Decision-making in women who considered planned oocyte cryopreservation: decision satisfaction or regret?

Abstract

Research question: Among women who considered planned oocyte cryopreservation, does decision regret differ between those who pursued planned oocyte cryopreservation and those who did not?

Design: A survey was e-mailed to all women who presented for an initial consultation for planned oocyte cryopreservation between January 2016 and December 2021 using a secure REDCap platform. The survey comprised questions on demographics, reproductive planning and the validated Decision Regret Scale (DRS). Univariable and multivariable models were fitted to compare decision regret in the group who had proceeded with planned oocyte cryopreservation with the group who had not. A sentiment analysis was employed to characterize the emotional tone of respondents.

Results: In total, 338 respondents met the eligibility criteria. Of these, 178 (52.7%) patients had proceeded with planned oocyte cryopreservation and 160 (47.3%) had not. The groups were similar in age, race, ethnicity and education. Respondents who had proceeded with planned oocyte cryopreservation were more likely to be single, to anticipate starting a family at ≥39 years of age, and to consider the use of donor spermatozoa to be an acceptable option. Respondents who had not proceeded with planned oocyte cryopreservation more frequently reported starting attempts at conception since their consultation. A higher proportion of respondents who had not undergone planned oocyte cryopreservation experienced moderate-to-severe regret with their decision compared with respondents who had undergone at least one cycle of planned oocyte cryopreservation (50% versus 13%; P < 0.001). There was a correlation between decreasing number of cryopreserved oocytes and increasing DRS score (R = -0.41, P < 0.001).

Conclusions: Women who consider planned oocyte cryopreservation but do not proceed with it experience substantial decision regret. The DRS score was highest among respondents who had not proceeded with planned oocyte cryopreservation, and respondents who had undergone at least one cycle of planned oocyte cryopreservation that resulted in a low number of cryopreserved oocytes.

Keywords: Decision-making; Egg freezing; Fertility; Oocyte cryopreservation.