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What is the net effect of introducing vitrification for cryopreservation of surplus 2PN oocytes in an IVF program?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to accurately describe outcome differences (cryo-survival, pregnancy rate and live birth rate, both per ET and cumulatively), between the vitrification method and slow-freezing method of surplus 2PN oocytes in an IVF program.

Methods

In 2004, the freezing method for 2PN oocytes was changed from slow-cooling to vitrification. The data of 711 patients (timespan: 1/1999–7/2011; 410 vitrification and 301 slow-cooling events) undergoing a first IVF/ICSI cycles with freezing of 2PN oocytes were retrospectively analyzed. The outcome of one, the first, IVF cycle per patient was explored. The data were analyzed per freezing–thawing attempt as well as cumulatively per one complete IVF cycle, taking pregnancy occurrence after a fresh embryo transfer preceding the cryo-cycle(s) and other confounders (such as female age, elective vs. surplus 2PN cryopreservation) into account by means of exploratory regression analyses.

Results

In the vitrification and slow-cooling group, 756 and 376, respectively, attempts of thawing 2PN oocytes were recorded. Each attempt of thawing 2PN oocytes showed statistically significantly higher mean cryo-survival rates after vitrification (effect size approximately 30–40%, with vitrification cryo-survival consistently above 90% in all thawing attempts). Furthermore, the incidence of “zero survival” was lower after vitrification (0.5 vs. 7.3%, p < 0.01). It is estimated that the odds of achieving a live birth per one IVF cycle (fresh and frozen transfers combined) with vitrification of 2PN oocytes is increased approximately 1.4-fold (OR of 1.405, 95% CI 0.968–2.038; p = 0.07); however, statistical significance was not achieved due to sample size. Female age and elective cryopreservation of all 2PN oocytes without a fresh transfer (e.g., hyperresponders) were found to be negatively and positively, respectively, associated with the chance of achieving a live birth.

Conclusions

The introduction of vitrification has a measurable impact on the efficacy of an IVF program. However, this effect is not large despite the impressively higher cryo-survival rates with vitrification. The “true” net efficacy effect of introducing 2PN vitrification in an IVF program will, in real life, be lower due to patients not having surplus 2PN oocytes available for freezing and later transfer.

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Acknowledgements

We acknowledge the work and contribution of the former head of the IVF laboratory at the University affiliated IVF center in Lübeck, Prof. Dr. Safaa Al-Hasani, who has introduced the vitrification technique in 2003 under head of department, Prof. Dr. Klaus Diedrich, after a stay in Japan with Prof. Kuwayama (Tokyo).

Funding

The study was financed by university funds. There was no primary funding for this study.

Author information

Authors and Affiliations

  1. Department of Gynecological Endocrinology and Reproductive Medicine and Universitaeres Kinderwunschzentrum Luebeck, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Manja Golakov, Marion Depenbusch, Askan Schultze-Mosgau, Beate Schoepper, Jennifer Hajek, Kay Neumann & Georg Griesinger

Authors
  1. Manja Golakov
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  2. Marion Depenbusch
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  3. Askan Schultze-Mosgau
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  7. Georg Griesinger
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Contributions

MG participated in designing the study, has collected, verified and analyzed the data and wrote the draft version of the manuscript. MD, ASM, KN, JH and BS participated in the data interpretation and revised the manuscript. GG designed the study, participated in and reviewed the analyses, and revised the manuscript. The final manuscript and order of authorship have been approved by all authors.

Corresponding author

Correspondence to Georg Griesinger.

Ethics declarations

Conflict of interest

MG has nothing to declare. MD has received personal fees from Finox and non-financial support from Merck-Serono. ASM has received personal fees and non-financial support from MSD, Ferring, Merck-Serono, Finox, TEVA. BS has nothing to declare. JH has received personal fees and non-financial support from MSD and Merck-Serono. KN has nothing to declare. GG has received personal fees and non-financial support from MSD, Ferring, Merck-Serono, Finox, TEVA, IBSA, Glycotope, as well as personal fees from VitroLife, NMC Healthcare LLC, ReprodWissen LLC and ZIVA LLC.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors—only retrospective analysis was performed. As this is a retrospective study, no statement of consent for participation could be obtained post hoc. As a retrospective analysis, consent for participation is not a necessity. This study was approved by the ethical review board of Luebeck University. Patient data were reversely blinded by creating a PatientID. University of Luebeck #11-233A.

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Golakov, M., Depenbusch, M., Schultze-Mosgau, A. et al. What is the net effect of introducing vitrification for cryopreservation of surplus 2PN oocytes in an IVF program?. Arch Gynecol Obstet 297, 529–537 (2018). https://doi.org/10.1007/s00404-017-4606-3

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  • DOI: https://doi.org/10.1007/s00404-017-4606-3

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