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Planned oocyte cryopreservation-10-15-year follow-up: return rates and cycle outcomes

Blakemore, Jennifer K; Grifo, James A; DeVore, Shannon M; Hodes-Wertz, Brooke; Berkeley, Alan S
OBJECTIVE:To evaluate the outcomes of planned oocyte cryopreservation patients most likely to have a final disposition. DESIGN/METHODS:Retrospective cohort study of all patients who underwent at least 1 cycle of planned oocyte cryopreservation between Jan 2005 and December 2009. SETTING/METHODS:Large urban University-affiliated fertility center PATIENT(S): All patients who underwent ≥1 cycle of planned oocyte cryopreservation in the study period. INTERVENTION(S)/METHODS:None MAIN OUTCOME MEASURE(S): Primary outcome was the disposition of oocytes at 10-15 years. Secondary outcomes included thaw/warming types, laboratory outcomes, and live birth rates. Outcomes and variables treated per patient. RESULT(S)/RESULTS:A total of 231 patients with 280 cycles were included. The mean age at the first retrieval was 38.2 years (range 23-45). A total of 3,250 oocytes were retrieved, with an average of 10 metaphase II frozen/retrieval. To date, the oocytes of 88 patients (38.1%) have been thawed/warmed, 109 (47.2%) remain in storage, 27 (11.7%) have been discarded, and 7 (3.0%) have been transported elsewhere. The return rate (patients who thawed/warmed oocytes) was similar by Society for Assisted Reproductive Technology age group. The mean age of patients discarding oocytes was 47.4 years (range, 40-57). Of the 88 patients who thawed/warmed oocytes, the mean age at the time of thaw/warming was 43.9 years (range, 38-50) with a mean of 5.9 years frozen (range, 1-12). Nine patients (10.2%) thawed/warmed for secondary infertility. A total of 62.5% of patients created embryos with a partner, and 37.5% used donor sperm. On average, 14.3 oocytes were thawed/warmed per patient, with 74.2% survival (range, 0%-100%) and a mean fertilization rate of 68.8% of surviving oocytes. Of 88 patients, 39 (44.3%) planned a fresh embryo transfer (ET); 36 of 39 patients had at least 1 embryo for fresh ET, and 11 had a total of 14 infants. Forty-nine of 88 patients (55.7%) planned for preimplantation genetic testing for aneuploidy, with a mean of 4.2 embryos biopsied (range, 0-14) and a euploidy rate of 28.9%. Of the 49 patients, 17 (34.7%) had all aneuploidy or no embryos biopsied. Twenty-four patients underwent a total of 36 single euploid ET with 18 live births from 16 patients. Notably, 8 PGT-A patients had a euploid embryo but no ET, affecting the future cumulative pregnancy rate. Overall, 80 patients with thaw/warming embryos had a final outcome. Of these, 20 had nothing for ET (arrested/aneuploid), and of the 60 who had ≥1 ET, 27 had a total of 32 infants, with a live birth rate of 33.8% (27/80). CONCLUSION(S)/CONCLUSIONS:We report the final outcomes of patients most likely to have returned, which is useful for patient counseling: a utilization rate of 38.1% and a no-use rate of 58.9%, similar across age groups. Further studies with larger cohorts as well as epidemiologic comparisons to patients currently cryopreserving are needed.
PMID: 33712289
ISSN: 1556-5653
CID: 4817192

Access to infertility care in a low-resource setting: bridging the gap through resident and fellow education in a New York City public hospital

Blakemore, Jennifer K; Maxwell, Susan M; Hodes-Wertz, Brooke; Goldman, Kara N
PURPOSE/OBJECTIVE:Improving access to care is an issue at the forefront of reproductive medicine. We sought to describe how one academic center, set in the background of a large and diverse metropolitan city, cares for patients with extremely limited access to reproductive specialists. METHODS:The NYU Reproductive Endocrinology and Infertility (REI) Fellowship program provides a "fellow-run clinic" within Manhattan's Bellevue Hospital Center, which is led by the REI fellows and supervised by the REI attendings of the NYU Langone Health system. A description of the history of the hospital as well as the logistics of the fertility clinic is provided as a logistical template for implementation. RESULTS:The fellow-run fertility clinic at Bellevue hospital is held on two half days per month seeing approximately 150 new patients per year. The fertility workup, counseling, surgery, as well as ovulation induction, and early pregnancy management are offered within the construct of the fellowship and residency at NYU. Barriers to care and ways to circumvent those barriers are discussed in detail. CONCLUSION/CONCLUSIONS:By utilizing the ambition and construct of the OB/GYN programs, we greatly improve care for an otherwise underserved patient population by offering an efficient and optimal infertility workup and treatment in a population that would otherwise be without care. We utilize the framework of graduate medical education to provide autonomy, experience, and mentorship to both residents and fellows in our programs in an effort to provide a solution to combating inequity in infertility care.
PMID: 32409983
ISSN: 1573-7330
CID: 4431622

THE EFFECT OF MATERNAL AGE ON CHROMOSOMAL MOSAICISM: AN ANALYSIS BY CHROMOSOME TYPE AND MOSAIC RESULT. [Meeting Abstract]

Reich, Jenna; Blakemore, Jennifer K.; Besser, Andria G.; Hodes-Wertz, Brooke; Grifo, James A.
ISI:000579355301291
ISSN: 0015-0282
CID: 4685372

AN ANALYSIS OF THE EFFECT OF MATERNAL AND PATERNAL AGE ON CHROMOSOMAL MOSAICISM. [Meeting Abstract]

Reich, Jenna; Blakemore, Jennifer K.; Besser, Andria; Hodes-Wertz, Brooke; Grifo, James A.
ISI:000582706800037
ISSN: 0015-0282
CID: 4677712

PLANNED OOCYTE CYROPRESERVATION-10-15 YEAR FOLLOW-UP: RETURN RATES AND CYCLE OUTCOMES. [Meeting Abstract]

Blakemore, Jennifer K.; Grifo, James A.; Devore, Shannon; Hodes-Wertz, Brooke; Berkeley, Alan S.
ISI:000579355300201
ISSN: 0015-0282
CID: 4685162

BEHIND THE BLEED: ANALYSIS OF THE FORMATION OF SUBCHORIONIC HEMATOMAS (SCH) IN SINGLE EUPLOID EMBRYO TRANSFER CYCLES BY PROTOCOL. [Meeting Abstract]

Edison, N.; Blakemore, J. K.; Goldman, K. N.; Hodes-Wertz, B.; Grifo, J. A.
ISI:000448713601071
ISSN: 0015-0282
CID: 3493692

A HURDLE IN THE EGG FREEZING RACE: COMPARISON DONOR AND AUTOLOGOUS OOCYTE CRYO-PRESERVATION (OC) OUTCOMES. [Meeting Abstract]

Druckenmiller, S; Labella, P; DeVore, S; Grifo, J; Hodes-Wertz, B; Noyes, N
ISI:000409446001101
ISSN: 1556-5653
CID: 2713712

Erratum: Comment on: Gleicher N et al.,2016. Reprod biol endocrinol Sep5;14(1):54[Reprod Biol Endocrinol (2017),17,15(24)] DOI:10.1186/s12958-017-0240-y [Correction]

Tiegs, A W; Grifo, J A; Munne, S; McCulloh, D H; Hodes-Wertz, B
EMBASE:615547823
ISSN: 1477-7827
CID: 2551272

Erratum to: Comment on: Gleicher N et al.,2016. Reprod biol endocrinol Sep 5;14(1):54 [Correction]

Tiegs, Ashley W; Grifo, James A; Munne, Santiago; McCulloh, David H; Hodes-Wertz, Brooke
PMCID:5387235
PMID: 28395662
ISSN: 1477-7827
CID: 2527742

Response to comment on: Gleicher N et al., 2016. Reprod biol endocrinol Sep 5;14(1):54 [Editorial]

Tiegs, Ashley W; Grifo, James A; Munne, Santiago; McCulloh, David H; Hodes-Wertz, Brooke
PMCID:5381034
PMID: 28376830
ISSN: 1477-7827
CID: 2519472