BJOG. 2020 Aug;127(9):e113-e121. doi: 10.1111/1471-0528.16025. Epub 2020 Feb 26.
Although a woman's fertility declines markedly in her late-30s and early-40s, gradually more and more women start a family at this stage of their lives, with the average age of childbirth progressively increasing. More women are storing their eggs (oocytes) to give them the potential opportunity to have a baby in the future. Nonetheless, the number of egg freezing cycles accounts for less than 2% of IVF cycles, and the number of cycles using stored eggs is even lower. The technology for freezing eggs changed dramatically about a decade ago with the development of a technique of rapid freezing called vitrification, which gives success rates almost as good as using fresh eggs. The growing use of this technique, and the publicity surrounding how this technique may have been promoted, has led to this paper. It is essential that women are very clearly informed about the likely success rates of egg freezing, particularly as it is entirely provided by the private sector, with the associated concerns of financial costs and inappropriate or inaccurate marketing. Its success is strongly dependent on the age of the woman at the time of freezing her eggs, with much higher success rates in those aged 35 years and under. Current legislation only allows women to store eggs for 10 years, which conflicts with the better success rates when women do so at a younger age. The reasons behind the increase in egg freezing are complex, but the most common reason given by women storing eggs is that they do not have a partner and are concerned that by the time they do find themselves in a relationship within which they wish to start a family, they may not be able to. We conclude that elective egg freezing provides women with an opportunity to take action about the drop in their fertility, but at present most women who are doing this are already in their later 30s when the success rates are limited. We strongly support the need for improved and continuing education of both women and men regarding the decline in female fertility with age.
尽管女性的生育能力在 30 多岁和 40 多岁时明显下降，但越来越多的女性开始在这个年龄段组建家庭，生育年龄逐渐推迟。越来越多的女性选择储存卵子（卵母细胞），以便将来有机会生育。然而，卵子冷冻周期的数量不到 IVF 周期的 2%，使用储存卵子的周期数量甚至更低。大约十年前，随着一种称为玻璃化的快速冷冻技术的发展，卵子冷冻技术发生了巨大变化，这种技术的成功率几乎与使用新鲜卵子一样高。这项技术的广泛应用，以及围绕这项技术如何可能被推广的宣传，导致了本文的产生。至关重要的是，女性必须非常清楚地了解卵子冷冻的可能成功率，特别是因为这完全是由私营部门提供的，随之而来的是财务成本和不恰当或不准确的营销方面的担忧。其成功率强烈取决于女性冷冻卵子时的年龄，35 岁及以下女性的成功率要高得多。现行法律仅允许女性储存卵子 10 年，这与女性年轻时储存卵子成功率更高的情况相冲突。卵子冷冻增加的原因很复杂，但女性储存卵子最常见的原因是她们没有伴侣，担心一旦找到合适的伴侣并希望组建家庭，她们可能无法生育。我们的结论是，选择性的卵子冷冻为女性提供了一个应对生育能力下降的机会，但目前大多数选择这样做的女性已经 30 多岁了，成功率有限。我们强烈支持需要对女性和男性进行关于女性生育能力随年龄下降的知识进行改进和持续教育。
