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

Fresh and cryopreserved oocyte cycles show no differences in autologous outcomes, some differences in per-cycle and per-pregnancy donor outcomes, and no differences in per-transfer donor implantation, pregnancy, or birth rates.

Volume 107, Issue 1, Pages 110-118


Sara Crawford, Ph.D., Sheree L. Boulet, Dr.P.H., M.P.H., Jennifer F. Kawwass, M.D., Denise J. Jamieson, M.D., M.P.H., Dmitry M. Kissin, M.D., M.P.H.



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.


Retrospective cohort study from the National ART Surveillance System.


Fertility treatment centers.


Fresh embryo cycles initiated in 2013 utilizing embryos created with fresh and cryopreserved, autologous and donor oocytes.


Cryopreservation of oocytes versus fresh.

Main Outcomes Measure(s)

Cancellation, implantation, pregnancy, miscarriage, and live birth rates per cycle, transfer, and/or pregnancy.


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.


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.

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