Decision regret and associated factors following oocyte cryopreservation in patients with diminished ovarian reserve and/or age-related fertility decline

PURPOSE

To evaluate the prevalence and factors associated with decision regret following oocyte cryopreservation (OC) in women with diminished ovarian reserve (DOR) and/or age-related fertility decline (ARFD).

METHODS

A cross-sectional survey study was conducted to five hundred fifty-two women with DOR and/or ARFD who underwent OC between 2014 and 2019 in two private-assisted reproductive units in Istanbul, Turkey. Decision regret was measured using the validated Decision Regret Scale (DRS).

RESULTS

The median and mean DRS scores were 10 (interquartile range: 25) and 13.4 (SD: 13.2, range 0-70), respectively. Eighty-five (52.5%) women reported mild regret and 26 (16%) had moderate to severe regret. Decision regret was inversely associated with the belief in fate regarding childbearing and trust in the efficacy of OC.

CONCLUSIONS

The prevalence of severe decision regret among patients with DOR and/or ARFD undergoing OC is low. Women who had belief in fate and trusted in the efficacy of oocyte cryopreservation had significantly lower decisional regret.

Childless women's beliefs and knowledge about oocyte freezing for social and medical reasons

STUDY QUESTION

What factors inform a woman's decision-making about oocyte freezing to preserve fertility for social and medical reasons?

SUMMARY ANSWER

Women lacked knowledge about the costs and viability of oocyte freezing as a fertility preservation option for social and medical reasons, and identified health consequences, costs, and viability as being particularly influential in their decision-making.

WHAT IS KNOWN ALREADY

Having only recently become a viable fertility preservation option, relatively little is known about childless women's beliefs or knowledge about oocyte freezing for social or medical reasons.

STUDY DESIGN, SIZE, DURATION

A cross sectional study of 500 childless women was conducted in August, 2015.

PARTICIPANTS/MATERIALS, SETTING, METHODS

A total of 500 childless, presumed fertile, women from 18 to 38 years of age completed an online, self-report questionnaire assessing beliefs and knowledge about oocyte freezing to preserve fertility for social or medical reasons.

MAIN RESULTS AND THE ROLE OF CHANCE

Financial costs (85.6%), health risks to themselves (86.4%) or their offspring (87.8%), and success rates (82%) were the primary factors that women felt would influence their decision to freeze their oocytes. Partner's feelings (88.6%), prognosis for a full recovery (85.4%), and concerns about the health effects of the hormones or oocyte retrieval procedure (85.4%) were identified as being particularly important when considering oocyte freezing for medical reasons. Consistent with their perceptions of having little or no knowledge about oocyte freezing, there was an overall correct response rate of 33% to the 12 knowledge questions.

LIMITATIONS, REASONS FOR CAUTION

The online format and use of a survey company to recruit participants may have increased the risk of self-selection bias and limit the generalizability of these findings. The findings may also be limited by the fact that the participants were not facing cancer treatments, and the younger participants were not nearing the end of their reproductive lifespan, and therefore would not have had reason to learn about, or consider, fertility preservation for medical or social reasons.

WIDER IMPLICATIONS OF THE FINDINGS

Given the worldwide trend towards delaying childbearing and the increasing availability of oocyte freezing as an option to preserve women's fertility, it is likely these results could be extended to wider North American, European, and Australasian populations of English speaking childless women.

STUDY FUNDING/COMPETING INTERESTS

No specific funding. No competing interests.