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Objectives: In 2012, an estimated 790,740 new female cancers will be diagnosed; 9% in women of reproductive age. This, combined with a global delay in childbearing threatens the ability of women to reproduce. Recent advances in cryobiology have resulted in >1500 live births as a result of OC, with pregnancy/live-birth rates matching those of conventional IVF in some centers, thus, providing the option for autonomous fertility preservation (FP) and the chance for successful reproduction at a time more conducive to childbearing. Methods: Given the demand for OC (both for cancer and personal indications), we now offer this FP measure at our center. In addition, we have surveyed a cohort of both young women and patients regarding OC. Along with NIH personnel, we have also created a mathematical model to analyze the cost-effectiveness of this FP measure. Results: NYU has now completed 1,063 OC cycles. Surveyed patients stated that despite being aware of age-related infertility, they continue to delay childbearing for personal reasons. For them, natural conception, autologous ART, then elective OC were ranked above donor oocyte and adoption as potential means to create family. To date, 60 women at NYU have undergone transfer using thawed oocytes (frozen at =42y; mean age: 34y); thirty-three (55%) have achieved pregnancy − 7 miscarried, 23 have delivered 29 liveborn infants and 3 currently have ongoing gestations. Thus, the livebirth/ongoing pregnancy rate is 43%; 18% for oocytes frozen at age 40–42y. With this information, assuming delay of attempted conception until age 40y, we calculated that the use of OC results in a lower cost-per-live-birth than timed intercourse, followed by conventional IVF if unsuccessful, so long as OC was performed by age 38y. Lastly, we surveyed women enrolled in American post-secondary institutions (n=1,111; mean age 22y) for their opinions regarding reproductive practices; 72% stated they would consider using OC as a conception-enhancing modality; 86% indicating a preference to use their own frozen oocytes over those of an anonymous donor. Conclusion: Although OC is labeled experimental by the ASRM, ample evidence now exists supporting its use in women who elect or need to delay reproduction. Furthermore, in select clinics, success rates mirror those reported after IVF. Therefore, wherever feasible, FP should be made available to interested women.

Copyright 2012 by The Society for the Study of Reproduction.
Issue Section:
8/13/2012
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