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因非医学原因冷冻卵子的女性的生殖经历。

Reproductive experiences of women who cryopreserved oocytes for non-medical reasons.

作者信息

Hammarberg Karin, Kirkman Maggie, Pritchard Natasha, Hickey Martha, Peate Michelle, McBain John, Agresta Franca, Bayly Chris, Fisher Jane

机构信息

Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Rd, Melbourne, Victoria 3004, Australia.

Victorian Assisted Reproductive Treatment Authority, Level 30, 570 Bourke Street, Melbourne, Victoria 3000, Australia.

出版信息

Hum Reprod. 2017 Mar 1;32(3):575-581. doi: 10.1093/humrep/dew342.

Abstract

STUDY QUESTION

What are the reproductive experiences of women who cryopreserve oocytes for non-medical reasons?

SUMMARY ANSWER

One in three women had been pregnant at some stage in their lives and while most still wanted to have a child or another child, very few had used their stored oocytes, predominantly because they did not want to be single parents.

WHAT IS KNOWN ALREADY

The number of healthy women who freeze oocytes to avoid age-related infertility is increasing. Evidence about reproductive outcomes after oocyte cryopreservation for non-medical reasons is needed to help women make informed decisions.

STUDY DESIGN SIZE, DURATION: A cross-sectional survey was carried out. Study packs which included a self-administered questionnaire were mailed by clinic staff to 193 eligible women.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Women who had stored oocytes for non-medical reasons at Melbourne IVF, a private ART clinic, between 1999 and 2014 were identified from medical records and invited to complete an anonymous questionnaire about their reproductive histories and experience of oocyte cryopreservation.

MAIN RESULTS AND THE ROLE OF CHANCE

A total of 10 survey packs were returned to the clinic marked 'address unknown'. Of the 183 potential respondents, 96 (53%) returned the questionnaire. One respondent provided only free-text comments, thus data from 95 respondents were compiled. The mean age at the time of freezing oocytes was 37.1 years (SD ± 2.6, range: 27-42) and the average number of oocytes stored was 14.2 (SD ± 7.9, range: 0-42); 2% had attempted to store oocytes but had none suitable for freezing, 24% had stored <8 oocytes, 35% had 8-15, 25% had 16-23 and 14% had stored >23 oocytes. About one-third of respondents (34%) had been pregnant at some point in their lives. Six women (6%) had used their stored oocytes and three of them had given birth as a result. The main reason for not using stored oocytes was not wanting to be a single parent. Of the 87 (91%) women who still had oocytes stored, 21% intended to use them while 69% indicated that their circumstances would determine usage. The mean number of children respondents would ideally have liked to have was significantly higher than the number of children they expected to have (2.11 versus 1.38, P < 0.001).

LIMITATIONS, REASONS FOR CAUTION: The limitations are inherent to any anonymously completed questionnaire: participation bias, missing data and the possibility that some questions or response alternatives may have been ambiguous.

WIDER IMPLICATIONS OF THE FINDINGS

The findings add to the very limited evidence about the reproductive outcomes experienced by women who freeze oocytes for non-medical reasons and can be used to help women make informed decisions about whether to store oocytes.

STUDY FUNDING/COMPETING INTEREST(S): The study was funded by Melbourne IVF. K.H. has received honoraria from Merck-Serono, J.M. is a clinician at Melbourne IVF, F.A. is a Melbourne IVF employee, J.F. is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship which receives funding from the L and H Hecht Trust, managed by Perpetual Trustees Pty Ltd. M.K., N.P., M.H., M.P. and C.B. have no competing interests.

TRIAL REGISTRATION NUMBER

Not applicable.

摘要

研究问题

出于非医疗原因冷冻卵母细胞的女性的生殖经历是怎样的?

总结答案

三分之一的女性在人生的某个阶段曾怀孕,虽然大多数人仍想要一个孩子或再要一个孩子,但很少有人使用她们冷冻保存的卵母细胞,主要原因是她们不想成为单亲家长。

已知信息

为避免与年龄相关的不孕不育而冷冻卵母细胞的健康女性数量正在增加。需要有关非医疗原因冷冻卵母细胞后生殖结局的证据,以帮助女性做出明智的决定。

研究设计、规模、持续时间:开展了一项横断面调查。诊所工作人员将包含自填问卷的研究包邮寄给193名符合条件的女性。

参与者/材料、环境、方法:从医疗记录中识别出1999年至2014年间在一家私立辅助生殖技术诊所墨尔本体外受精中心因非医疗原因冷冻卵母细胞的女性,并邀请她们填写一份关于其生殖史和卵母细胞冷冻经历的匿名问卷。

主要结果及机遇的作用

共有10个调查包被退回诊所,标记为“地址不详”。在183名潜在受访者中,96名(53%)返回了问卷。一名受访者仅提供了自由文本评论,因此整理了95名受访者的数据。冷冻卵母细胞时的平均年龄为37.1岁(标准差±2.6,范围:27 - 42岁),平均冷冻保存的卵母细胞数量为14.2个(标准差±7.9,范围:0 - 42个);2%的人曾尝试冷冻卵母细胞但没有合适的可供冷冻,24%的人冷冻保存的卵母细胞少于8个,35%的人有8 - 15个,25%的人有16 - 23个,14%的人冷冻保存的卵母细胞超过23个。约三分之一的受访者(34%)在人生的某个阶段曾怀孕。6名女性(6%)使用了她们冷冻保存的卵母细胞,其中3人因此分娩。不使用冷冻保存卵母细胞的主要原因是不想成为单亲家长。在仍有冷冻卵母细胞的87名(91%)女性中,21%打算使用,69%表示她们的情况将决定是否使用。受访者理想中希望拥有的孩子平均数量显著高于她们预期会拥有的孩子数量(2.11对1.38,P < 0.001)。

局限性、谨慎理由:这些局限性是任何匿名填写的问卷所固有的:参与偏倚、数据缺失以及某些问题或回答选项可能存在歧义的可能性。

研究结果的更广泛影响

这些发现增加了关于出于非医疗原因冷冻卵母细胞的女性生殖结局的非常有限的证据,可用于帮助女性就是否冷冻卵母细胞做出明智的决定。

研究资金/利益冲突:该研究由墨尔本体外受精中心资助。K.H. 从默克雪兰诺公司获得了酬金,J.M. 是墨尔本体外受精中心的一名临床医生,F.A. 是墨尔本体外受精中心的一名员工,J.F. 由莫纳什教授奖学金和珍·海尔斯教授奖学金资助,该奖学金由L和H·赫希特信托基金提供资金,由永久受托人有限公司管理。M.K.、N.P.、M.H.、M.P. 和C.B. 没有利益冲突。

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