Wang Wei, Yan Zheng-jie, Cai Ling-bo, Chai De-chun, Liu Cui-zhen, Mao Yun-dong, Liu Jia-yin
Clinical Center of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Yi Xue Za Zhi. 2008 Oct 28;88(39):2755-8.
To investigate the clinical effects of oocyte cryopreservation in assisted reproduction technology (ART).
258 patients undergoing retrieval of more than 20 oocytes during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) were divided into 2 groups:Group A, undergoing surplus oocytes cryopreservation (84 cycles) and Group B undergoing embryo cryopreservation (174 cycles) according to the patients' choices. Fertilization rate and clinical pregnancy rate of fresh embryo transfer cycle were compared between these two groups. Twenty-three infertile couples' frozen oocytes were thawed for further ART treatment. Among them, fifteen couples received embryo transfer using their own frozen-thawed oocytes, and other four couples used donated frozen-thawed oocytes. The survival rate, fertilization rate, cleavage rate, implantation rate, and clinical pregnancy rate of these 19 cycles were compared to the outcome of 56 frozen-thawed embryo transfer cycles.
The fertilization rate of Group A who underwent IVF was 65.9%, not significantly different from that of Group B who received IVF (66.9%, P > 0.05), and the fertilization rate of Group A who underwent ICSI was 71.6%, not significantly different from that of Group B who received ICSI (64.1%, P > 0.05). The clinical pregnancy rate (per embryo transfer cycle) of Group A who received IVF was 52.9%, not significantly different from that of Group B who received IVF (42.3%, P > 0.05), and the clinical pregnancy rate (per embryo transfer cycle) of Group A who received ICSI was 35.5%, not significantly different from that of Group B who received ICSI (34.4%, P > 0.05). The clinical pregnancy rate of frozen-thawed oocyte group (per embryo transfer cycle) was 47.4% (9/19). Four couples used donated frozen-thawed oocytes, two of them got clinical pregnancy and one of them had term delivery.
For women who undergo retrieval of more than 20 oocytes in IVF/ICSI, the clinical outcome of fresh embryo transfer cycle, such as fertilization rate and clinical pregnancy rate, are not influenced by oocyte cryopreservation and embryo cryopreservation. There is no significant difference in the clinical pregnancy rate (per embryo transfer cycle) between frozen-thawed oocyte group and frozen-thawed embryo group. Compared with embryo cryopreservation, oocyte cryopreservation has obvious advantages in fertility preservation and oocyte donation.
探讨卵母细胞冷冻保存技术在辅助生殖技术(ART)中的临床效果。
将258例在体外受精/卵胞浆内单精子注射(IVF/ICSI)过程中获取20枚以上卵母细胞的患者,根据患者意愿分为两组:A组进行多余卵母细胞冷冻保存(84个周期),B组进行胚胎冷冻保存(174个周期)。比较两组新鲜胚胎移植周期的受精率和临床妊娠率。对23对不孕夫妇的冷冻卵母细胞进行解冻,用于进一步的ART治疗。其中,15对夫妇使用自身冷冻解冻后的卵母细胞进行胚胎移植,另外4对夫妇使用捐赠的冷冻解冻后的卵母细胞。将这19个周期的存活率、受精率、卵裂率、着床率和临床妊娠率与56个冷冻解冻胚胎移植周期的结果进行比较。
A组IVF患者的受精率为65.9%,与接受IVF的B组(66.9%,P>0.05)无显著差异;A组ICSI患者的受精率为71.6%,与接受ICSI的B组(64.1%,P>0.05)无显著差异。A组接受IVF的临床妊娠率(每胚胎移植周期)为52.9%,与接受IVF的B组(42.3%,P>0.05)无显著差异;A组接受ICSI的临床妊娠率(每胚胎移植周期)为35.5%,与接受ICSI的B组(34.4%,P>0.05)无显著差异。冷冻解冻卵母细胞组(每胚胎移植周期)的临床妊娠率为47.4%(9/19)。4对夫妇使用捐赠的冷冻解冻后的卵母细胞,其中2对临床妊娠,1例足月分娩。
对于在IVF/ICSI中获取20枚以上卵母细胞的女性,新鲜胚胎移植周期的临床结局,如受精率和临床妊娠率,不受卵母细胞冷冻保存和胚胎冷冻保存的影响。冷冻解冻卵母细胞组与冷冻解冻胚胎组的临床妊娠率(每胚胎移植周期)无显著差异。与胚胎冷冻保存相比,卵母细胞冷冻保存在生育力保存和卵母细胞捐赠方面具有明显优势。