Searched for: in-biosketch:true
person:jkh305
Making it (net)work: a social network analysis of "fertility" in Twitter before and during the COVID-19 pandemic
Smith, Meghan B; Blakemore, Jennifer K; Ho, Jacqueline R; Grifo, James A
Objective/UNASSIGNED:To characterize activity, text sentiment, and online community characteristics regarding "fertility" on Twitter before and during the COVID-19 pandemic using social network analysis. Design/UNASSIGNED:Cross-sectional analysis. Setting/UNASSIGNED:Publicly available Twitter data. Patients/UNASSIGNED:Not applicable. Interventions/UNASSIGNED:Not applicable. Main Outcome Measures/UNASSIGNED:Number of users (vertices); edges (connections, defined as unique and total); self-loops (tweet without connection to another user); connected components (groups of users communicating back and forth frequently); maximum vertices in a connected component (largest group size); maximum and average geodesic distance (number of tweets to connect two users in the network); graph density; positive and negative sentiment tweets; and top 5 hashtags and top 5 word pairs. Results/UNASSIGNED:There were 1426 unique users and 401 groups in the pre-COVID-19 data compared to 1492 unique users and 453 groups in the during COVID-19 data. There was no difference in the number of total connections (96.8% [1381/1426] vs. 96.0% [1433/1492]) or self-loops (20.0% [286/1426] vs. 22.1% [329/1492]) before and during the COVID-19 pandemic. The percentage of unique connections per user decreased during COVID-19 (91.6% [1381/1508] pre-COVID-19 vs. 83.3% [1433/1720] during COVID-19). The average and maximum distance between users in the community increased during COVID-19 (maximum: 5 pre-COVID-19, 8 during COVID-19; average 1.95 pre-COVID-19, 2.43 during COVID-19). The percentage of positive sentiments per total number of tweets increased during COVID-19 (58.1% pre-COVID-19 [773/1331] vs. 64.3% [1198/1863] during COVID-19). The top 5 hashtags changed during COVID-19 to include COVID-19. The top word pairs changed from "family, hereditary; parents, children" to "fertility, treatment; healthcare, decisions." Conclusions/UNASSIGNED:Despite the challenge to the fertility community amidst the COVID-19 pandemic, the overall Twitter sentiment regarding fertility was more positive during than before the pandemic. Top hashtags and word pairs changed to reflect the emergence of COVID-19 and the unique healthcare decision-making challenges faced. While the character, the number of users, and the total connections remained constant, the number of unique connections and the distance between users changed to reflect more self-broadcasting and less tight connections.
PMCID:8655431
PMID: 34934990
ISSN: 2666-3341
CID: 5108862
Universal SARS-CoV-2 polymerase chain reaction screening and assisted reproductive technology in a coronavirus disease 2019 pandemic epicenter: screening and cycle outcomes from a New York City fertility center
Shaw, Jacquelyn; Tozour, Jessica; Blakemore, Jennifer K; Grifo, James
OBJECTIVE:To evaluate the prevalence of coronavirus disease 2019 (COVID-19) and efficacy of a universal screening program in patients undergoing controlled ovarian stimulation (COS). DESIGN:Single-center retrospective cohort study. SETTING:Academic fertility center in an epicenter of the COVID-19 pandemic. PATIENT(S):All patients undergoing COS from June 17, 2019, to February 28, 2021. INTERVENTION(S):Universal COVID-19 screening starting June 17, 2020, with SARS-CoV-2 polymerase chain reaction testing within 5 days of oocyte retrieval, patient-reported symptom screening, and temperature monitoring. MAIN OUTCOMES MEASURE(S):The primary outcome was the number of positive COVID-19 cases in patients undergoing COS cycles. The secondary outcomes were cycle outcomes compared with before COVID-19 COS cycles, adverse outcomes in COVID-canceled cycles, and center-specific COVID-19 detection rates compared with New York City cases. RESULT(S):From June 17, 2020, to February 28, 2021, 1,696 COS cycles were initiated with only seven positive COVID-19 cases for an overall positivity rate of 0.4%. When compared with before COVID cycles from June 17, 2019, to February 28, 2020, the volume of COS cycles were higher, while the overall cycle cancelation rate was lower during COVID-19. Cycle outcomes including oocyte yield and blast utilization rates were unchanged from pre-COVID cycles. Cases of COVID-19, while very low, occurred more frequently during surges in New York City rates. CONCLUSION(S):Assisted reproductive technology can be performed during the COVID-19 pandemic utilizing frequent universal screening and safe practices with low SARS-CoV-2 positivity, low cycle cancelation rates, and positive patient outcomes.
PMID: 34238573
ISSN: 1556-5653
CID: 5038832
OVERALL POSITIVE POSTS AFTER INTRODUCTION OF COVID-19 VACCINE ON FERTILITY-RELATED SOCIAL MEDIA [Meeting Abstract]
Yoder, N D; Pecoriello, J; Smith, M B; Blakemore, J K
OBJECTIVE: Social media is a popular way to disseminate new information and opinions, perhaps furthered by the COVID-19 pandemic and quarantine. Our objective was to analyze information and sentiments posted regarding the COVID-19 vaccine (VAX) on fertility-related social media. MATERIALS AND METHODS: The search function of Instagram (IG) and Twitter (TW) was used to identify the first fifty accounts with the following terms: fertility doctor, fertility, OBGYN, infertility, TTC, and IVF. Accounts not in English, private, no posts in >1 year, or content unrelated to search terms were excluded. Accounts were evaluated for author type and categorized as physician (PH), individual (ID), or fertility center/fertility-related organization (FCO). Account demographics including number of followers and prior baseline post activity (number of likes/number of followers) were recorded. The VAX was approved on 12/11/2020 and posts dated 12/1/2020 - 2/28/2021 were reviewed. Posts mentioningthe VAX were analyzed for content: sentiment (positive, negative, or neutral), mention of research studies (RS), national guidelines (NG), personal experience (PE), side effects (SE), reproductive related (RR) content and post activity. Statistical analysis included Chi-Squared and Fisher's exact tests, with significance set to <0.05 (*).
RESULT(S): 536 accounts were identified and 276 were included (133 IG and 143 TW). There were 104 PH accounts (45 IG, 59 TW), 91 ID accounts (62 IG, 29 TW), and 81 FCO accounts (26 IG, 55 TW). PH accounts were most associated with mention of COVID (83.7%*) and VAX (68.3%*), followed by FCO (37% COVID*, 30.9% VAX*), and ID (8.8% COVID*, 6.6% VAX*). PH was most associated with >1 VAX posts compared to FCO or ID (51.0% v 11.1% v 1.0%*). Sentiments toward the VAX were largely positive for all groups (PH 90.3%, ID 71.4%, FCO 70%), or neutral (PH 9.7%, ID 28.6%, FCO 30%), with no negative posts identified. Trends in mentions and sentiments were similar on both IG and TW platforms. PH cited NG (24.6%*) and RS (17.5%) more than ID and FCO, with most cited guidelines from ACOG, ASRM, and SMFM. ID posts were mostly PE (87.5%*) and SE (57.1%*). RR posts were most associated with FCO accounts (80%*) which included pregnancy, infertility, and breastfeeding. Sub-group analysis of IG accounts showed an increase in activity on VAX posts compared to baseline by likes (PH 4.86% v 3.76%, ID 7.5% v 6.37%, FCO 2.49% v 0.52%) as well as comments (PH 0.35% v 0.28%, ID 0.90% v 0.69%, FCO 0.10% v 0.02%).
CONCLUSION(S): Overall, the majority of posts expressed positive sentiments toward the VAX with no negative posts identified. PH were most likely to post about COVID-19, the VAX and guidelines. Few ID accounts posted but when present were about personal experiences or side effects and remained positive. IMPACT STATEMENT: There is an active conversation regarding COVID-19 and VAX information on social media, with the majority of posts expressing positive sentiment. Physicians play a large role in circulating information regarding the VAX on social media platforms, and can be influential in discussions of VAX guidelines and dispelling fertility myth
EMBASE:638129231
ISSN: 1556-5653
CID: 5250962
ON THE MOVE: THE IMPACT OF THE COVID-19 PANDEMIC ON MOVEMENT OF CRYOPRESERVED OOCYTES AND EMBRYOS [Meeting Abstract]
Kelly, A G; Roth, L; Shaw, J; McCaffrey, C; Atkinson, A L; Blakemore, J K
OBJECTIVE: COVID-19 has influenced family building, delayed fertility care, and affected people's decisions about where to live.We sought to understand differences in movement of cryopreserved reproductive tissue before and during the pandemic. MATERIALS AND METHODS: This was a retrospective cohort study of patients who transported tissue into or out of a single academic fertility center in New York City (NYC). Tissue transport was compared the year before (PRE, 4/1/2019-3/31/2020) and after (DUR, 4/1/2020-3/31/2021) the height of the COVID-19 pandemic in NYC, an epicenter. The primary outcome was the number of patients transporting tissue DUR compared to PRE. Secondary outcomes were the number of geographic changes, type of tissue, geographic origin/destination, and type of movement (in or out). Statistical analyses were performed using Kolmogorov-Smirnov, Wilcoxon Signed Rank Sum, Chi-Square, and Fisher's Exact tests with p<0.05 considered significant.
RESULT(S): A total of 367 tissue transports were included, with similar rates between cohorts (PRE 46.3% (170/367) vs DUR 53.7% (197/367), p=0.16). The median age at transport was the same (PRE 41 (range 29-54) vs DUR 41 (range 28-54) years, p=0.54). A similar amount of tissue was transported in (PRE 30.0% (51/170) vs DUR 35.0% (69/197)) and out (PRE 70.0% (119/170) vs DUR 65.0% (128/197), p=0.32). Patients were more likely to transport embryos pre-pandemic (37.6% (64/170) oocytes vs 61.8% (105/170) embryos, PRE) and oocytes during COVID-19 (51.8% (102/197) oocytes vs 44.2% (87/197) embryos, DUR) (p<0.01). A subgroup analysis excluding tissue moved for a gestational carrier or donor gametes found a similar number of transports were due to patient geographic relocation (PRE 50.0% (61/122) vs DUR 40.5% (60/148), p=0.12). Examination of geographic origin and destination of tissue PRE vs DUR produced no identifiable trends (p=0.38). Timing of tissue transport varied. The monthly transport rates were relatively even PRE (average 8% per month). However, during the pandemic, there were few transports in the beginning (April-May 2020, 0-1% per month) followed by a peak of transports in June-August 2020 (10-11% per month) and February-March 2021 (11-16% per month) (p<0.01). Transport activities were impacted by closure of clinics and courier service availability.
CONCLUSION(S): The rate of cryopreserved tissue movement did not differ in the year before versus during the pandemic at our center, despite being in a COVID-19 epicenter, although transport activities were concentrated into fewer days. There was peak movement of tissue three months after the pandemic onset and roughly one year from the start of the pandemic. The type of tissue transported shifted to favor oocytes during the pandemic, warranting more investigation in how COVID-19 impacted family building activities. IMPACT STATEMENT: Despite the impact of COVID-19 on reproductive and place of living choices, the pandemic did not affect the amount of cryopreserved tissue that was relocated. However, insight into the increased movement of oocytes and potential impacts on warming outcomes or timelines is necessary
EMBASE:638129301
ISSN: 1556-5653
CID: 5250902
TWO IS NOT ALWAYS GREATER THAN ONE: PATIENTS (PTS) WITH ONE OVARY (1O) HAVE SIMILAR ASSISTED REPRODUCTIVE TECHNOLOGY (ART) OUTCOMES COMPARED TO PTS WITH TWO OVARIES (2O) [Meeting Abstract]
Auran, E E; Cascante, S D; Blakemore, J K
OBJECTIVE: Current data conflicts on ART outcomes in pts with 1O. Furthermore, data is limited evaluating embryo quality in these pts. We assessed number of mature oocytes (M2s) and total oocytes retrieved, embryo quality, and embryo transfer outcomes in pts with 1O compared to 2O. MATERIALS AND METHODS: We performed a retrospective cohort study of all pts with 1O who underwent ART at one academic institution from 2012-2020. Pts were 3-to-1 matched to 2O controls by age, ART cycle type (oocyte freezing vs. embryo banking/in vitro fertilization) and number of ART cycles. Our primary outcome was number of M2s. Secondary outcomes included AMH and day 2 FSH prior to first cycle, number of retrieved oocytes, %M2s, 2PN fertilization rate, blastocyst formation rate (BFR), number of euploid embryos, euploidy rate, clinical pregnancy rate per pt (CPR), and live birth rate per pt (LBR). Subgroup analyses were performed comparing left vs. right ovary in situ and reason for loss of 1O. Mann-Whitney, Kruskal-Wallis, Fisher's exact, and Wilcoxon signed-rank tests were used for statistics; with p<0.05 considered significant.
RESULT(S): 104 pts (158 cycles) with 1O were matched to 312 pts (474 cycles) with 2O. Reasons for loss of 1O were torsion (18%), benign cyst (30%), malignant tumor (46%), and congenital absence (6%). Median pt age was 35.5y vs. 35.0y in pts with 1O vs. 2O (p=0.9). AMH was lower (median 1.1 vs 2.2, p<0.01) and day 2 FSH was higher (median 7.4 vs 6.2, p<0.01) in pts with 1O. See Table 1 for outcomes. Pts with 1O had fewer M2s and oocytes retrieved than pts with 2O; however, pts with 1O had more than half the number of M2s and oocytes retrieved than in pts with 2O (Z >5.8, p<0.01). The % M2s, 2PN fertilization rate, and BFR did not differ among groups. The median number of euploid embryos was 1.0 in each group, with a trend towards more euploids in pts with 2O (mean 2.0 vs 1.3, p<0.03). However, euploidy rate, CPR, and LBR did not differ among groups. Among 1O subgroups (left vs. right and reason for 1O), number of M2s, euploidy rate, CPR, and LBR did not differ.
CONCLUSION(S): Pts with 1O had fewer M2s and oocytes retrieved than pts with 2O; however, had more than 50% of the number of M2s and oocytes retrieved in pts with 2O, suggesting a compensatory mechanism in the solitary ovary. In pts with 1O compared to 2O, oocyte and embryo quality, euploidy rate, and embryo transfer outcomes were similar. IMPACT STATEMENT: Pts with 1O can be counseled that, while ART cycles may yield fewer M2s and oocytes, there is no decrease in embryo quality and LBR compared to pts with 2O. (Table Presented)
EMBASE:638129270
ISSN: 1556-5653
CID: 5250922
PLANNED OOCYTE CRYOPRESERVATION (POC) AND THE BLACK OBSTETRICIAN GYNECOLOGIST (BOG): UTILIZATION AND PERSPECTIVES [Meeting Abstract]
Wiltshire, A M; Martinez, M L; Ghidei, L A; Licciardi, F L; Blakemore, J K
OBJECTIVE: POC is underutilized by Black women and persons of color1 . We sought to describe the opinions and attitudes toward POC among BOGs and their experiences in counseling patients of color. MATERIALS AND METHODS: An anonymous survey was distributed to BOGs via separate listservs belonging to a BOG organization and a historically Black college/university in April 2021. The survey included 30 demographic and qualitative questions pertaining to personal family building goals, fertility preservation, and patient counseling experiences. Analyses included descriptive statistics and chi square test to compare answers across demographic, professional and subspecialty groups using SPSS (v25) with p<0.05 considered significant.
RESULT(S): Of the 136 potential participants, the response rate was 49% (n=67). The majority of respondents were female (93%) and heterosexual (93%). The mean age was 34.2 years. Attendings (ATT), fellows (FEL) and residents (RES) represented 47%, 17% and 36% of respondents, respectively. Fifty-four percent of ATTs were generalists. Subspecialties represented by ATTs and FELs included Maternal Fetal Medicine (24%), Minimally Invasive Gynecology (2%), Reproductive Endocrinology and Infertility (14%), and Urogynecology (8%). Sixty-six percent of subjects did not currently have children and 20% did not want children. Sixty-eight percent felt the need to postpone family building due to medical training, most commonly citing career plans (88%) and financial concerns (60%). Of the 41% who had tried to conceive in the past, 9% required fertility treatment. Nineteen percent had already undergone POC or planned to in the future. Most (70%) felt that all women planning to undergo residency +/- fellowship training should consider POC. Fifty-six percent reported receiving some form of education on POC and 22% felt ''very comfortable'' counseling patients on POC. Fifty-six percent had recommended POC to patients in the past. When asked to exclude cost, the most common reported personal barriers for POC were time (31%) and fear/stigma (22%) and the most common barriers for their patients of color were knowledge (41%) and fear/stigma (25%). Those <35 years were more likely to not have a child (p <0.01) and more likely to feel the need to postpone family building due to their medical training (p<0.01). RES and FELs were more likely to agree that all women planning medical training should consider POC (p<0.03). Generalist ATTs who had not undergone POC trended toward having more regret compared to subspecialists (p=0.05).
CONCLUSION(S): Medical careers can have an unfavorable impact on family building and our results highlight this effect in Black women and persons of color. Most BOGs think trainees may benefit from POC. Improved education and access to POC could support personalized reproductive planning. IMPACT STATEMENT: Considering the underutilization of POC among Black women1 and the increase in infertility among female physicians2 , a better understanding of the mitigating factors is important in order to develop culturally appropriate counseling and educational interventions for women of color
EMBASE:638129269
ISSN: 1556-5653
CID: 5250932
EGG FREEZING UNSCRAMBLED: AUTOLOGOUS OOCYTE (AO) THAW OUTCOMES FROM OVER 500 PATIENTS (PTS) AT A LARGE ACADEMIC FERTILITY CENTER (FC) [Meeting Abstract]
Cascante, S D; Blakemore, J K; DeVore, S; Parra, C M; Hodes-Wertz, B; McCaffrey, C; Grifo, J A
OBJECTIVE: AO cryopreservation (cryo) is widely used, but published thaw data is scarce. We reviewed our elective AO thaws. MATERIALS AND METHODS: Pts who thawed AOs at our FC in 2004- 2020 were reviewed. Pts were excluded if AO cryo was performed for a medical reason, as research, due to no sperm or a natural disaster, with embryo cryo or for use with a gestational carrier. Outcomes included implantation (IR), spontaneous abortion (SABR) and ongoing pregnancy + live birth (LBR) rates / embryo transfer (ET). We calculated a final LBR (FLBR) defined as LBR / pt; FLBR only included pts who a) had live birth (LB) or ongoing pregnancy (OP), or b) consumed all AOs and resultant embryos. Statistics included Mann-Whitney U and Fisher's exact test.
RESULT(S): 543 pts (median age at 1st cryo 38y) underwent 800 cryos (89% our FC, 9% elsewhere, 2% both), 605 thaws and 416 ETs. Cryo used vitrification for 72%, slow freezing for 4% and both for 24% of pts. Median time from 1st cryo to 1st thaw was 4y. In total, we thawed 8511 AOs (7492 M2s). AO survival was 79%, M2 survival was 80% and 2PN fertilization was 66%. When pts returned for thaw, 25% pursued fresh ET, 73% pursued preimplantation genetic testing (PGT), and 2% pursued a combination of both. In pts who pursued fresh ET, 92% had >=1 embryo for ET. In pts who pursued PGT, 57% had >=1 euploid. 13% of pts had no useable embryos (embryos for fresh ET, PGT, cryo). 59% of pts had >=1 ET. 37% of ETs were fresh, with 2% using rush-PGT. 63% of ETs were frozen, with 97% using PGT. In non-biopsied ETs, IR was 29%, SABR was 19% and LBR was 31%. In euploid ETs, IR was 64%, SABR was 10% and LBR was 55%. In our cohort, FLBR was 38%. In total, 178 babies (11 twin, 1 triplet) and 24 OPs resulted. 176 pts have >=1 LB or OP, and 23 pts have >=2 LBs or OPs from AO thaw. 33% of pts have remaining AOs or euploid or untested embryos; 45% of these pts do not have a LB or OP from AO thaw. See table for outcomes by age.
CONCLUSION(S): AO thaw leads to a FLBR of 38%, comparable to our FC's 34% LBR per intended retrieval in pts of similar age1 . IMPACT STATEMENT: Our real thaw data may be more useful than models in pt counseling
EMBASE:638129103
ISSN: 1556-5653
CID: 5250982
AN ANALYSIS OF THE EFFECT OF MATERNAL AGE ON SEGMENTAL CHROMOSOMAL ANEUPLOIDY [Meeting Abstract]
Reich, J; Besser, A G; Blakemore, J K
OBJECTIVE: Segmental aneuploidies (SA) are generated when a piece of chromosome is gained or lost and may contribute to sub-optimal birth outcomes[ 1]. Our objective was to examine the frequency, type and association with maternal age of SA. MATERIALS AND METHODS: This is a retrospective cohort study of all embryos that underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A) via Next Generation Sequencing between 1/2015 and 12/2020 at a single university-based fertility center that resulted with a non-mosaic SA. SA were characterized by type of abnormality and location (p or q arm). Maternal age was stratified by SART age groups. Primary outcome was the association between age and SA. Secondary outcomes were SA location and type. Statistical analysis included ANOVA and chisquare where appropriate, with p<0.05 considered significant.
RESULT(S): There were 711 embryos with an SA included; of 30,300 embryos biopsied (2.3%). Mean maternal age was 38.8+/-4.7. The frequency of SA increased with maternal age (Table 1). The distribution of SA on p, q and both arms was 58 (8.2%), 539 (75.8%) and 114 (16%) respectively. Partial monosomy was the most common type of SA (298, 41.6%), followed by partial trisomy (154, 21.7%) and the combination of SA and whole chromosome aneuploidy (WCA; 154, 21.7%). There is a significant association between type of SA and increasing maternal age (p<0.00). SA occurred most frequently on chromosomes (CH) 1, 2 and 16 and least frequently on CHs 19, 20 and 21. For single SA only, CH 1, 2 and 4 were most common. For double SA, CH 2 and 8 occurred most. For SA with WCA, SA on CH 1 and WCA on CHs 16 and 22 was most common. Acrocentric CH have less SA than non-acrocentric. Chromosome location was not associated with maternal age across SA types (All: p=0.39, single p=0.86, SA + WCA p= 0.48)
CONCLUSION(S): Among our embryo cohort, the frequency of nonmosaic SA increased with maternal age. Since previous literature suggests that SA is mainly affected by paternal age, this association may be attributed to age similarities within romantic partnerships (2). SA were most common on chromosomes 1 and 2, and the q arm. IMPACT STATEMENT: This is the first study of the association between SA prevalence, type and location with maternal age to provide a basis for future research and understanding about SA detected by PGT-A
EMBASE:638129294
ISSN: 1556-5653
CID: 5250912
LOCKDOWN UPTICK: DID THE SARS-COV-2 PANDEMIC GENERATE AN INCREASE IN PLANNED OOCYTE CRYOPRESERVATION (POC)? [Meeting Abstract]
Weidenbaum, E M; Cascante, S D; DeVore, S; Hodes-Wertz, B; Grifo, J A; Blakemore, J K
OBJECTIVE: The rise of the SARS-CoV-2 pandemic and temporary closures of fertility centers made the effect on POC cycles uncertain but garnered national attention1,2. We sought to assess the impact of the pandemic on POC cycles in a pandemic epicenter. MATERIALS AND METHODS: This is a retrospective cohort study of all POC cycles at an academic fertility center in New York City from 1/1/2019- 12/31/2020. Primary outcomes were number of POC patients (pts) and cycles. Secondary outcomes were pt relationship status, payment method, AMH, and cycle parameters; with subgroup analyses by age groups. We also examined the relationship between monthly number of POC cycles and national SaRS-CoV-2 cases. Statistical analyses included z-score analysis, Mann-Whitney, and Chi-squared, with p<0.05 significant.
RESULT(S): Despite a 5.5 week center closure in 2020, POC pts increased 14% and POC cycles increased 16% from 2019 to 2020 (Table), with a 32% increase seen between June-Dec, 2020 . There was a 28% increase in POC pts <37yo in 2020 (252 pts vs. 323 pts, p<0.04) and no change in pts >37yo in 2020 (p=0.9). Relationship status did not differ between years (16% partnered, 76% single, 8% unknown in 2019 vs. 16% partnered, 73% single, 11% unknown in 2020; p=0.6). Fewer patients in 2020 had insurance coverage (16% vs. 24%, p<0.001). AMH was higher in 2020 (2.3 vs. 2.1, p<0.03), but days of stimulation, oocytes retrieved, oocytes frozen, total gonadotropins, and maximum estradiol (E2) were not different (Table). While national SARS-CoV-2 cases peaked in April, July, and November 2020, monthly POC cycles at our center did not decrease with surges in SARS-CoV-2 after our center reopened in May (p=0.24). In 2020 there were 23 cycles cancelled, none due a positive SARS-CoV-2 test.
CONCLUSION(S): POC volume increased at our center in 2020, especially in young patients, despite center closures and SARS-CoV-2 surges. IMPACT STATEMENT: More young people pursued POC despite the SARS-CoV-2 pandemic. Further research is needed to understand POC pt motivations and experiences during a pandemic. (Table Presented)
EMBASE:638129262
ISSN: 1556-5653
CID: 5250952
HOW MANY EGGS DO I NEED? A COUNSELING TOOL FOR OOCYTE CRYOPRESERVATION (OC) BASED ON REAL-WORLD DATA [Meeting Abstract]
Parra, C M; Cascante, S D; Blakemore, J K; DeVore, S; McCulloh, D H; Grifo, J A
OBJECTIVE: OC is widely used for fertility preservation. Many models predict the live birth (LB) rate of OC, but real-world data is lacking. We reviewed our LBs from OC to develop an OC counseling tool based on real outcomes. MATERIALS AND METHODS: We reviewed patients (pts) who thawed autologous oocytes (AOs) at our academic fertility center from 2004-2020. We included pts who: 1) had a LB or ongoing pregnancy (OP) >12 weeks at last contact, or 2) consumed all AOs and resultant embryos. Pts were excluded if they transferred AOs or resultant embryos to another center or if OC was performed for a medical reason, as research, due to no sperm or a natural disaster, combined with embryos or for use with a gestational carrier. We calculated OP + LB rate (LBR) based on number of AOs and metaphase II oocytes (M2s) thawed. Data were stratified by age (<38y vs. >=38y). For pts who underwent OC at <38y and >=38y, a weighted age was calculated (for each OC cycle, #AOs thawed was multiplied by age at OC; the sum of these numbers was then divided by total #AOs thawed). Statistics included Fisher's exact test (p<0.05 significant).
RESULT(S): We included 462 pts (median age at 1st OC 38.5y). Weighted ages were used for 21 pts (5%). Our pts underwent 650 OCs (90% our center, 9% elsewhere, 1% both), 512 thaws and 385 embryo transfers. OC involved vitrification for 72%, slow freezing for 4% and both for 24% of pts. A total of 7050 AOs and 6178 M2s were thawed. 38% of pts (n=176) have >=1 LB or OP from AO thaw. See table for outcomes. Pts who thawed 0-10 AOs had a lower LBR than pts who thawed 11-20, 21-30, or >30 AOs (p<=0.03). Pts who thawed 0-10 M2s had a lower LBR than pts who thawed 11-20 or 21- 30 M2s (p<=0.02). LBR was not significantly different between pts who thawed 11-20, 21-30, or >30 AOs or M2s.
CONCLUSION(S): Pts who thawed 0-10 AOs had a lower LBR (27%) than pts who thawed >10 AOs (LBR >= 43%), and pts who thawed 0-10 M2s had a lower LBR (30%) than pts who thawed > 10 M2s (LBR >= 42%), but LBR was not different with >10 thawed AOs. IMPACT STATEMENT: Our real-world OC outcomes are not consistent with LBRs in published models. These results provide more realistic expectations about OC outcomes and may help pts decide how many AOs to freeze
EMBASE:638129084
ISSN: 1556-5653
CID: 5251002