Bergin Keri, Wiseman Carlie, Levin Isabelle, Baird Morgan, Hernandez-Nieto Carlos, Lee Joseph, Copperman Alan B, Sekhon Lucky
Reproductive Medicine Associates of NY, New York, NY, USA.
Icahn School of Medicine Mount Sinai, New York, NY, USA.
J Womens Health (Larchmt). 2025 Jul;34(7):882-888. doi: 10.1089/jwh.2024.0960. Epub 2025 Jan 28.
Utilization of fertility preservation treatments has increased since the American Society for Reproductive Medicine lifted the "experimental" label for oocyte cryopreservation in 2012. This study characterizes changes in insurance coverage, clinical outcomes, and live birth probabilities over a span of a decade (2012-2022) in patients who underwent planned oocyte cryopreservation. Retrospective analysis of planned oocyte cryopreservation cycles using vitrification from 2012 to 2022. Medically indicated cycles were excluded. Age, anti-mullerian hormone (AMH), number of mature oocytes vitrified, and insurance coverage were evaluated by year of procedure. Comparative statistics were performed using Kruskal-Wallis and chi-square analysis. Linear regression models and Cochran-Armitage trend test were performed to determine the relationships between each variable and time. A total of 4,544 planned oocyte cryopreservation cycles were included. Mean age at egg retrieval decreased significantly over time (37.9 ± 2.9 years versus 34.9 ± 3.3, < 0.0001). Mature oocytes frozen per cycle rose significantly over time (10.7 ± 7.4 in 2012 versus 13.3 ± 8.6 in 2022, ≤ 0.0001). Cycles with insurance coverage significantly increased, 0% covered in 2012 versus 46.9% covered in 2022 ( ≤ 0.0001). Since 2012, patient age at time of egg freezing has decreased, coinciding with a mean increase in AMH and number of mature oocytes frozen per cycle. Younger participation in extending fertility is likely driven by a boost in social awareness regarding reproductive aging, cryopreservation technologies, and improved access to treatment. Modern oocyte cryopreservation includes more access to insurance coverage, shown by nearly half of current cycles benefiting from plan support. Shifts in patient demographics and insurance coverage, paired with updates to stimulation protocols that optimize oocyte yield, are expected to improve the overall prognosis and future fertility of patients who utilize thawed oocytes.
自美国生殖医学学会于2012年取消卵母细胞冷冻保存的“实验性”标签以来,生育力保存治疗的使用率有所上升。本研究描述了在十年期间(2012 - 2022年)接受计划性卵母细胞冷冻保存的患者在保险覆盖范围、临床结局和活产概率方面的变化。对2012年至2022年使用玻璃化冷冻的计划性卵母细胞冷冻保存周期进行回顾性分析。排除医学指征性周期。按手术年份评估年龄、抗苗勒管激素(AMH)、冷冻的成熟卵母细胞数量和保险覆盖情况。使用Kruskal - Wallis检验和卡方分析进行比较统计。进行线性回归模型和 Cochr an - Armitage趋势检验以确定每个变量与时间之间的关系。共纳入4544个计划性卵母细胞冷冻保存周期。随着时间推移,取卵时的平均年龄显著下降(37.9±2.9岁对34.9±3.3岁,<0.0001)。每个周期冷冻的成熟卵母细胞数量随时间显著增加(2012年为10.7±7.4个对2022年为13.3±8.6个,≤0.0001)。有保险覆盖的周期显著增加,2012年为0%,2022年为46.9%(≤0.0001)。自
2012年以来,卵子冷冻时的患者年龄下降,同时AMH平均增加,每个周期冷冻的成熟卵母细胞数量增加。年轻人群参与生育力延长可能是由于社会对生殖衰老、冷冻保存技术的认识提高以及治疗可及性改善所致。现代卵母细胞冷冻保存包括更多获得保险覆盖的机会,目前近一半的周期受益于保险支持。患者人口统计学和保险覆盖范围的变化,以及刺激方案的更新以优化卵母细胞产量,预计将改善使用解冻卵母细胞患者的总体预后和未来生育能力。