Does level of educational attainment influence the pursuit of elective fertility preservation and use of cryopreserved oocytes?

To identify if higher education level influences the decision to pursue elective fertility preservation procedures and subsequent return to thaw and utilize previously cryopreserved autologous oocytes. All autologous oocyte cryopreservation cycles for elective fertility preservation at one institution from 2010-2020 were identified. A retrospective cohort study was performed assessing demographic factors, including age, ethnicity, occupation, and education level at the time the patient presented for a new patient visit. A cohort of new patients presenting for consultation to discuss elective fertility preservation served as control. Patients undergoing cryopreservation for medical indication or oncofertility were excluded. Patients were categorized by highest level of education completed: high school or associates, bachelors, masters, and doctorate. Those who declined to answer were categorized as unknown. A total of 5915 women pursued initial fertility preservation consultation at our institution over a 10-year timeframe. Of those, 3504 moved forward with oocyte cryopreservation cycle(s) and 2411 decided not to pursue further treatment. Those with bachelors or graduate degrees were more likely to pursue cryopreservation following initial consultation compared to those who declined to answer (OR 0.24, 95% CI 0.08-0.74; p<0.01). Individuals with college and graduate-level education were also more likely to thaw oocytes and attempt embryo transfer compared to those in the unknown education group (OR 0.23, 95% CI 0.06-0.86; p<0.03). There was no significant association between education level and use of sperm donor or sexual partner during subsequent thaw/utilization cycles. Patients who listed their highest education level as college or graduate school were significantly more likely to not only pursue oocyte cryopreservation following initial fertility consultation, but also to return to thaw and utilize cryopreserved oocytes.