De Munck Neelke, Vajta Gábor
Universitair Ziekenhuis Brussel (UZ Brussel), Centrum voor Reproductieve Geneeskunde, Laarbeeklaan 101, 1090 Brussels, Belgium.
Central Queensland University, Bruce Highway, North Rockhampton QLD 4702, Australia.
Cryobiology. 2017 Oct;78:119-127. doi: 10.1016/j.cryobiol.2017.07.009. Epub 2017 Aug 1.
As the oocyte is the starting point for a new life, artificial reproductive technology (ART) techniques should not affect the (ultra) structural and functional integrity, or the developmental competence. Oocyte vitrification -one of the most significant achievements in human ART during the past decade- should therefore be a safe and efficient technique. This review discusses the principles and developments of the existing and future techniques, applications possibilities and safety concerns. The broad range of vitrification media and devices that are currently available, show differences in their effects on the oocyte ultrastructure and preimplantation development. It is not yet fully decided whether this has an influence on the obstetric and neonatal outcome, since only limited information is available with different media and devices. For autologous oocytes, the obstetric and neonatal outcomes appear promising and comparable to pregnancies obtained with fresh oocytes. This however, is not the case for heterologous fresh or vitrified oocytes, where the immunological foreign foetus induces adverse obstetric and neonatal outcomes. Besides the oocyte vitrification process itself, the effect of multiple stimulations (for oocyte banking or for oocyte donors), seems to influence the possibility to develop gynaecological cancers further in life. Automated vitrification/warming should offer a consistent, cross-contamination free process that offers the highest safety level for the users. They should also produce more consistent results in survival, development and clinical pregnancies between different IVF clinics.
由于卵母细胞是新生命的起点，辅助生殖技术（ART）不应影响其（超）结构和功能完整性或发育潜能。因此，卵母细胞玻璃化冷冻——过去十年人类辅助生殖技术最重要的成就之一——应该是一种安全有效的技术。本综述讨论了现有及未来技术的原理与发展、应用可能性及安全性问题。目前可用的多种玻璃化冷冻介质和设备，对卵母细胞超微结构和植入前发育的影响存在差异。由于不同介质和设备的相关信息有限，其是否会影响产科和新生儿结局尚未完全明确。对于自体卵母细胞，产科和新生儿结局似乎很有前景，且与新鲜卵母细胞妊娠的情况相当。然而，对于异体新鲜或玻璃化冷冻的卵母细胞并非如此，其中免疫性外来胎儿会导致不良的产科和新生儿结局。除了卵母细胞玻璃化冷冻过程本身外，多次刺激（用于卵母细胞储存或卵母细胞捐赠者）的影响似乎会增加日后患妇科癌症的可能性。自动化玻璃化冷冻/复温应提供一个一致、无交叉污染的过程，为使用者提供最高的安全水平。不同体外受精诊所使用自动化设备在卵母细胞存活、发育及临床妊娠方面也应能产生更一致的结果。
