Analysis of the Literature and Patient Counseling Considerations for Planned Oocyte Cryopreservation

Abstract

As oocyte cryopreservation use increases among reproductive-aged women, health care professionals are challenged with counseling patients on fertility-sparing technology based on limited high-quality research. Since the first successful slow freezing of mouse embryos in England in 1972, reproductive scientists have employed various protocols for successful cryopreservation and warming of gametes. From outdated slow-freeze technologies to improved vitrification methods, science has successfully shifted the pendulum from cryoinjury-related cell death to the preservation of cellular immortality. The clinical applications of oocyte cryopreservation first increased among oncofertility patients faced with limited fertility-sparing options. Breakthroughs in oncofertility opened a window of opportunity for the transgender community, which also led to an entirely new frontier-planned oocyte cryopreservation for potential future use. Reasons for cryopreservation are complex and often overlap. Socially, these can include not having a support person to share childcare responsibilities, prioritizing career goals and aspirations, and the financial constraints of the ever-rising cost of childrearing. Medically, reasons can include diseases, primary ovarian insufficiency, traumatic injury, planned female to male gender transition, and fertility loss that occurs with aging. Women are faced with many, if not all, of the above scenarios during their "ideal" reproductive window. These women are presenting to fertility centers in hopes of allowing for future reproductive freedom. Owing to media influence, women may be misled of the success potential of cryopreserved oocytes as a guarantee of future biological children. Here, we review current literature and propose guidelines for counseling patients on planned oocyte cryopreservation.