Exploring women's attitudes, knowledge and intentions to use oocyte freezing for non-medical reasons: a systematic review.

INTRODUCTION Women are postponing childbearing and preventing age-related fertility decline with oocyte freezing for non-medical reasons (OFNMR). The objective of this systematic evaluation was to gain an understanding of women's attitudes, knowledge and intentions to use OFNMR amongst users of OFNMR and the general public. MATERIAL AND METHODS A systematic search of MEDLINE, EMBASE and PyschINFO databases was undertaken, for studies that examined the psychosocial attitudes amongst women towards OFNMR. Limited to English Language. No time restriction was set for publications. Extracted data was analysed using thematic analysis. Performed according to PRISMA guidelines with prospective PROSPERO registration [CRD4201912578]. RESULTS Overall, 35 studies met the inclusion criteria. Studies were broadly categorised into studies i) investigating users or potential users of OFNMR, and ii) examining the views of members of the general public. Users of OFNMR have good knowledge of age-related fertility decline and awareness of OFNMR procedure. The lack of partner was identified as the most common motivating factor to undertake OFNMR, with cost as a predominant concern. Knowledge amongst the general public of OFNMR is highly variable. Under-estimation of age-related fertility decline is common amongst the general public. Intentions of women to use OFNMR also varied drastically between studies. CONCLUSIONS Women are predominantly motivated to freeze eggs by the lack of a suitable partner, but cost is a significant barrier. Increasing the number of women pursuing OFNMR at an earlier stage may positively impact upon the risk of future involuntary childlessness. Better information should be made available to both women and men, about their fertility and options to inform their reproductive decision making.