Fertility Center A HURDLE IN THE EGG FREEZING RACE: COMPARISON OF DONOR AND AUTOLOGOUS OOCYTE CRYOPRESERVATION (OC) OUTCOMES Sarah Druckenmiller, Patty.

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Fertility Center A HURDLE IN THE EGG FREEZING RACE: COMPARISON OF DONOR AND AUTOLOGOUS OOCYTE CRYOPRESERVATION (OC) OUTCOMES Sarah Druckenmiller, Patty Ann Labella, Shannon DeVore, James Grifo, Brooke Hodes-Wertz, Nicole Noyes

OBJECTIVE Oocyte cryopreservation is now a mainstream fertility preservation option Minimal outcome data is available Much of our knowledge is based on donor oocyte cryopreservation, which may be superior to autologous oocyte cryopreservation Aim: to compare donor and autologous oocyte cryopreservation thaw outcomes Retrospective cohort study Reviewed all donor and autologous oocyte cryopreservation thaw cycles from October 2004 – January 2017 at our large university-based fertility center Fertility Center

RESULTS DONOR OOCYTE CRYOPRESERVATION (n=110 recipients) ALL AUTOLOGOUS OOCYTE CRYOPRESERVATION (n=123 patients) AUTOLOGOUS OOCYTE CRYOPRESERVATION <35y (n=23 patients) Younger (median 26y, range 21-31y) Older (median 38y, range 25-42y) (median 33y, range 25-33y) Fewer MIIs thawed (median 8) More MIIs thawed (median 11) (median 13) Significantly higher: Oocyte survival (88%) 2-PN fertilization (67%) Blastocyst formation (49%) Significantly lower: Oocyte survival (78%) 2-PN fertilization (53%) Blastocyst formation (27%) Oocyte survival (79%) 2-PN fertilization (60%) Blastocyst formation (36%) Significantly fewer thaw cycles with NO transfer (7%) Significantly more thaw cycles with NO transfer (34%) Significantly more thaw cycles with NO transfer (33%) Live birth rate for all transfers: 53% Live birth rate for all transfers: 41% Live birth rate for all transfers: 56% Fertility Center

CONCLUSIONS As women increasingly rely on autologous oocyte cryopreservation for fertility preservation, it is critical to provide realistic expectations about outcomes Developmental parameters for autologous oocyte cryopreservation were inferior to donor oocyte cryopreservation, resulting in: Production of fewer blastocysts Higher proportion of patients with no embryos for transfer In those achieving embryo transfer, live birth outcomes in autologous vs. donor oocyte cryopreservation cycles appear comparable Donor oocyte thaw data is not an appropriate counselling tool for women pursuing autologous oocyte cryopreservation  only autologous thaw data should be used Fertility Center