Understanding the Strengths and Limitations of Online Oocyte Cryopreservation Calculators

Amber T. Wolf; Evelyn Minis; Shruthi Mahalingaiah

doi:10.1055/s-0044-1788030

Seminars in Reproductive Medicine, Table of Contents

Semin Reprod Med 2024; 42(02): 130-139
DOI: 10.1055/s-0044-1788030

Review Article

Understanding the Strengths and Limitations of Online Oocyte Cryopreservation Calculators

Amber T. Wolf

¹Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

,

Evelyn Minis

²Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts

³Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts

,

Shruthi Mahalingaiah

¹Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

²Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts

³Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts

› Author Affiliations

Abstract

Between 2010 and 2016, elective oocyte cryopreservation (OC) increased in use by 880% in the United States; however, there have been increasing reports of regret among patients after elective OC. There is a growing need for individualized counseling on the timing and number of oocytes to cryopreserve for patients to make informed choices and set realistic expectations, but currently available tools seem to be insufficient. The purpose of this review is to describe the OC calculators currently available online, identify sources of regret, and illustrate the need for unified counseling tools for improved patient care and education. OC calculators were identified via Google search. Only calculators that cite scientific literature were included in the review. Calculators for in vitro fertilization or embryo transfer were excluded. Thirteen OC calculators were found; however, only six cited literature supporting the calculator's design. When entering the same hypothetical patient parameters for age and number of oocytes cryopreserved, the calculators provided drastically different probabilities of live births. The lack of cohesive online educational materials creates confusion and stress for patients considering OC, leading to unrealistic expectations and increased feelings of regret thereafter. Physicians need tools to provide comprehensive guidance to patients seeking to cryopreserve oocytes.

Keywords

oocyte cryopreservation - egg freezing - calculator - predictors - patient education

Full Text

References

References
1 Chen C. Pregnancy after human oocyte cryopreservation. Lancet 1986; 1 (8486): 884-886
2 Rienzi L, Gracia C, Maggiulli R. et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update 2017; 23 (02) 139-155
3 Cobo A, Meseguer M, Remohí J, Pellicer A. Use of cryo-banked oocytes in an ovum donation programme: a prospective, randomized, controlled, clinical trial. Hum Reprod 2010; 25 (09) 2239-2246
4 Domingues TS, Aquino AP, Barros B. et al. Egg donation of vitrified oocytes bank produces similar pregnancy rates by blastocyst transfer when compared to fresh cycle. J Assist Reprod Genet 2017; 34 (11) 1553-1557
5 García JI, Noriega-Portella L, Noriega-Hoces L. Efficacy of oocyte vitrification combined with blastocyst stage transfer in an egg donation program. Hum Reprod 2011; 26 (04) 782-790
6 Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril 2013; 99 (01) 37-43
7 Johnston M, Richings NM, Leung A, Sakkas D, Catt S. A major increase in oocyte cryopreservation cycles in the USA, Australia and New Zealand since 2010 is highlighted by younger women but a need for standardized data collection. Hum Reprod 2021; 36 (03) 624-635
8 Huttler A, Koelper N, Mainigi M, Gracia C, Senapati S. Impact of the COVID-19 pandemic on the perception of planned oocyte cryopreservation in the United States. F S Rep 2022; 3 (02) 145-152
9 Mesen TB, Mersereau JE, Kane JB, Steiner AZ. Optimal timing for elective egg freezing. Fertil Steril 2015; 103 (06) 1551-6.e1 , 4
10 Walker Z, Lanes A, Ginsburg E. Oocyte cryopreservation review: outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation. Reprod Biol Endocrinol 2022; 20 (01) 10
11 Jones BP, Kasaven L, L'Heveder A. et al. Perceptions, outcomes, and regret following social egg freezing in the UK; a cross-sectional survey. Acta Obstet Gynecol Scand 2020; 99 (03) 324-332
12 Gurbuz A, Cil AP, Karakis LS. et al. Decision regret and associated factors following oocyte cryopreservation in patients with diminished ovarian reserve and/or age-related fertility decline. J Assist Reprod Genet 2021; 38 (06) 1469-1479
13 Gupta AH, Blum D. 7 Women on Egg Freezing: Hope, Regret, Uncertainty - The New York Times. New York Times. Accessed January 6, 2023 at: https://www.nytimes.com/2022/12/23/well/family/egg-freezing-fertility.html?smid=em-share Published December 23, 2022
14 Goldman RH, Racowsky C, Farland LV, Munné S, Ribustello L, Fox JH. Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients. Hum Reprod 2017; 32 (04) 853-859
15 Cobo A, García-Velasco JA, Coello A, Domingo J, Pellicer A, Remohí J. Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril 2016; 105 (03) 755-764.e8
16 Cobo A, García-Velasco J, Domingo J, Pellicer A, Remohí J. Elective and onco-fertility preservation: factors related to IVF outcomes. Hum Reprod 2018; 33 (12) 2222-2231
17 Practice Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org. Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline. Fertil Steril 2021; 116 (01) 36-47
18 Cascante SD, Blakemore JK, DeVore S. et al. Fifteen years of autologous oocyte thaw outcomes from a large university-based fertility center. Fertil Steril 2022; 118 (01) 158-166
19 Doyle JO, Richter KS, Lim J, Stillman RJ, Graham JR, Tucker MJ. Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval. Fertil Steril 2016; 105 (02) 459-66.e2
20 Nagy ZP, Anderson RE, Feinberg EC, Hayward B, Mahony MC. The Human Oocyte Preservation Experience (HOPE) Registry: evaluation of cryopreservation techniques and oocyte source on outcomes. Reprod Biol Endocrinol 2017; 15 (01) 10
21 Kawwass JF, Crawford S, Hipp HS. Frozen eggs: national autologous oocyte thaw outcomes. Fertil Steril 2021; 116 (04) 1077-1084
22 Westphal L. What is the Right Age for Egg Freezing? Kindbody. Published March 10, 2022. Accessed February 26, 2023 at: https://kindbody.com/right-age-for-egg-freezing/
23 UNC Fertility Center. Egg Banking Calculator. Accessed January 14, 2023 at: https://uncfertility.com/treatment-options/egg-calculator/
24 Zheng C. Egg Freezing Live Birth Calculator. Accessed February 12, 2023 at: https://drzheng.com.au/fertility/egg-freezing-live-birth-calculator/
25 ELANZA Wellness. How Many Egg Freezing Cycles Calculator. ELANZA Wellness. Accessed February 12, 2023 at: https://www.elanzawellness.com/howmanyeggsshouldifreezecalculator
26 Ice Fertility. Egg Freezing Explained | ICE Fertility. Accessed February 26, 2023 at: https://icefertility.com/about-egg-freezing/
27 Olive Fertility Centre. Egg Freezing. Accessed February 26, 2023 at: https://www.olivefertility.com/egg-freezing
28 Eugin. Fertility preservation. Published September 13, 2021. Accessed February 26, 2023 at: https://www.eugin.co.uk/fertility-preservation/
29 Sekhon L. Egg Freezing Success Calculator. The Lucky Egg. Accessed February 28, 2024 at: https://theluckyegg.com/egg-freezing-success-calculator/
30 Fox J, Goldman R. BWH Egg Freezing Counseling Tool (EFCT). MDCalc. Accessed January 14, 2023 at: https://www.mdcalc.com/calc/3937/bwh-egg-freezing-counseling-tool-efct
31 Zaborowska L. Egg Freezing Calculator. Published October 10, 2022. Accessed January 14, 2023 at: https://www.omnicalculator.com/health/egg-freezing
32 Embryonics. Egg Freezing Calculator. Accessed January 14, 2023 at: https://calc.embryonics.me/
33 Embryonics. Embryonics personalized fertility assessment tool (Egg Freezing Calculator). Accessed December 17, 2022 at: https://www.embryonics.me/_files/ugd/14e8f3_cfd0deb0de90432f98a7c194cd4db4eb.pdf
34 Oktay K. Egg Freezing Success Rate Calculator. Innovation Fertility Preservation & IVF. Accessed January 14, 2023 at: https://www.fertilitypreservation.org/contents/probability-calc
35 Cil AP, Bang H, Oktay K. Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis. Fertil Steril 2013; 100 (02) 492-9.e3
36 Spring Fertility. Egg Calculator - Spring Fertility. Accessed January 14, 2023 at: https://springfertility.com/eggcalc/
37 When to Freeze Your Eggs - EVOLVE Egg Freezing Clinics. EVOLVE Egg Freezing. Accessed February 28, 2024 at: https://evolveeggfreeze.com/egg-freezing-calculator/
38 Milman LW, Senapati S, Sammel MD, Cameron KD, Gracia C. Assessing reproductive choices of women and the likelihood of oocyte cryopreservation in the era of elective oocyte freezing. Fertil Steril 2017; 107 (05) 1214-1222.e3
39 Wafi A, Nekkebroeck J, Blockeel C, De Munck N, Tournaye H, De Vos M. A follow-up survey on the reproductive intentions and experiences of women undergoing planned oocyte cryopreservation. Reprod Biomed Online 2020; 40 (02) 207-214
40 Shao YH, Tulandi T, Abenhaim HA. Evaluating the quality and reliability of online information on social fertility preservation. J Obstet Gynaecol Can 2020; 42 (05) 561-567
41 Esfandiari N, Litzky J, Sayler J, Zagadailov P, George K, DeMars L. Egg freezing for fertility preservation and family planning: a nationwide survey of US obstetrics and gynecology residents. Reprod Biol Endocrinol 2019; 17 (01) 16
42 Reich JA, Caplan A, Quinn GP, Blakemore JK. Counseling, risks, and ethical considerations of planned oocyte cryopreservation. Fertil Steril 2022; 117 (03) 481-484
43 Yee S, Goodman CV, Fu V. et al Assessing the quality of decision-making for planned oocyte cryopreservation. J Assist Reprod Genet 2021; 38 (04) 907-916
44 Campbell AG, Hillemeier M. Fertility counseling information adequacy as a moderator of regret among adolescent and young adult breast cancer survivors. Support Care Cancer 2021; 29 (05) 2689-2697
45 Greenwood EA, Pasch LA, Hastie J, Cedars MI, Huddleston HG. To freeze or not to freeze: decision regret and satisfaction following elective oocyte cryopreservation. Fertil Steril 2018; 109 (06) 1097-1104.e1
46 Giannopapa M, Sakellaridi A, Pana A, Velonaki VS. Women electing oocyte cryopreservation: characteristics, information sources, and oocyte disposition: a systematic review. J Midwifery Womens Health 2022; 67 (02) 178-201
47 TʼSjoen G, Van Caenegem E, Wierckx K. Transgenderism and reproduction. Curr Opin Endocrinol Diabetes Obes 2013; 20 (06) 575-579
48 Sundaram V, Stark B, Jaswa E, Letourneau J, Mok-Lin E. Decision regret, and other mental health outcomes, following fertility preservation in the transgender individual compared to the cisgender woman. J Assist Reprod Genet 2024; 41 (04) 1077-1085