OOCYTE

CRYOPRESERVATION
DR ASTHA GUPTA
CONSULTANT REPRODUCTIVE MEDICINE
HISTORY
◦ The first human pregnancy from a previously cryopreserved
oocyte - 1986 .

◦ Investigational until 2013, American Society for Reproductive

Medicine (ASRM) Practice Committee stated that oocyte
freezing is NOT ‘‘EXPERIMENTAL’’
AIM

WHAT WHY HOW

INDICATIONS OR WHY??
◦ MEDICAL-

1. CANCER TREATMENT

2. OVARIAN SURGERY

3. GENETIC CAUSES
WHY IS NEED?
RECOMMENDATIONS

ASAP
SOCIAL INDICATIONS
 PLANNED OOCYTE CRYOPRESERVATION
(SOCIAL EGG FREEZING)

• Protection against future infertility for nonmedical reasons-

Anticipated Gamete Exhaustion

‘‘AGE”
TIME IS NOT OUR FRIEND
BIOLOGICAL CLOCK
BIOLOGICAL CLOCK
WAITING FOR RIGHT PARTNER
RELATIONSHIP UNSTABILITY
ANEUPLOIDY INCREASES WITH MATERNAL AGE
n=5,515 Blastocysts; p<0.0001
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
<35 Years
35-37 Years
38-40 Years
41-42 Years
Euploid 43+ Years
Aneuploid

CCRM unpublished, personal communication

PLANNED GENDER TRANSITION
 OVARIAN RESERVE
• AGE

• AMH

• OVARIAN VOLUME

• AFC
Egg Freezing AS GOOD AS fresh
 Forman E., et al. Fertil Steril 2012

• No differences in

 aneuploidy rates

 implantation rates

 pregnancy rates

 live birth rates

 INFANT DATA
• Initial retrospective data suggest frozen eggs BETTER
outcomes as infants are larger
 MANY UNANSWERED QUESTIONS

– Who should freeze?

• balance between waiting too long and unnecessary
procedure

– What is the optimal age to freeze?

– How long are frozen eggs good for?

– How old is too old to use eggs?

IDEAL AGE
 CONCLUSION
• Age related infertility is one of the biggest challenges of modern
medicine

• Oocyte pool is fixed and declines with age

• Ovarian reserve testing shows size of recruitable follicle pool

• Oocytes can be cryopreserved with IVF success rates similar to

fresh IVF cycles
 CONCLUSION
• Oocyte vitrification is a viable option for fertility
preservation

• Multiple cycles may be needed to have an adequate

group of available oocyte

• Oocyte banks will likely become as ubiquitous as sperm

banks