Elective fertility preservation in women: oocyte and ovarian tissue cyopreservation – effectiveness, safety, and legal aspects

Elective fertility preservation (EFP) has emerged as a crucial strategy for women seeking to maintain reproductive potential in the context of delayed childbearing. Among the available techniques, elective oocyte cryopreservation (ЕOC) is the most established and widely practiced approach, while ovarian tissue cryopreservation has been gaining attention as an alternative with unique advantages, including the restoration of natural fertility and endocrine function. Advances in vitrification have significantly improved survival and fertilization rates of cryopreserved oocytes, yet key questions remain regarding the optimal number of oocytes required, the ideal age for cryopreservation, and the cost-effectiveness of these procedures across different patient groups. It has been consistently evident that younger age at cryopreservation is associated with higher live birth rates and reduced need for multiple stimulation cycles. It was also verified that long-term storage does not negatively impact oocyte viability or offspring health. Importantly, available data suggest no increased obstetric or perinatal risks for children born from cryopreserved oocytes, although long-term and intergenerational outcomes require further investigation. Ethical and legal debates continue to shape practice worldwide. While ЕОС is broadly permitted, regulatory frameworks vary significantly across countries. In the Russian Federation, fertility preservation is legally permitted and widely applied, though formal age limits are not defined. Overall, EFP offers women greater reproductive autonomy, yet requires careful counseling regarding realistic success rates, maternal age–related risks, ethical considerations, and financial barriers. Future directions should focus on standardized clinical guidelines, expanded patient education, and supportive health policies to ensure equitable access and safe implementation of fertility preservation technologies.

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