Gook Debra A, Edgar David H
Reproductive Services/Melbourne IVF, Royal Women's Hospital, 132 Grattan Street, Carlton, Victoria 3053, and Department of Obstetrics and Gynaecology, University of Melbourne, Australia.
Hum Reprod Update. 2007 Nov-Dec;13(6):591-605. doi: 10.1093/humupd/dmm028. Epub 2007 Sep 10.
The clinical role of oocyte cryopreservation in assisted reproduction, as an adjunct to sperm and embryo cryopreservation, has been comparatively slow to evolve as a consequence of theoretical concerns related to efficacy and safety. Basic biological studies in the 1990's alleviated many of these concerns leading to more widespread adoption of the technology. While a number of babies were born from the approach validated in the 1990's, its perceived clinical inefficiency led to the search for improved methods. Introduction of elevated dehydrating sucrose concentrations during cryopreservation increased survival and fertilization rates, but there is no well-controlled evidence of improved clinical outcome. Similarly, the use of sodium-depleted cryopreservation media has not been demonstrated to increase clinical efficiency. More recently, and in the absence of basic biological studies addressing safety issues, the application of vitrification techniques to human oocytes has resulted in reports of a number of live births. The small number of babies born from clinical oocyte cryopreservation and the paucity of well-controlled studies currently preclude valid comparisons between approaches. Legal restrictions on the ability to select embryos from cryopreserved oocytes in Italy, where many of the available reports originate, also obscure attempts to assess oocyte cryopreservation objectively.
作为精子和胚胎冷冻保存的辅助手段,卵母细胞冷冻保存在辅助生殖中的临床应用发展相对缓慢,这是由于在有效性和安全性方面存在一些理论上的担忧。20世纪90年代的基础生物学研究缓解了许多此类担忧,使得该技术得到更广泛的应用。虽然有一些婴儿是通过20世纪90年代验证的方法出生的,但该方法在临床上被认为效率低下,因此人们开始寻找改进方法。在冷冻保存过程中引入高浓度脱水蔗糖可提高存活率和受精率,但目前尚无充分对照的证据表明临床结局得到改善。同样,使用低钠冷冻保存培养基也未被证明能提高临床效率。最近,在缺乏针对安全性问题的基础生物学研究的情况下,玻璃化技术应用于人类卵母细胞已产生了一些关于活产的报道。目前,通过临床卵母细胞冷冻保存出生的婴儿数量较少,且缺乏充分对照的研究,因此无法对不同方法进行有效的比较。在许多现有报道的来源地意大利,对从冷冻保存的卵母细胞中选择胚胎的能力存在法律限制,这也使得客观评估卵母细胞冷冻保存变得困难。