Personalizing elective oocyte cryopreservation: a novel predictive model for oocyte yield across multiple stimulation...

Area of Science:

• Reproductive Endocrinology
• Infertility Research
• Biostatistics in Medicine

Background:

• Increasing trend of delayed childbearing necessitates fertility preservation strategies like elective oocyte cryopreservation (EOC).
• Ovarian reserve naturally declines with age, impacting oocyte quality and quantity, increasing risks of age-related fertility decline.
• Existing models for oocyte yield prediction often focus on single cycles or sub-fertile populations, limiting applicability to fertile individuals undergoing EOC.

Purpose of the Study:

• To develop and validate a predictive model for cryopreserved oocyte yield in patients undergoing EOC.
• To assess the predictive accuracy of models incorporating patient age and ovarian reserve markers (AFC, AMH, FSH).
• To enhance clinician-patient counseling regarding expected oocyte yield from EOC cycles.

Main Methods:

• Retrospective cohort study of 579 patients undergoing one or more EOC cycles.
• Collected baseline data including age, BMI, antral follicle count (AFC), anti-Müllerian hormone (AMH), and FSH levels.
• Utilized negative binomial regression with generalized estimating equations and receiver operating characteristic (ROC) curve analysis to evaluate model performance.

Main Results:

• A model combining age, AFC, AMH, and FSH demonstrated the highest predictive accuracy (AUC 0.7922 for good response; 0.7917 for adequate response).
• Models incorporating age and ovarian reserve markers showed significant predictive capability for both good (≥10 oocytes) and adequate (≥5 oocytes) cryopreservation outcomes.
• The combination of age and AMH alone provided the lowest predictive accuracy among the tested models.

Conclusions:

• A predictive model integrating patient age and ovarian reserve tests (AFC, AMH, FSH) offers robust accuracy for estimating oocyte yield in EOC.
• These models can significantly improve the counseling process for individuals considering EOC for fertility preservation.
• Future research could enhance model precision by including ethnicity and prior EOC outcomes in multicenter studies.