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卵母细胞冷冻保存活产概率的年龄特异性:一项个体患者数据分析荟萃分析。

Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis.

机构信息

Innovation Institute for Fertility Preservation and IVF, New York, NY 10028, USA.

出版信息

Fertil Steril. 2013 Aug;100(2):492-9.e3. doi: 10.1016/j.fertnstert.2013.04.023. Epub 2013 May 24.

Abstract

OBJECTIVE

To estimate age-specific probabilities of live birth with oocyte cryopreservation in nondonor (ND) egg cycles.

DESIGN

Individual patient data meta-analysis.

SETTING

Assisted reproduction centers.

PATIENT(S): Infertile patients undergoing ND mature oocyte cryopreservation.

INTERVENTION(S): PubMed was searched for clinical studies on oocyte cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen-thawed mature oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data.

MAIN OUTCOME MEASURE(S): Live birth probabilities based on age, cryopreservation method, and the number of oocytes thawed, injected, or embryos transferred.

RESULT(S): Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified oocytes, respectively. Estimated probabilities of live birth for vitrified oocytes were higher than those for slowly frozen.

CONCLUSION(S): The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering oocyte cryopreservation. Given the success probabilities, we suggest that policy makers should consider oocyte freezing as an integral part of prevention and treatment of infertility.

摘要

目的

评估非捐赠者(ND)卵子周期中卵母细胞冷冻保存的活产特定年龄概率。

设计

个体患者数据荟萃分析。

设置

辅助生殖中心。

患者

接受 ND 成熟卵母细胞冷冻保存的不孕患者。

干预措施

通过检索 PubMed 数据库,我们检索了 1996 年 1 月至 2011 年 7 月期间有关卵母细胞冷冻保存的临床研究。纳入了使用 ND 冷冻-解冻成熟卵母细胞并获得妊娠结局的随机和非随机研究。我们联系了合格研究的作者,以获取个体患者数据。

主要观察指标

基于年龄、冷冻保存方法以及解冻、注射或移植的卵母细胞数量的活产概率。

结果

我们获得了来自 10 项研究的原始数据,包括 1805 名患者的 2265 个周期。无论冷冻技术如何,活产成功率都随年龄的增长而下降。尽管存在这种年龄相关的不利因素,但缓慢冷冻和玻璃化的卵母细胞分别在 42 岁和 44 岁时仍然可以发生活产。玻璃化冷冻的卵母细胞的活产概率估计值高于缓慢冷冻。

结论

我们计算的活产概率可以为考虑卵母细胞冷冻保存的不孕女性提供更准确的咨询和知情决策。鉴于成功概率,我们建议政策制定者应将卵母细胞冷冻保存视为预防和治疗不孕不育的一个组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37ce/3888550/21398a93d000/nihms485518f1.jpg

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