To freeze or not to freeze: decision regret and satisfaction following elective oocyte cryopreservation

Abstract

Objective: To characterize the degree of decision regret following elective oocyte cryopreservation (EOC) for social indications, and identify factors associated with regret.

Design: Retrospective cohort survey study.

Setting: Academic center.

Patients: Two hundred one women who underwent EOC for fertility preservation between 2012 and 2016.

Interventions: None.

Main outcome measures: Decision Regret Scale (DRS) score, from 0-100, with a cut-off >25 indicative of moderate to severe regret; and attitudes regarding decision satisfaction.

Results: Median DRS score was 0 (interquartile range 0-15) and the mean was 10 (range 0-90). Thirty-three women (16%) experienced moderate to severe decision regret. Factors associated with decision regret included: number of eggs frozen, perceived adequacy of information prior to EOC, adequacy of emotional support during EOC, and patient-estimated probability of achieving a live birth using their banked eggs. In a multivariate logistic model, increased perceived adequacy of information (adjusted odds ratio 0.63, 95% confidence interval 0.42-0.97) and patient-estimated probability of achieving a live birth (adjusted odds ratio 0.80, 95% confidence interval 0.67-0.96) were associated with reduced odds of regret. One hundred sixty-seven women (88%) reported increased control over reproductive planning following EOC. One hundred eighty-three (89%) affirmed they will be happy they froze eggs, even if they never use them.

Conclusions: The risk of decision regret following EOC is non-negligible. Low number of mature oocytes cryopreserved is a risk factor for increased regret, while perceptions of adequate information and emotional support, and increased patient-estimates of achieving a live birth using banked eggs are associated with reduced risk of regret.

Keywords: Elective oocyte cryopreservation; decision regret; fertility preservation; social egg freezing.