Seshadri S, Saab W, Exeter H, Drew E, Petrie A, Davies M, Serhal P
The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK.
The Centre for Reproductive & Genetic Health, 230-232 Great Portland Street, London, W1W 5QS, UK.
Eur J Obstet Gynecol Reprod Biol. 2018 Jun;225:136-140. doi: 10.1016/j.ejogrb.2018.04.017. Epub 2018 Apr 22.
To assess the survival rate of vitrified oocytes used in an egg recipient programme and compare the clinical outcomes of pregnancy and live-birth rates per warmed oocyte with fresh autologous oocytes. The differences in the obstetrical outcomes between the two groups were also studied.
A prospective case control study from a single in-vitro fertilisaton (IVF) Centre in UK SETTING: Centre of Reproductive and Genetic Health (CRGH), London POPULATION: Vitrified oocytes from egg donors and autologous fresh oocytes from patients attending for an IVF cycle METHODS: The study group consisted of 1490 vitrified oocytes, which were obtained from 145 egg donors who underwent a stimulation cycle at CRGH Centre. The control group included 145 age-matched women who underwent intra cytoplasmic sperm injection (ICSI) treatment with their own oocytes (n = 1528). The clinical outcomes clinical pregnancy rates (CPR) and live-birth rates (LBR) and obstetrical outcomes (gestational age and weight at delivery) were compared between the two groups. Statistical analysis of the summary data and logistic regression analysis was performed using statistical packages (SPSS Version 23 and Stata 2015). The percentages of all parameters in the cases and control groups were compared by Fisher's exact test. A statistical significance level of 5% was adopted throughout the study.
Survival rate per thawed oocyte, clinical pregnancy rate and live-birth rate per embryo transfer was compared to the autologous oocyte group RESULTS: The survival rate of vitrified oocytes was 73.6% (95% CI: 71.3-75.8%). The clinical pregnancy rate (per embryo transfer) using vitrified oocytes was found to be 51.8% compared to 59.3% in the control group. The live birth rate per embryo transfer in the vitrified oocyte group was 46% (95% CI 37.4-54.7%) compared to 57.1% (95% CI 48.5-68.5%) in the control group. The live-birth rate per thawed oocyte was found to be 4.2%. The gestational ages of the fetus at delivery in both the groups were comparable 39.0 (95% CI 32.7-41.9%) and 39.1 (95% CI 25.6-42.0) (p = 0.38). There was no statistically significant difference in the birth weight between the study and the control group 3100 g (750-4337) and 3232 g (1616-4500) respectively (p = 0.28).
This is the first study reporting on the efficacy of a vitrified donor oocyte programme from within the UK. There were no significant differences in the obstetrical outcomes between vitrified donor oocytes and autologous oocytes. The above data will be encouraging for women who are undertaking egg freezing for medical and or social reasons.
评估在卵子受者计划中使用的玻璃化冷冻卵母细胞的存活率，并比较每枚解冻卵母细胞与新鲜自体卵母细胞的临床妊娠结局和活产率。同时研究两组间产科结局的差异。
来自英国一家体外受精（IVF）中心的前瞻性病例对照研究
伦敦生殖与遗传健康中心（CRGH）
卵子捐赠者的玻璃化冷冻卵母细胞以及接受IVF周期治疗患者的自体新鲜卵母细胞
研究组包括1490枚玻璃化冷冻卵母细胞，这些卵母细胞来自145名在CRGH中心接受促排卵周期的卵子捐赠者。对照组包括145名年龄匹配的女性，她们使用自己的卵母细胞进行卵胞浆内单精子注射（ICSI）治疗（n = 1528）。比较两组的临床结局（临床妊娠率（CPR）和活产率（LBR））以及产科结局（孕周和出生体重）。使用统计软件包（SPSS 23版和Stata 2015）对汇总数据进行统计分析和逻辑回归分析。通过Fisher精确检验比较病例组和对照组所有参数的百分比。整个研究采用5%的统计学显著性水平。
比较每枚解冻卵母细胞的存活率、每次胚胎移植的临床妊娠率和活产率与自体卵母细胞组的情况
玻璃化冷冻卵母细胞的存活率为73.6%（95%可信区间：71.3 - 75.8%）。使用玻璃化冷冻卵母细胞的临床妊娠率（每次胚胎移植）为51.8%，而对照组为59.3%。玻璃化冷冻卵母细胞组每次胚胎移植的活产率为46%（95%可信区间37.4 - 54.7%），对照组为57.1%（95%可信区间48.5 - 68.5%）。每枚解冻卵母细胞的活产率为4.2%。两组分娩时胎儿的孕周相当，分别为39.0（95%可信区间32.7 - 41.9%）和39.1（95%可信区间25.6 - 42.0）（p = 0.38）。研究组和对照组的出生体重无统计学显著差异，分别为3100g（750 - 4337）和3232g（1616 - 4500）（p = 0.28）。
这是英国国内第一项关于玻璃化冷冻捐赠者卵母细胞计划疗效的研究报告。玻璃化冷冻捐赠者卵母细胞与自体卵母细胞的产科结局无显著差异。上述数据对于因医学和/或社会原因进行卵子冷冻的女性来说是令人鼓舞的。
