Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, and the Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina; and the Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado.
Obstet Gynecol. 2020 Mar;135(3):709-716. doi: 10.1097/AOG.0000000000003695.
To compare the odds of a good perinatal outcome between cryopreserved and fresh donor oocytes.
We used the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System to conduct a retrospective cohort study of women undergoing donor oocyte in vitro fertilization (IVF) from 2012 to 2015. Cycles using cryopreserved embryos, a gestational carrier, or preimplantation genetic testing were excluded. The primary outcome was a good perinatal outcome, defined as a singleton live birth at 37 weeks of gestation or more with birth weight at or within 2,500 g and 4,000 g. Secondary outcomes included live birth, multiple birth, and prematurity. Generalized estimating equation models were used to test the effect of oocyte type on the primary outcome while accounting for covariates and the correlation induced by repeated cycles within a patient.
Of the 36,925 cycles included in the analysis, 8,381 (22.7%) used cryopreserved and 28,544 (77.3%) used fresh oocytes. The odds of a good perinatal outcome were marginally but significantly lower with cryopreserved than with fresh oocytes before and after covariate adjustment (22.0% vs 24.1%, unadjusted odds ratio [OR] 0.90, 95% CI 0.85-0.96, adjusted OR 0.88, 95% CI 0.81-0.95). Compared with fresh oocytes, cryopreserved oocytes were associated with lower rates of live birth (39.6% vs 47.7%, OR 0.75, 95% CI 0.72-0.79), multiple birth (22.3% vs 31.2%, OR 0.63, 95% CI 0.58-0.69), and prematurity (27.6% vs 30.6%, OR 0.86, 95% CI 0.79-0.94).
This retrospective national study demonstrated that the use of cryopreserved compared with fresh donor oocytes in IVF cycles is associated with marginally lower odds of a good perinatal outcome.
比较冷冻保存的和新鲜的供卵体外受精（IVF）周期的围产儿结局。
我们使用辅助生殖技术协会（SART）的临床结果报告系统，对 2012 年至 2015 年期间进行供卵 IVF 的女性进行回顾性队列研究。排除使用冷冻胚胎、代孕或植入前遗传学检测的周期。主要结局是围产儿结局良好，定义为单胎活产，孕龄 37 周或以上，出生体重为 2500g 或 4000g 及以上。次要结局包括活产、多胎和早产。使用广义估计方程模型来检验卵母细胞类型对主要结局的影响，同时考虑了协变量和患者内重复周期引起的相关性。
在分析的 36925 个周期中，8381 个（22.7%）使用冷冻保存的卵母细胞，28544 个（77.3%）使用新鲜卵母细胞。在调整协变量前后，冷冻保存的卵母细胞的围产儿结局良好的可能性略低于新鲜卵母细胞（22.0%比 24.1%，未调整的优势比[OR]0.90，95%置信区间[CI]0.85-0.96，调整后的 OR 0.88，95% CI 0.81-0.95）。与新鲜卵母细胞相比，冷冻保存的卵母细胞活产率较低（39.6%比 47.7%，OR 0.75，95% CI 0.72-0.79）、多胎率较低（22.3%比 31.2%，OR 0.63，95% CI 0.58-0.69）和早产率较低（27.6%比 30.6%，OR 0.86，95% CI 0.79-0.94）。
这项回顾性全国性研究表明，与新鲜供卵 IVF 周期相比，冷冻保存的供卵在 IVF 周期中使用与围产儿结局良好的可能性略低相关。
