathews T.J.
        • Hamilton B.E.
        Delayed childbearing: more women are having their first child later in life. NCHS data brief, no. 21. DHHS publication no. (PHS) 2009-1209.
        National Center for Health Statistics, Hyattsville, Maryland2009
        • ESHRE Capri Workshop Group
        Social determinants of human reproduction.
        Hum Reprod. 2001; 16: 1518-1526
        • Kreider R.M.
        • Ellis R.
        Number, timing, and duration of marriages and divorces: 2009. Current population reports.
        U.S. Census Bureau, Washington, D.C.2011: 70-125
        • van Noord-Zaadstra B.M.
        • Looman C.W.
        • Alsbach H.
        • Habbema J.D.
        • te Velde E.R.
        • Karbaat J.
        Delaying childbearing: effect of age on fecundity and outcome of pregnancy.
        BMJ. 1991; 302: 1361-1365
        • Luke B.
        • Brown M.B.
        • Wantman E.
        • Lederman A.
        • Gibbons W.
        • Schattman G.L.
        • et al.
        Cumulative birth rates with linked assisted reproductive technology cycles.
        N Engl J Med. 2012; 366: 2483-2491
        • Lockwood G.M.
        Social egg freezing: the prospect of reproductive “immortality” or a dangerous delusion?.
        Reprod Biomed Online. 2011; 23: 334-340
        • Cobo A.
        • Meseguer M.
        • Remohí J.
        • Pellicer A.
        Use of cryo-banked oocytes in an ovum donation programme: a prospective, randomized, controlled, clinical trial.
        Hum Reprod. 2010; 25: 2239-2246
        • Cobo A.
        • Garcia-Velasco J.A.
        • Domingo J.
        • Remohí J.
        • Pellicer A.
        Is vitrification of oocytes useful for fertility preservation for age-related fertility decline and in cancer patients?.
        Fertil Steril. 2013; 99: 1485-1495
        • Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology
        Mature oocyte cryopreservation: a guideline.
        Fertil Steril. 2013; 99: 37-43
        • Dondorp W.
        • de Wert G.
        • Pennings G.
        • Shenfield F.
        • Devroey P.
        • Tarlatzis B.
        • et al.
        • ESHRE Task Force on Ethics and Law
        Oocyte cryopreservation for age-related fertility loss.
        Hum Reprod. 2012; 27: 1231-1237
      1. McGregor J. The new Silicon Valley perk? Freezing your eggs. Available at: Accessed October 15, 2014.

        • Lepkowski J.M.
        • Mosher W.D.
        • Davis K.E.
        • Groves R.M.
        • van Hoewyk J.
        The 2006–2010 National Survey of Family Growth: sample design and analysis of a continuous survey (DHHS publication no. [PHS] 2010-1350).
        Vital Health Stat 2. 2010; 2: 1-35
        • Steiner A.Z.
        • Pritchard D.A.
        • Young S.L.
        • Herring A.H.
        Peri-implantation intercourse lowers fecundability.
        Fertil Steril. 2014; 102: 178-182
        • Nybo Andersen A.M.
        • Wohlfahrt J.
        • Christens P.
        • Olsen J.
        • Melbye M.
        Maternal age and fetal loss: population based register linkage study.
        BMJ. 2000; 320: 1708-1712
        • Centers for Disease Control and Prevention, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology
        2011 Assisted reproductive technology national summary report.
        U.S. Department of Health and Human Services, Atlanta2013
      2. Criteria for number of embryos to transfer: a committee opinion.
        Fertil Steril. 2013; 99: 44-46
        • Vitek W.S.
        • Galárraga O.
        • Klatsky P.C.
        • Robins J.C.
        • Carson S.A.
        • Blazar A.S.
        Management of the first in vitro fertilization cycle for unexplained infertility: a cost-effectiveness analysis of split in vitro fertilization-intracytoplasmic sperm injection.
        Fertil Steril. 2013; 100: 1381-1388
        • Little S.E.
        • Ratcliffe J.
        • Caughey A.B.
        Cost of transferring one through five embryos per in vitro fertilization cycle from various payor perspectives.
        Obstet Gynecol. 2006; 108: 593-601
      3. Resolve the national infertility association. The costs of infertility treatments. McLean, Virginia. Available at: Last Accessed March 26, 2015.

      4. American Society for Reproductive Medicine. Frequently asked questions about infertility. Birmingham, Alabama. Available at: Accessed October 1, 2014.

        • Smit J.G.
        • Kasius J.C.
        • Eijkemans M.J.
        • Koks C.A.
        • van Golde R.
        • Oosterhuis J.G.
        • et al.
        The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial.
        BMC Womens Health. 2012; 12: 22
        • van Loendersloot L.L.
        • Moolenaar L.M.
        • Mol B.W.
        • Repping S.
        • van der Veen F.
        • Goddijn M.
        Expanding reproductive lifespan: a cost-effectiveness study on oocyte freezing.
        Hum Reprod. 2011; 26: 3054-3060
        • Hirshfeld-Cytron J.
        • Grobman W.A.
        • Milad M.P.
        Fertility preservation for social indications: a cost-based decision analysis.
        Fertil Steril. 2012; 97: 665-670
        • Cil A.P.
        • Bang H.
        • Oktay K.
        Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis.
        Fertil Steril. 2013; 100: 492-493
        • Copen C.E.
        • Daniels K.
        • Vespa J.
        • Mosher W.D.
        First marriages in the United States: Data from the 2006–2010 national survey of family growth.
        Natl Health Stat Report. 2012; : 1-21
        • Kennedy S.
        • Fitch C.A.
        Measuring cohabitation and family structure in the United States: assessing the impact of new data from the Current Population Survey.
        Demography. 2012; 49: 1479-1498
        • Ventura S.J.
        Changing patterns of nonmarital childbearing in the United States. NCHS data brief, no. 18. DHHS publication no. (PHS) 2009-1209.
        National Center for Health Statistics, Hyattsville, Maryland2009
        • Martinez G.M.
        • Daniels K.
        • Chandra A.
        Fertility of men and women aged 15–44 years in the United States: National Survey of Family Growth, 2006–2010. National health statistics reports, no. 51. DHHS publication no. (PHS) 2012-1250.
        National Center for Health Statistics, Hyattsville, Maryland2012