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通过双原核卵母细胞冷冻保存和解冻后延长培养进行延期移植后的持续高妊娠率。

High ongoing pregnancy rates after deferred transfer through bipronuclear oocyte cryopreservation and post-thaw extended culture.

作者信息

Shapiro Bruce S, Daneshmand Said T, Garner Forest C, Aguirre Martha, Hudson Cynthia, Thomas Shyni

机构信息

Fertility Center of Las Vegas, University of Nevada School of Medicine, Las Vegas, Nevada 89117, USA.

出版信息

Fertil Steril. 2009 Nov;92(5):1594-9. doi: 10.1016/j.fertnstert.2008.08.103. Epub 2008 Nov 11.

Abstract

OBJECTIVE

To describe success rates with bipronuclear (2PN) oocyte cryopreservation, followed by thaw, extended culture, and blastocyst transfer.

DESIGN

Retrospective study.

SETTING

Private fertility center.

PATIENT(S): There were 48 blastocyst transfers after post-thaw extended culture in patients less than 35 years old and 43 transfers in patients 35-40 years old.

INTERVENTION(S): Patients opted for cryopreservation of their entire cohorts at the 2PN stage. Thawed 2PN oocytes were cultured to the blastocyst stage before transfer.

MAIN OUTCOME MEASURE(S): Implantation, ongoing pregnancy.

RESULT(S): Among patients less than 35 years old at oocyte retrieval, there were 59 thaws of 2PN oocytes, 48 blastocyst transfers, and 40 ongoing pregnancies (79.2% per transfer), the implantation rate was 64.2%, and the ongoing pregnancy rate (PR) per thaw was 64.4%. Among patients 35-40 years of age at retrieval, there were 58 thaws, 43 blastocyst transfers, and 22 ongoing pregnancies (51.2% per transfer), the implantation rate was 44.0%, and the ongoing PR per thaw was 39.3%. Patients less than 35 years old had significantly greater rates of implantation and ongoing pregnancy than did patients 35-40 years of age. Patients with 12 or more 2PN oocytes had significantly greater rate of ongoing pregnancy than those with fewer than 12 2PN oocytes.

CONCLUSION(S): Post-thaw extended culture and blastocyst transfer yield high rates of implantation and ongoing pregnancy. Ongoing PRs decline with increasing age.

摘要

目的

描述双原核(2PN)卵母细胞冷冻保存、解冻、延长培养及囊胚移植后的成功率。

设计

回顾性研究。

地点

私立生育中心。

患者

年龄小于35岁的患者在解冻后延长培养后进行了48次囊胚移植,35 - 40岁的患者进行了43次移植。

干预措施

患者选择在2PN阶段冷冻保存其全部卵母细胞队列。解冻后的2PN卵母细胞在移植前培养至囊胚阶段。

主要观察指标

着床、持续妊娠。

结果

在取卵时年龄小于35岁的患者中,2PN卵母细胞解冻59次,囊胚移植48次,持续妊娠40次(每次移植79.2%),着床率为64.2%,每次解冻的持续妊娠率(PR)为64.4%。在取卵时年龄为35 - 40岁的患者中,解冻58次,囊胚移植43次,持续妊娠22次(每次移植51.2%),着床率为44.0%,每次解冻的持续PR为39.3%。年龄小于35岁的患者着床率和持续妊娠率明显高于35 - 40岁的患者。拥有12个或更多2PN卵母细胞的患者持续妊娠率明显高于少于12个2PN卵母细胞的患者。

结论

解冻后延长培养及囊胚移植可获得较高的着床率和持续妊娠率。持续PR随年龄增长而下降。

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