Faculty Bibliography

OBJECTIVE: To better understand women's beliefs, priorities, and attitudes toward oocyte cryopreservation, to appreciate the extent of their reproductive education, and to track the reproductive paths of women who chose to undergo oocyte cryopreservation treatment. DESIGN: An anonymous 30-question survey. SETTING: Not applicable. PATIENT(S): From 2005-2011, 478 women completed >/=1 oocyte cryopreservation treatment cycle at our center to defer reproduction. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Demographics, motivations, desires, fertility knowledge, and outcomes related to oocyte cryopreservation. RESULT(S): A total of 183 patients (38%) completed the survey with >80% being aged >/=35 years; white; having no partner at time of oocyte cryopreservation; undergoing oocyte cryopreservation after an optimal reproductive age; feeling they had improved their reproductive future after oocyte cryopreservation and being empowered by the process; aware of age-related infertility; sensing popular media falsely portrayed the upper age limit for natural conception; and recorded lack of partner as the primary rationale for not yet starting a family. Nineteen percent of respondents added that workplace inflexibility contributed to their reproductive dilemma. Half stated they learned about oocyte cryopreservation from a friend; others became aware through a medical provider, the media, and the internet. Most patients (93%) have not yet returned to use their frozen oocytes; 11 stated they had. Overall, 20% reported a successful conception after oocyte cryopreservation. CONCLUSION(S): Surveying oocyte cryopreservation patients provides a glimpse into the knowledge base and motivations surrounding current female reproductive practices. Oocyte cryopreservation technology may prove to bridge the gap between reproductive prime and when a woman is realistically "ready" to have children.

PURPOSE: Assess fertility preservation (FP) measures chosen by patients newly diagnosed with malignancy and their outcomes. METHODS: Reproductive-age patients referred for FP underwent counseling and elected cryopreservation vs. no treatment. Outcome measures included ovarian stimulation, FP choice, oocytes/zygotes retrieved/cryopreserved and pregnancy outcome. RESULTS: From 2005 to 2012, 136 patients were counseled with 124 electing treatment: 83 oocyte-only, 21 oocyte + zygote and 20 zygote-only cryopreservation. Age, partnership and financial status factored into FP choice. Treatment was completed in 12 +/- 2 days with 14 +/- 11 metaphase-II oocytes harvested and cryopreserved/cycle. Eight patients returned to attempt pregnancy; three succeeded. CONCLUSIONS: Our data demonstrate that oocyte and/or zygote banking are feasible FP options for women with malignancy; given the choice, the majority elected oocyte cryopreservation, highlighting desire for reproductive autonomy. Continued growth and research, combined with interdisciplinary communication, will ensure that appropriate candidates are offered FP and the potential for future parenthood, an important quality-of-life marker for survivors.