Vidal Mar, Vellvé Kilian, González-Comadran Mireia, Robles Ana, Prat Maria, Torné Mar, Carreras Ramón, Checa Miguel A
Obstetrics and Gynecology Department, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
Obstetrics and Gynecology Department, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain; GRI-BCN, Barcelona Infertility Research Group, IMIM, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
Fertil Steril. 2017 Apr;107(4):940-947. doi: 10.1016/j.fertnstert.2017.01.021. Epub 2017 Mar 11.
To ascertain whether perinatal outcomes are affected by vitrification and/or controlled ovarian hyperstimulation (COH).
Register-based cohort study.
Not applicable.
PATIENT(S): Women undergoing in vitro fertilization (IVF) between 2008 and 2012 using autologous or donated eggs who had a singleton pregnancy delivered from the 24th week onward.
INTERVENTION(S): Fresh embryo transfer (ET) or frozen-thawed ET in women undergoing IVF.
MAIN OUTCOME MEASURE(S): Primary outcome birthweight, and secondary outcomes gestational age at delivery, small for gestational age, mode of delivery, and perinatal mortality.
RESULT(S): In the autologous egg population, newborns from the fresh ET group had lower birthweight than the frozen-thawed ET group (3,152.9 ± 545.5g and 3,343.2 ± 532.3g, respectively), and this difference persisted even after adjusting for confounding factors, and the newborns had a higher risk of being small for gestational age (SGA). In contrast, among egg-donor recipients undergoing ET, the mean birthweight did not differ between the groups (3,165 ± 604.15 g and 3,143.60 ± 604.21g in the fresh and frozen-thawed ET groups, respectively); however, in the adjusted regression model birthweight was statistically significantly higher in the fresh ET group than the frozen-thawed ET group. The risk of SGA remained comparable between the fresh versus frozen-thawed ET groups. We observed no statistically significant differences in perinatal mortality between groups either in the autologous egg population or in the donor recipient group.
CONCLUSION(S): Perinatal outcomes are negatively affected by COH and not affected by the vitrification process.
确定围产期结局是否受玻璃化冷冻和/或控制性卵巢刺激（COH）影响。
基于登记的队列研究。
不适用。
2008年至2012年间接受体外受精（IVF）的女性，使用自体或捐赠卵子，且自第24周起分娩单胎妊娠。
接受IVF的女性进行新鲜胚胎移植（ET）或冻融胚胎移植。
主要结局为出生体重，次要结局为分娩时的孕周、小于胎龄儿、分娩方式和围产期死亡率。
在自体卵子人群中，新鲜胚胎移植组的新生儿出生体重低于冻融胚胎移植组（分别为3152.9±545.5克和3343.2±532.3克），即使在调整混杂因素后，这种差异仍然存在，且新生儿小于胎龄儿（SGA）的风险更高。相比之下，在接受胚胎移植的卵子捐赠受者中，两组的平均出生体重没有差异（新鲜胚胎移植组和冻融胚胎移植组分别为3165±604.15克和3143.60±604.21克）；然而，在调整后的回归模型中，新鲜胚胎移植组的出生体重在统计学上显著高于冻融胚胎移植组。新鲜胚胎移植组与冻融胚胎移植组之间小于胎龄儿的风险仍然相当。我们在自体卵子人群或捐赠受者组中均未观察到两组围产期死亡率的统计学显著差异。
围产期结局受到控制性卵巢刺激的负面影响，而不受玻璃化冷冻过程的影响。
