Cryopreserved oocyte versus fresh oocyte assisted reproductive technology cycles, United States, 2013.

Objective: To compare characteristics, explore predictors, and compare assisted reproductive technology (ART) cycle, transfer, and pregnancy outcomes of autologous and donor cryopreserved oocyte cycles with fresh oocyte cycles.

Design: Retrospective cohort study from the National ART Surveillance System. Setting: Fertility treatment centers. Patient(s): Fresh embryo cycles initiated in 2013 utilizing embryos created with fresh and cryopreserved, autologous and donor oocytes. Intervention(s): Cryopreservation of oocytes versus fresh. Main outcomes measure(s): Cancellation, implantation, pregnancy, miscarriage, and live birth rates per cycle, transfer, and/or pregnancy. Result(s): There was no evidence of differences in cancellation, implantation, pregnancy, miscarriage, or live birth rates between autologous fresh and cryopreserved oocyte cycles. Donor cryopreserved oocyte cycles had a decreased risk of cancellation before transfer (adjusted risk ratio [aRR] 0.74, 95% confidence interval [CI] 0.57-0.96) as well as decreased likelihood of pregnancy (aRR 0.88, 95% CI 0.81-0.95) and live birth (aRR 0.87, 95% CI 0.80-0.95); however, there was no evidence of differences in implantation, pregnancy, or live birth rates when cycles were restricted to those proceeding to transfer. Donor cryopreserved oocyte cycles proceeding to pregnancy had a decreased risk of miscarriage (aRR 0.75, 95% CI 0.58-0.97) and higher live birth rate (aRR 1.05, 95% CI 1.01-1.09) with the transfer of one embryo, but higher miscarriage rate (aRR 1.28, 95% CI 1.07-1.54) and lower live birth rate (aRR 0.95, 95% CI 0.92-0.99) with the transfer of two or more. Conclusion(s): There was no evidence of differences in ART outcomes between autologous fresh and cryopreserved oocyte cycles. There was evidence of differences in per-cycle and per-pregnancy outcomes between donor cryopreserved and fresh oocyte cycles, but not in per-transfer outcomes.