Lew Raelia, Foo Jinny, Kroon Ben, Boothroyd Clare, Chapman Michael
Royal Women's Hospital Melbourne, Melbourne, Victoria, Australia.
Melbourne IVF, Melbourne, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2019 Oct;59(5):616-626. doi: 10.1111/ajo.13028. Epub 2019 Jul 22.
One in six Australian women and couples suffer infertility. A rising proportion relates to advanced maternal age, associated with poorer oocyte quality and in vitro fertilisation (IVF) outcomes. Internationally, oocyte cryopreservation technology applied to oocytes vitrified before 35 years provides similar live-birth statistics compared to IVF treatment using fresh oocytes. Oocyte cryopreservation is accessible in Australasian settings and elective uptake is increasing. For women accessing treatment, oocyte cryopreservation may expand future family building options.
To develop the first Australasian Certification in Reproductive Endocrinology and Infertility (CREI) subspecialist-led consensus guideline on oocyte cryopreservation.
The ANZSREI ACCEPT (Australasian CREI Consensus Expert Panel on Trial evidence group) met in 2017 and 2018 and identified clinical aspects of care for inclusion and review. Review of the available evidence was conducted and consensus statements prepared. Areas of dissent of expert opinion and for further research were noted.
Consensus was reached on definition and best practice in oocyte cryopreservation for freeze method, controlled ovarian stimulation, medical risk reduction and treatment and outcomes counselling. The term 'social egg freezing' may marginalise, stigmatise or attribute social blame to women, and there is a need to revise this to a neutral and non-judgemental term such as elective or planned oocyte cryopreservation.
Oocyte cryopreservation has the potential to improve cumulative live birth outcomes for women. Implementation of this guideline should facilitate an optimal approach for providing care.
六分之一的澳大利亚女性及夫妇患有不孕症。其中，因产妇年龄增大导致不孕的比例不断上升，这与卵母细胞质量较差以及体外受精（IVF）结果不佳有关。在国际上，对35岁之前玻璃化冷冻的卵母细胞应用卵母细胞冷冻保存技术，与使用新鲜卵母细胞进行体外受精治疗相比，活产统计数据相似。在澳大利亚的医疗机构中，卵母细胞冷冻保存技术已可获得，且选择性应用正在增加。对于接受治疗的女性而言，卵母细胞冷冻保存可能会增加未来组建家庭的选择。
制定首个由澳大利亚和新西兰生殖内分泌与不孕症认证（CREI）专科医生主导的关于卵母细胞冷冻保存的共识指南。
澳大利亚和新西兰生殖内分泌学会ACCEPT（澳大利亚和新西兰CREI试验证据组共识专家小组）于2017年和2018年召开会议，确定了纳入审查的护理临床方面。对现有证据进行了审查并编写了共识声明。记录了专家意见存在分歧以及有待进一步研究的领域。
就卵母细胞冷冻保存的定义、冷冻方法、控制性卵巢刺激、降低医疗风险、治疗及结果咨询等方面的最佳实践达成了共识。“社会卵子冷冻”这一术语可能会使女性受到边缘化、污名化或承担社会指责，因此有必要将其修改为中性且无评判性的术语，如选择性或计划性卵母细胞冷冻保存。
卵母细胞冷冻保存有可能改善女性的累积活产结局。本指南的实施应有助于提供最佳护理方法。
