Ana Cobo1, Juan A García-Velasco2, Aila Coello3, Javier Domingo4, Antonio Pellicer5, José Remohí3. 1. IVI-Valencia, Institut Universitari IVI, Valencia, Spain. Electronic address: ana.cobo@ivi.es. 2. IVI-Madrid, Universidad Rey Juan Carlos, Madrid, Spain. 3. IVI-Valencia, Institut Universitari IVI, Valencia, Spain. 4. IVI-Las Palmas, Las Palmas, Spain. 5. IVI Foundation, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
Abstract
OBJECTIVE: To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP). DESIGN: Retrospective observational multicenter study. SETTING: Private university-affiliated center. PATIENT(S): A total of 1,468 women who underwent EFP because of age or having associated a medical condition other than cancer (January 2007 to April 2015). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Survival and cumulative live birth rate (CLBR) per consumed oocyte. RESULT(S): Mean age was higher with EFP due to age versus having an associated medical reason (37.7 y [95% confidence interval (CI) 36.5-37.9] vs. 35.7 y [95% CI 34.9-36.3]). In total, 137 patients (9.3%) returned to use their oocytes. Overall survival rate was 85.2% (95% CI 83.2-87.2). Live birth rate per patient was higher in women ≤35 years old than ≥36 years old (50% [95% CI 32.7-67.3] vs. 22.9% [95% CI 14.9-30.9]). CLBR was higher and increased faster in younger women. The gain in CLBR was sharp from 5 (15.4%, 95% CI -4.2 to 35.0) to 8 oocytes (40.8%, 95% CI 13.2-68.4), with an 8.4% gain per additional oocyte, in the ≤35-year-old group. The increase was slower with 10-15 oocytes, reaching a plateau CLBR of 85.2%. A milder increase (4.9% gain) was observed in the ≥36-year-old group (from 5.1% [95% CI -0.6 to 10.7] to 19.9% [95% CI 8.7-31.1] when 5-8 oocytes were consumed), reaching the plateau with 11 oocytes (CLBR 35.6%). Forty babies were born. CONCLUSION(S): At least 8-10 metaphase II oocytes are necessary to achieve reasonable success. Numbers should be individualized in women >36 years old. We suggest encouraging women who are motivated exclusively by a desire to postpone childbearing because of age, to come at younger ages to increase success possibilities.
OBJECTIVE: To provide a detailed description of the current oocyte vitrification status as a means of elective fertility preservation (EFP). DESIGN: Retrospective observational multicenter study. SETTING: Private university-affiliated center. PATIENT(S): A total of 1,468 women who underwent EFP because of age or having associated a medical condition other than cancer (January 2007 to April 2015). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Survival and cumulative live birth rate (CLBR) per consumed oocyte. RESULT(S): Mean age was higher with EFP due to age versus having an associated medical reason (37.7 y [95% confidence interval (CI) 36.5-37.9] vs. 35.7 y [95% CI 34.9-36.3]). In total, 137 patients (9.3%) returned to use their oocytes. Overall survival rate was 85.2% (95% CI 83.2-87.2). Live birth rate per patient was higher in women ≤35 years old than ≥36 years old (50% [95% CI 32.7-67.3] vs. 22.9% [95% CI 14.9-30.9]). CLBR was higher and increased faster in younger women. The gain in CLBR was sharp from 5 (15.4%, 95% CI -4.2 to 35.0) to 8 oocytes (40.8%, 95% CI 13.2-68.4), with an 8.4% gain per additional oocyte, in the ≤35-year-old group. The increase was slower with 10-15 oocytes, reaching a plateau CLBR of 85.2%. A milder increase (4.9% gain) was observed in the ≥36-year-old group (from 5.1% [95% CI -0.6 to 10.7] to 19.9% [95% CI 8.7-31.1] when 5-8 oocytes were consumed), reaching the plateau with 11 oocytes (CLBR 35.6%). Forty babies were born. CONCLUSION(S): At least 8-10 metaphase II oocytes are necessary to achieve reasonable success. Numbers should be individualized in women >36 years old. We suggest encouraging women who are motivated exclusively by a desire to postpone childbearing because of age, to come at younger ages to increase success possibilities.
Authors: F Cavagna; A Pontes; M Cavagna; A Dzik; N F Donadio; R Portela; M T Nagai; L H Gebrim Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677