Advertisement

Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval

      Objective

      To evaluate a single treatment center's experience with autologous IVF using vitrified and warmed oocytes, including fertilization, embryonic development, pregnancy, and birth outcomes, and to estimate the likelihood of live birth of at least one, two, or three children according to the number of mature oocytes cryopreserved by elective fertility preservation patients.

      Design

      Retrospective cohort study.

      Setting

      Private practice clinic.

      Patient(s)

      Women undergoing autologous IVF treatment using vitrified and warmed oocytes. Indications for oocyte vitrification included elective fertility preservation, desire to limit the number of oocytes inseminated and embryos created, and lack of available sperm on the day of oocyte retrieval.

      Intervention(s)

      Oocyte vitrification, warming, and subsequent IVF treatment.

      Main Outcome Measure(s)

      Post-warming survival, fertilization, implantation, clinical pregnancy, and live birth rates.

      Result(s)

      A total of 1,283 vitrified oocytes were warmed for 128 autologous IVF treatment cycles. Postthaw survival, fertilization, implantation, and birth rates were all comparable for the different oocyte cryopreservation indications; fertilization rates were also comparable to fresh autologous intracytoplasmic sperm injection cycles (70% vs. 72%). Implantation rates per embryo transferred (43% vs. 35%) and clinical pregnancy rates per transfer (57% vs. 44%) were significantly higher with vitrified–warmed compared with fresh oocytes. However, there was no statistically significant difference in live birth/ongoing pregnancy (39% vs. 35%). The overall vitrified–warmed oocyte to live born child efficiency was 6.4%.

      Conclusion(s)

      Treatment outcomes using autologous oocyte vitrification and warming are as good as cycles using fresh oocytes. These results are especially reassuring for infertile patients who must cryopreserve oocytes owing to unavailability of sperm or who wish to limit the number of oocytes inseminated. Age-associated estimates of oocyte to live-born child efficiencies are particularly useful in providing more explicit expectations regarding potential births for elective oocyte cryopreservation.

      Key Words

      To read this article in full you will need to make a payment

      References

        • Noyes N.
        • Porcu E.
        • Borini A.
        Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies.
        Reprod Biomed Online. 2009; 18: 769-776
        • Practice Committees of American Society for Reproductive Medicine
        Society for Assisted Reproductive Techologies. Mature oocyte cryopreservation: a guideline.
        Fertil Steril. 2013; 99: 37-43
        • Cobo A.
        • Meseguer M.
        • Remohi 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
        • Sole M.
        • Santalo J.
        • Boada M.
        • Clua E.
        • Rodriguez I.
        • Martinez F.
        • et al.
        How does vitrification affect oocyte viability in oocyte donation cycles? A prospective study to compare outcomes achieved with fresh versus vitrified sibling oocytes.
        Hum Reprod. 2013; 28: 2087-2092
        • Trokoudes K.M.
        • Pavlides C.
        • Zhang X.
        Comparison outcome of fresh and vitrified donor oocytes in an egg-sharing donation program.
        Fertil Steril. 2011; 95: 1996-2000
        • Chang C.C.
        • Elliott T.A.
        • Wright G.
        • Shapiro D.B.
        • Toledo A.A.
        • Nagy Z.P.
        Prospective controlled study to evaluate laboratory and clinical outcomes of oocyte vitrification obtained in in vitro fertilization patients aged 30 to 39 years.
        Fertil Steril. 2013; 99: 1891-1897
        • Rienzi L.
        • Romano S.
        • Albricci L.
        • Maggiulli R.
        • Capalbo A.
        • Baroni E.
        • et al.
        Embryo development of fresh ‘versus’ vitrified metaphase II oocytes after ICSI: a prospective randomized sibling-oocyte study.
        Hum Reprod. 2010; 25: 66-73
        • Forman E.J.
        • Li X.
        • Ferry K.M.
        • Scott K.
        • Treff N.R.
        • Scott Jr., R.T.
        Oocyte vitrification does not increase the risk of embryonic aneuploidy or diminish the implantation potential of blastocysts created after intracytoplasmic sperm injection: a novel, paired randomized controlled trial using DNA fingerprinting.
        Fertil Steril. 2012; 98: 644-649
        • Antinori M.
        • Licata E.
        • Dani G.
        • Cerusico F.
        • Versaci C.
        • Antinori S.
        Cryotop vitrification of human oocytes results in high survival rate and healthy deliveries.
        Reprod Biomed Online. 2007; 14: 72-79
        • Stillman R.J.
        • Richter K.S.
        • Banks N.K.
        • Graham J.R.
        Elective single embryo transfer: a 6-year progressive implementation of 784 single blastocyst transfers and the influence of payment method on patient choice.
        Fertil Steril. 2009; 92: 1895-1906
        • Kuwayama M.
        • Vajta G.
        • Kato O.
        • Leibo S.P.
        Highly efficient vitrification method for cryopreservation of human oocytes.
        Reprod Biomed Online. 2005; 11: 300-308
        • Gardner D.K.
        • Schoolcraft W.B.
        In vitro culture of human blastocysts.
        in: Jansen R. Mortimer D. Towards reproductive certainty: fertility and genetics beyond 1999. Parthenon Publishing Group, Carnforth, UK1999: 378-388
        • Liebermann J.
        • Tucker M.J.
        Comparison of vitrification and conventional cryopreservation of day 5 and day 6 blastocysts during clinical application.
        Fertil Steril. 2006; 86: 20-26
        • Cao Y.
        • Xing Q.
        • Zhang Z.G.
        • Wei Z.L.
        • Zhou P.
        • Cong L.
        Cryopreservation of immature and in-vitro matured human oocytes by vitrification.
        Reprod Biomed Online. 2009; 19: 369-373
        • Fasano G.
        • Demeestere I.
        • Englert Y.
        In-vitro maturation of human oocytes: before or after vitrification?.
        J Assist Reprod Genet. 2012; 29: 507-512
        • Jee B.C.
        • Chen H.Y.
        • Chian R.C.
        • Suh C.S.
        • Kim S.H.
        • Moon S.Y.
        Vitrification of immature mouse oocyte using stepwise equilibration before or after in vitro maturation.
        Fertil Steril. 2009; 92: 1153-1157
        • Roque M.
        • Lattes K.
        • Serra S.
        • Sola I.
        • Geber S.
        • Carreras R.
        • et al.
        Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis.
        Fertil Steril. 2013; 99: 156-162
        • Shapiro B.S.
        • Daneshmand S.T.
        • Garner F.C.
        • Aguirre M.
        • Hudson C.
        • Thomas S.
        Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responders.
        Fertil Steril. 2011; 96: 344-348
        • Shapiro B.S.
        • Daneshmand S.T.
        • Restrepo H.
        • Garner F.C.
        • Aguirre M.
        • Hudson C.
        Matched-cohort comparison of single-embryo transfers in fresh and frozen-thawed embryo transfer cycles.
        Fertil Steril. 2013; 99: 389-392
        • Evans J.
        • Hannan N.J.
        • Hincks C.
        • Rombauts L.J.
        • Salamonsen L.A.
        Defective soil for a fertile seed? Altered endometrial development is detrimental to pregnancy success.
        PLoS One. 2012; 7: e53098
        • Fauser B.C.
        • Devroey P.
        Reproductive biology and IVF: ovarian stimulation and luteal phase consequences.
        Trends Endocrinol Metab. 2003; 14: 236-242
        • Cobo A.
        • Castello D.
        • Vallejo B.
        • Albert C.
        • de los Santos J.M.
        • Remohi J.
        Outcome of cryotransfer of embryos developed from vitrified oocytes: double vitrification has no impact on delivery rates.
        Fertil Steril. 2013; 99: 1623-1630
        • Devine K.
        • Mumford S.L.
        • Goldman K.N.
        • Hodes-Wertz B.
        • Druckenmiller S.
        • Propst A.M.
        • et al.
        Baby budgeting: oocyte cryopreservation in women delaying reproduction can reduce cost per live birth.
        Fertil Steril. 2015; 103: 1446-1453.e2
        • Mesen T.B.
        • Mersereau J.E.
        • Kane J.B.
        • Steiner A.Z.
        Optimal timing for elective egg freezing.
        Fertil Steril. 2015; 103: 1551-1556.e4
        • Garcia-Velasco J.A.
        • Domingo J.
        • Cobo A.
        • Martinez M.
        • Carmona L.
        • Pellicer A.
        Five years' experience using oocyte vitrification to preserve fertility for medical and nonmedical indications.
        Fertil Steril. 2013; 99: 1994-1999
        • Martinez M.
        • Rabadan S.
        • Domingo J.
        • Cobo A.
        • Pellicer A.
        • Garcia-Velasco J.A.
        Obstetric outcome after oocyte vitrification and warming for fertility preservation in women with cancer.
        Reprod Biomed Online. 2014; 29: 722-728
        • Levi Setti P.E.
        • Porcu E.
        • Patrizio P.
        • Vigiliano V.
        • de Luca R.
        • d'Aloja P.
        • et al.
        Human oocyte cryopreservation with slow freezing versus vitrification. Results from the National Italian Registry data, 2007-2011.
        Fertil Steril. 2014; 102: 90-95.e2