Risks of child bearing at advanced maternal ages Increased risk of congenital abnormalities*įinancial risk (eg cost of medication, cycles, IVF, etc) Risks during oocyte collection including infection, damage to organs, blood loss, ovarian torsion, risks related to anaesthesia Which is not a risk of oocyte cryopreservation? The age of the women at time of freezing is not a good predictor of oocyte potential.* The highest live birth rate is seen when oocytes are cryopreserved at younger ages.Īge-related decline in fertility is primarily related to the decline in the quality of the oocyte as it ages and not the age of the uterus. Many women have cryopreserved oocytes over the age of 35 years.
While individual circumstances must be considered, which comment regarding the age at freezing is incorrect? Oocyte cryopreservation is now considered very effective. Oocyte cryopreservation is no longer considered experimental according to the ASRM and the ESHRE. The largest reduction in natural fertility occurs during which age range? Knowledge on fertility and fertility preservation and ovarian reserve testing (n = 72) the correct answer is marked with an asterisk Quantitative interpretation of AMH levels was also poorly understood. Forty per cent failed to identify that AMH was not a measure of oocyte quality/natural fertility. Participants showed poor understanding of ovarian reserve testing. The average knowledge score was 5.4/12 (SD = 1.8 range = 0–9). While 82% of participants were aware that EOC is no longer considered experimental, 40% were incorrect on timing of female fertility decline (Table 2). RACGP, The Royal Australian College of General Practitioners How did participants hear about this survey? Demographic characteristics of participants The average time to complete the questionnaire was 16 minutes (standard deviation = 7). Although a large variety of participants were represented, the majority were younger female GPs in metropolitan areas (Table 1). Seventy-two GPs and general practice registrars participated.
Free-text responses were analysed for common themes. A student’s t-test was used to compare mean knowledge scores between those who had reservations about EOC and those who did not or were unsure. 13 Age remains the best predictor of IVF success, with live birth rates per blastocyst transfer of 40% in women aged annually vs < annually) were explored using Chi-squared tests. Ovarian reserve testing does not predict fertility or fecundity outcomes. Ovarian reserve testing, requisite to planning EOC, 4 includes measurement of anti-Müllerian hormone (AMH) and antral follicle count (AFC), which are helpful in assessing oocyte quantity and enable assisted reproductive technology (ART) practitioners to tailor treatment. 2 The public are generally aware of EOC and ovarian reserve testing and support it. With encouraging data emerging on safety and efficacy, the Australian and New Zealand Society for Reproductive Endocrinology and Infertility (ANZSREI) in 2019 described EOC as an ethically permissible, safe, well-established mainstream treatment. 8 It is used to store oocytes, ideally collected at a younger age when egg quality is better, 4 to be used later through IVF. 6,7 EOC has been considered non-experimental since 2012. Commonly women feel unready to conceive in the immediate future, often associated with the absence of a partner’s commitment to co-parenting. 5 The reasons women consider EOC are complex. EOC may allow conception of biologically related children later in life through in vitro fertilisation (IVF). 4 In this context, growing numbers of women and couples are being treated for age-related infertility.Ĭoncurrently, a growing number of women are considering elective oocyte cryopreservation (EOC). 2 The risk of female infertility rises from 6% at age 20–24 years to 64% at age 40–44 years, 3 with the most significant reduction occurring from the ages of 37–38 years. 1 The prevalence of female infertility increases with advancing age because of the biological limits of oocyte metabolism and function. Women and couples are delaying having children until later ages when compared with previous generations.