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人类卵母细胞和囊胚的封闭玻璃化:一系列临床病例的结果

Closed vitrification of human oocytes and blastocysts: outcomes from a series of clinical cases.

作者信息

Gook Debra A, Choo Boon, Bourne Harold, Lewis Kelly, Edgar David H

机构信息

Reproductive Services and Melbourne IVF, Royal Women's Hospital, Parkville, Victoria, Australia.

Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.

出版信息

J Assist Reprod Genet. 2016 Sep;33(9):1247-52. doi: 10.1007/s10815-016-0748-7. Epub 2016 May 28.

Abstract

PURPOSE

High survival rates and clinical outcomes similar to those from fresh oocytes and blastocysts have been observed with open oocyte vitrification systems. It has been suggested that the extremely fast cooling rates that are only achieved with open systems are necessary for human oocyte and blastocyst vitrification. However, there is a potential risk of introducing contamination with open systems. The aim of this study was to assess whether similar survival and subsequent implantation rates could be achieved using a closed vitrification system for human oocytes and blastocysts.

METHODS

Initially, donated immature oocytes that were matured in vitro were vitrified using the cryoprotectants ethylene glycol (EG) + dimethyl sulphoxide (DMSO) + sucrose and either a closed system (Rapid-i®) or an open system (Cryolock). The closed system was subsequently introduced clinically for mature oocyte cryopreservation cases and blastocyst vitrification.

RESULTS

Using in vitro matured oocytes, a similar survival was achieved with the open system of 92.4 % (73/79) and with the closed system of 89.7 % (35/39). For clinical oocyte closed vitrification, high survival rate of 90.5 % (374/413) and an implantation rate of 32.7 % (18/55) from the transfer of day 2 embryos was achieved, which is similar to fresh day 2 embryo transfers. Blastocysts have also been successfully cryopreserved using the Rapid-i closed vitrification system with 94 % of blastocysts having an estimated ≥75 % of cells intact and a similar implantation rate (31.5 %) to fresh single blastocyst transfers.

CONCLUSION

Closed vitrification can achieve high survival and similar implantation rates to fresh for both oocytes and blastocysts.

摘要

目的

开放型卵母细胞玻璃化冷冻系统已显示出与新鲜卵母细胞和囊胚相似的高存活率及临床结局。有人提出,只有开放系统才能实现的极快速降温速率对于人类卵母细胞和囊胚的玻璃化冷冻是必要的。然而,开放系统存在引入污染的潜在风险。本研究的目的是评估使用封闭型玻璃化冷冻系统对人类卵母细胞和囊胚进行冷冻是否能实现相似的存活率及后续着床率。

方法

首先,将体外成熟的捐赠未成熟卵母细胞用冷冻保护剂乙二醇(EG)+二甲基亚砜(DMSO)+蔗糖进行玻璃化冷冻,使用封闭系统(Rapid-i®)或开放系统(Cryolock)。随后,封闭系统被应用于临床成熟卵母细胞冷冻保存病例及囊胚玻璃化冷冻。

结果

对于体外成熟的卵母细胞,开放系统的存活率为92.4%(73/79),封闭系统为89.7%(35/39),二者相似。对于临床卵母细胞封闭玻璃化冷冻,获得了90.5%(374/413)的高存活率以及第2天胚胎移植32.7%(18/55)的着床率,这与新鲜第2天胚胎移植相似。囊胚也已成功使用Rapid-i封闭玻璃化冷冻系统进行冷冻保存,94%的囊胚估计有≥75%的细胞完整,且着床率与新鲜单个囊胚移植相似(31.5%)。

结论

封闭型玻璃化冷冻对卵母细胞和囊胚均可实现高存活率及与新鲜样本相似的着床率。

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