Aspects on social egg freezing – current state in Bulgaria

Abstract

Problem statement: Oocyte cryopreservation for non-medical reasons has been widely promoted among young women who tend to delay their reproduction. As the methodology has proved its safety and efficiency in the field of assisted reproduction technology and the embryo laboratory, the interest in oocyte cryopreservation has increased highly. However, do social freezers ever come back and use these oocytes, or they keep them as a safety boat with no real near-future plans for reproduction? Methods: The following study has been performed as a retrospective analysis of 296 women who had oocyte freezing procedure for non-medical (social) reasons, medical conditions (oncological treatment) and oocyte donation from January 2013 to June 2023 at Medical Complex Ob/ Gyn “Dr Shterev” – Sofia, Bulgaria. Results: Throughout the observed period, 190 women with 221 procedures vitrified their oocytes for future use. Only 9.47% of them had medical conditions and 7.36% were hindered to use their reproductive gametes at the day of 
the oocyte retrieval (absence of spermatozoa, sickness). The average age of the women in this group was 35.59 ± 1.5 years and the mean number of cryopreserved oocytes was 5.63 ± 1.4 per women. Compared to social cryopreserves, and bound to the Bulgarian 
legislation, the 106 women who donated their oocytes were younger (28.86 ± 1.5 years (p < 0.05)) with 7.34 ± 1.7 (p < 0.05) cryopreserved oocytes per donor. As the clinic has well represented program for oocyte donation 82.1% of the donors were used. In result, there were 37 clinical pregnancies with 47 children born. In the same period, only 46 (24.2%) women who stored their own gametes in our cryobank came back and claimed them for assisted reproduction. Nine clinical pregnancies had been registered and 10 children were born. An intriguing fact we can point from the medical history of the clear social freezers (SF) is the record of previous procedure(s) for abortion on demand. It was reported for 12% of the women in this group. Conclusion: According to the results we observed as evident that patients need more clarity towards the procedures for oocyte cryopreservation and consequent fertility treatment. We should rise more awareness to the most preferable age for cryopreservation and number of oocytes to be stored.