title: Optimal timing for elective egg freezing.
abstract: OBJECTIVE
  To estimate the optimal age to pursue elective oocyte cryopreservation.
  
  
  METHODS
  A decision-tree model was constructed to determine the success and cost-effectiveness of oocyte preservation versus no action when considered at ages 25-40 years, assuming an attempt at procreation 3, 5, or 7 years after initial decision.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Hypothetical patients 25-40 years old presenting to discuss elective oocyte cryopreservation.
  
  
  METHODS
  Decision to cryopreserve oocytes from age 25 years to age 40 years versus taking no action.
  Probability of live birth after initial decision whether or not to cryopreserve oocytes.
  
  
  RESULTS
  Oocyte cryopreservation provided the greatest improvement in probability of live birth compared with no action (51.6% vs. 21.9%) when performed at age 37 years. The highest probability of live birth was seen when oocyte cryopreservation was performed at ages <34 years (>74%), although little benefit over no action was seen at ages 25-30 years (2.6%-7.1% increase). Oocyte cryopreservation was most cost-effective at age 37 years, at $28,759 per each additional live birth in the oocyte cryopreservation group. When the probability of marriage was included, oocyte cryopreservation resulted in little improvement in live birth rates.
  
  
  CONCLUSIONS
  Oocyte cryopreservation can be of great benefit to specific women and has the highest chance of success when performed at an earlier age. At age 37 years, oocyte cryopreservation has the largest benefit over no action and is most cost-effective.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina. Electronic address: tolga_mesen@med.unc.edu.
authors.forename: Tolga B
authors.initials: TB
authors.lastname: Mesen
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Mersereau
authors.affiliation: Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Kane
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Anne Z
authors.initials: AZ
authors.lastname: Steiner
mesh_terms: D000328:Adult; D017677:Age Distribution; D002470:Cell Survival; D003362:Cost-Benefit Analysis; D015925:Cryopreservation / Q000191:economics* / Q000379:methods; D003661:Decision Support Techniques; D005260:Female; D059247:Fertility Preservation / Q000191:economics* / Q000379:methods; D005307:Fertilization in Vitro / Q000191:economics* / Q000379:methods; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D050498:Live Birth / Q000191:economics* / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D054315:Oocyte Retrieval / Q000191:economics* / Q000379:methods; D011247:Pregnancy; D015995:Prevalence; D043762:Reproductive Behavior / Q000706:statistics & numerical data; D013048:Specimen Handling / Q000191:economics / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
keywords: Elective oocyte cryopreservation; egg freezing; fertility preservation