CReATe Fertility Centre, Toronto, ON, Canada.
Department of Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
BJOG. 2021 May;128(6):950-962. doi: 10.1111/1471-0528.16555. Epub 2020 Nov 3.
Advances in vitrification techniques have enabled planned oocyte cryopreservation ('Planned OC').
To explore the cost-efficiency and utilisation of planned OC, as well as patients' perspectives on the process.
A systematic search in PubMed/MEDLINE, Embase, Cochrane Database and PsychINFO, for all relevant studies published between January 2007 and December 2019.
The protocol followed PRISMA guidelines in PECO format, and was registered with PROSPERO.
Two independent reviewers evaluated all manuscripts for inclusion eligibility. Authors were contacted for missing data. Included studies were assessed for risk of bias and for heterogeneity. Weighted effects were measured and plotted.
The search yielded 12 545 records, of which 43 were included. Planned OC is cost-efficient at 35, assuming 60% utilisation; and at 37 assuming utilising donor sperm when necessary. At 38 it is cost-efficient to defer planned OC in favour of undergoing 2 IVF cycles. Currently, utilisation of banked-oocytes within 22-58 months, is up to 15%. Nine percent of warmed banked oocytes result in life births. Online resources and treating physicians are equally important sources of information regarding planned OC. Most patients think planned OC is ideal before age 35 and are not fully aware of what the process entails and tend to overestimate the success rates. The main barrier to wider endorsement of planned OC is being wary of potential health implications or of limited success.
Planned OC is an adequate method for preserving fertility. However, knowledge gaps result in under-utilisation leading to reduced cost-efficiency.
Identifying facilitators and barriers for wider adoption of banking oocytes can enhance the cost-efficiency of this modality.
玻璃化技术的进步使得计划卵母细胞冷冻保存（“计划 OC”）成为可能。
探讨计划 OC 的成本效益和利用率，以及患者对该过程的看法。
系统检索 PubMed/MEDLINE、Embase、Cochrane 数据库和 PsychINFO 中 2007 年 1 月至 2019 年 12 月期间发表的所有相关研究。
该方案遵循 PRISMA 指南的 PECO 格式，并在 PROSPERO 上注册。
两名独立审查员评估所有纳入文献的入选资格。联系作者获取缺失数据。纳入的研究评估了偏倚风险和异质性。测量并绘制加权效应。
搜索结果产生了 12545 条记录，其中 43 条被纳入。假设利用率为 60%，计划 OC 的成本效益为 35；假设需要时使用捐赠精子，则为 37。为了推迟计划 OC 而进行 2 次 IVF 周期，成本效益为 38。目前，在 22-58 个月内使用银行卵母细胞的利用率高达 15%。解冻的银行卵母细胞中有 9%导致活产。在线资源和治疗医生是计划 OC 相关信息的同等重要来源。大多数患者认为在 35 岁之前进行计划 OC 是理想的，他们并不完全了解该过程的具体内容，并且往往高估了成功率。更广泛地认可计划 OC 的主要障碍是对潜在健康影响或有限成功率的担忧。
计划 OC 是保存生育能力的一种适当方法。然而，知识差距导致利用率降低，从而降低了成本效益。
确定更广泛采用卵子银行的促进因素和障碍可以提高这种方式的成本效益。
