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患者对捐赠剩余冷冻胚胎用于治疗或研究的态度。

Patients' attitudes towards donation of surplus cryopreserved embryos for treatment or research.

作者信息

Bangsbøll S, Pinborg A, Yding Andersen C, Nyboe Andersen A

机构信息

The Fertility Clinic and Laboratory of Reproductive Biology, Copenhagen University Hospital, Copenhagen, Denmark.

出版信息

Hum Reprod. 2004 Oct;19(10):2415-9. doi: 10.1093/humrep/deh441. Epub 2004 Aug 13.

Abstract

BACKGROUND

The aim of the study was 2-fold: first, to investigate couples' reasons for not using cryopreserved embryos within the maximum storage period; second, to study their attitudes towards potential embryo donation for specific purposes.

METHODS

A questionnaire was sent to 284 IVF/ICSI couples who experienced destruction of their cryopreserved embryos (n=1180) because the cryopreservation period exceeded the Danish legislative limit of 24 months.

RESULTS

Seventy-four per cent of the couples responded. The main reasons for not utilizing surplus embryos was 'successful delivery' (85%), 'consider family completed' (61%) and 'too short legislative limit for cryopreservation' (59%). Sixty per cent of the couples agreed to the concept of donation of cryopreserved embryos for infertility research, 57% responded affirmatively to donation for stem cell research and 49% for stem cell treatment, but only 29% agreed to the concept of donation to infertile couples. Multiple logistic regression analysis showed that delivery of a child after IVF treatment (OR 3.8, 95% CI 1.4-10.2) and female age <35 years (OR 2.2, 95% CI 1.3-6.0) were predictive of agreement to the idea of donation for stem cell research and stem cell treatment respectively; however, male age, duration of infertility, mode of conception (IVF or ICSI) and having IVF children were not significant predictors. The following predictive variables were entered into the analysis: female and male age, duration of infertility, IVF versus ICSI, donor semen and +/- IVF children.

CONCLUSIONS

This study shows that 23% of all couples having cryopreserved embryos do not utilize them for further treatment within the legislative storage period of 2 years. A major reason is successful delivery. More than half of these patients agreed to the concept of donation of surplus outdated embryos for research, whereas less than one-third agreed to donation to other infertile couples. Based on these figures, an alternative utilization of surplus embryos for stem cell research would require a 100-fold larger pool of available embryos to provide a realistic basis for this purpose.

摘要

背景

本研究目的有两个:其一,调查夫妻在最长保存期内未使用冷冻胚胎的原因;其二,研究他们对出于特定目的进行胚胎捐赠的态度。

方法

向284对接受体外受精/卵胞浆内单精子注射(IVF/ICSI)的夫妻发放问卷,这些夫妻因冷冻保存期超过丹麦24个月的法定时限而经历了冷冻胚胎被销毁的情况(共1180枚胚胎)。

结果

74%的夫妻做出了回应。不使用多余胚胎的主要原因是“已成功分娩”(85%)、“认为家庭完整”(61%)以及“冷冻保存的法定时限过短”(59%)。60%的夫妻同意将冷冻胚胎捐赠用于不孕症研究的概念,57%对用于干细胞研究的捐赠做出肯定回应,49%对用于干细胞治疗的捐赠做出肯定回应,但只有29%同意捐赠给其他不孕夫妻的概念。多因素逻辑回归分析显示,IVF治疗后分娩(比值比[OR]3.8,95%置信区间[CI]1.4 - 10.2)以及女性年龄<35岁(OR 2.2,95%CI 1.3 - 6.0)分别是同意干细胞研究捐赠和干细胞治疗捐赠想法的预测因素;然而,男性年龄、不孕持续时间、受孕方式(IVF或ICSI)以及有无IVF子女并非显著的预测因素。以下预测变量纳入了分析:女性和男性年龄、不孕持续时间、IVF与ICSI、供精以及有无IVF子女。

结论

本研究表明,所有有冷冻胚胎的夫妻中,23%在2年的法定保存期内未将其用于进一步治疗。一个主要原因是已成功分娩。超过半数的这些患者同意将多余过期胚胎捐赠用于研究的概念,而不到三分之一的患者同意捐赠给其他不孕夫妻。基于这些数据,若要将多余胚胎用于干细胞研究,需要比现有胚胎数量多100倍的可用胚胎库才能为此提供现实基础。

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