Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Department of Assisted Reproduction, Shanghai East Hospital, Shanghai Tongji University School of Medicine, Shanghai, 200120, China.
Arch Gynecol Obstet. 2019 Oct;300(4):1083-1092. doi: 10.1007/s00404-019-05298-3. Epub 2019 Sep 16.
To evaluate the impact of artificial oocyte activation (AOA) in pregnancy and neonatal outcomes in infertile patients undergoing cryopreserved embryo transfer.
This retrospective study included 5686 patients' transferred embryos from routine intracytoplasmic sperm injection (ICSI) and 194 patients' transferred embryos from ICSI combined with AOA (ICSI-AOA) from January 2011 to December 2016. Pregnancy and neonatal outcomes of couples undergoing routine ICSI or ICSI-AOA were analyzed before and after propensity score matching. Artificial oocyte activation was performed with ionomycin.
The pregnancy outcomes showed no significant difference in the rates of biochemical pregnancy, clinical pregnancy, implantation, miscarriage, ectopic pregnancy, multiple pregnancy, and live births between the routine ICSI and ICSI-AOA groups before and after propensity score matching, respectively. The assessment of neonatal outcomes showed no statistically significant differences in the birth defect rate, birth weight, gestational age, preterm birth rate, early-neonatal death rate, and fetal sex ratio between the two groups, and similar results were also observed in the two matched cohorts.
Artificial oocyte activation with ionomycin does not adversely affect pregnancy and neonatal outcomes in patients undergoing frozen-thawed embryo transfer, which is beneficial to clinicians counseling patients on the risks of artificial oocyte activation.
评估在接受冻融胚胎移植的不孕患者中,人工卵母细胞激活(AOA)对妊娠和新生儿结局的影响。
本回顾性研究纳入了 2011 年 1 月至 2016 年 12 月期间接受常规胞浆内单精子注射(ICSI)的 5686 个胚胎转移患者和 194 个接受 ICSI 联合 AOA(ICSI-AOA)的胚胎转移患者。分别在进行倾向评分匹配前后分析接受常规 ICSI 或 ICSI-AOA 的夫妇的妊娠和新生儿结局。使用离子霉素进行人工卵母细胞激活。
在进行倾向评分匹配前后,常规 ICSI 和 ICSI-AOA 组的生化妊娠率、临床妊娠率、着床率、流产率、异位妊娠率、多胎妊娠率和活产率等妊娠结局均无显著差异。新生儿结局评估显示,两组间的出生缺陷率、出生体重、胎龄、早产率、早期新生儿死亡率和胎儿性别比例均无统计学差异,在两个匹配队列中也观察到了相似的结果。
使用离子霉素进行人工卵母细胞激活不会对接受冻融胚胎移植的患者的妊娠和新生儿结局产生不利影响,这有利于临床医生向患者咨询人工卵母细胞激活的风险。