Fertility preservation to prevent age-related fertility decline: systematic review

Abstract

Background: Fertility Preservation (FP) to prevent age-related fertility decline has been subject of great discussion, concerning ethical, legal and religious questions. The present study aims to provide a systematic revision of the contributes in the literature on fertility preservation to prevent age-related fertility decline, namely on 1) what characterize women that consider FP but did not make a decision yet and the women that have actually done it, specifically their individual characteristics and reasons, as well as 2) the knowledge and attitudes of the general practitioners (GPs) about FP, since they are the first-line agents in its disclosure. Methods: An electronic search in three databases was performed, following the procedure of PRISMA, using the keywords: (“oocyte freezing”, “cryopreserve oocytes”, “fertility preservation”, “oocyte vitrification”) and (“age-related fertility decline”, “agerelated fertility loss”, “decline in fertility age”). Nine studies were selected and included in this systematic review. Results: The percentage of women who considered FP as a future option varied according to the studies (15.1% - 31.5%). Women generally performed cryopreservation of oocytes at a later age (approximately 36 to 38 years old) from the recommended period to optimize the technique. The desire to find a suitable partner to share parenting was the main reason that led the women to perform this procedure. In general, GPs have a limited knowledge on FP. Conclusions: In order to provide the necessary conditions for women of childbearing age to make conscious and informed reproductive decisions, fertility procedures need to be more disseminated, namely toward GPs.