_id

683a1615c782e11e38d1b1aa

id

3937

title

BWH Egg Freezing Counseling Tool (EFCT)

full_title

BWH Egg Freezing Counseling Tool (EFCT)

short_title

BWH Egg Freezing Counseling Tool

med_description

Predicts likelihood of live birth for elective egg freezing in women.

short_description

Predicts likelihood of live birth for elective egg freezing in women.

slug

bwh-egg-freezing-counseling-tool-efct

description

Brigham and Women’s Hospital (BWH) Egg Freezing Counseling Tool predicts likelihood of live birth for elective egg freezing in women.

keywords

Eggs, egg freezing, oocyte, cryopreservation, infertile, infertility, fertile, fertility, brigham, brigam, BWH, ivf, in vitro, in vitro fertilization, icsi, intracytoplasmic sperm injection

complaint

[ "Infertility" ]

formula

p(Livebirth) = 1 – [1 – 0.6 × p(Euploid) × p(Blast)] ^ (Number of mature eggs) where p(Blast) = 0.95 × exp(2.8043 – 0.1112 × Age) if Age <36 p(Blast) = 0.85 × exp(2.8043 – 0.1112 × Age) if Age ≥36 and p(Euploid) is from table below Note:number of mature eggs assumes 95% survival of thawed eggs (85% if age is ≥36 years).

evidence

The BWH Egg Freezing Counseling Tool was developed by Goldman and Fox et al at Brigham and Women’s Hospital based on a data set of 520 patients who underwent first fresh autologous cycles using ICSI (intracytoplasmic sperm injection).

Poisson regression was used to predict the proportion of mature eggs that ultimately developed into usable blastocysts, using patient age as the primary parameter.

Estimates of live birth rates were found to be similar to other models, including by Doyle et al (2016), which used broader age groups instead of age by individual years.

The authors assumed that 60% of euploid blastocysts, on average, would ultimately result in a live birth based on published data, but the actual rate is known to vary among IVF clinics (Harton 2013).

measurements

[ { "name": "Age", "unit": "age_bwh", "error_min": "24", "error_max": "44", "warn_min": "24", "warn_max": "44", "conversion": "1", "normal_max_si": "44", "normal_max_us": "44", "normal_min_si": "24", "normal_min_us": "24", "units_si": "years", "units_us": "years" }, { "name": "eggs", "unit": "eggs", "error_min": "1", "error_max": "101", "warn_min": "1", "warn_max": "100", "conversion": "1", "normal_max_si": "0", "normal_max_us": "0", "normal_min_si": "0", "normal_min_us": "0", "units_si": "eggs", "units_us": "eggs" } ]

information

Note: In the study, ages 24–35 were grouped together, as fertility is fairly stable up to age 35 and begins to decrease appreciably after that age.

refrences

{ "Clinical Practice Guidelines": [], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/28166330", "text": "Goldman RH, Racowsky C, Farland LV, Munné S, Ribustello L, Fox JH. Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients. Hum Reprod. 2017;32(4):853-859. " } ], "Other References": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/26604065", "text": "Doyle JO, Richter KS, Lim J, Stillman RJ, Graham JR, Tucker MJ. Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval. Fertil Steril. 2016;105(2):459-66.e2." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/24034939 ", "text": "Harton GL, Munné S, Surrey M, et al. Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization. Fertil Steril. 2013;100(6):1695-703." }, { "href": "https://pubmed.ncbi.nlm.nih.gov/35597614/", "text": "Cascante SD, Blakemore JK, DeVore S, et al. Fifteen years of autologous oocyte thaw outcomes from a large university-based fertility center. Fertility and Sterility. 2022;118(1):158-166." } ], "Outcomes": [], "Validation": [], "Validations": [] }

pearls

• Uses a woman’s age at egg retrieval and the number of mature eggs frozen to predict the probability of having at least one, two, or three live births.
• Since limited data exist regarding live births following elective egg freezing, the BWH Egg Freezing Counseling Tool was developed from a surrogate population of presumably fertile women (egg donor, male-factor, and tubal-factor only infertility).
• No number of frozen eggs can guarantee a live birth.
• IVF stimulation cycles produce a variable number of eggs, even among women of similar ages. Older women typically obtain fewer eggs per stimulation cycle.
• May be less reliable for women ≥39 years old.
• May overestimate live birth rates for women undergoing non-elective egg freezing for medical reasons, such as cancer.
• Data are retrospective and from a single academic institution in an insurance-mandated state.
• Individual IVF clinics with different thaw survival and live birth rates may need to modify and customize this model.
• Has yet to be prospectively validated.

usecase

Patients seeking fertility preservation with elective egg freezing.

reasons

Predicts likelihood of having at least one, two, or three live births using only two data points. Incorporates likelihood that an embryo will have normal number of chromosomes. Helps determine whether undergoing additional egg freezing cycles would result in a meaningful increase in likelihood of having a live birth.

next_advice

next_actions

next_management

Decisions about egg freezing should be made by the patient in conjunction with her physician, considering patient-specific characteristics.

diseases

[ "Infertility", "Pregnancy" ]

input_schema

[ { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Age", "name": "age", "optional": false, "tips_en": "", "type": "textbox", "unit": "age_bwh" }, { "conditionality": "", "default": null, "fhir_rules": null, "inct": null, "label_en": "Number of mature eggs", "name": "eggs", "optional": false, "tips_en": "", "type": "textbox", "unit": "eggs" } ]

instructions

Use in women age 24–44 years undergoing fertility counseling.

published

2022-04-21T20:29:27.077Z

purpose

[ "Prognosis", "Formula" ]

search_terms

[ "egg freezing", "male factor", "Egg", "oocyte", "oocytes", "cryopreservation", "infertility", "fertility", "pregnancy", "birth", "ivf", "intracytoplasmic sperm injection", "tubal", "in vitro fertilization", "icsi" ]

seo

{ "keywords_en": "Eggs, egg freezing, oocyte, cryopreservation, infertile, infertility, fertile, fertility, brigham, brigam, BWH, ivf, in vitro, in vitro fertilization, icsi, intracytoplasmic sperm injection", "meta_description_en": "Brigham and Women’s Hospital (BWH) Egg Freezing Counseling Tool predicts likelihood of live birth for elective egg freezing in women." }

specialty

[ "OB-Gyn" ]

departments

[ "Reproductive" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10433, "short_title_en": "VBAC (MFMU)", "slug": "vaginal-birth-after-cesarean-vbac" }, { "calcId": 3320, "short_title_en": "Bishop Score", "slug": "bishop-score-vaginal-delivery-induction-labor" }, { "calcId": 423, "short_title_en": "Pregnancy Due Dates", "slug": "pregnancy-due-dates-calculator" } ]

ismed

true

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "gynecology" ]

cleaned_use

[ "Patients seeking fertility preservation with elective egg freezing." ]

pub

false