Reproductive Biology Associates, Atlanta, Georgia.
Reproductive Biology Associates, Atlanta, Georgia.
Fertil Steril. 2020 Feb;113(2):241-247. doi: 10.1016/j.fertnstert.2019.12.009.
Cryopreservation has become a central pillar in assisted reproduction, reflected in the exponential increase of "freeze all" cycles in the past few years. Vitrification makes it possible to cool and warm human eggs and embryos with far less cryo-damage than 'slow-freeze' and allows nearly intact survival of embryos with very high survival rates for eggs as well. This has resulted in a complete transformation how we manage treatment for in vitro fertilization patients. Fresh transfers can be avoided without compromising outcomes, and in fact, cumulative pregnancy/delivery rates may be improved by performing sequential elective "frozen" single embryo transfers. Some recent evidence suggests that previously vitrified embryos give better perinatal outcomes than fresh embryo transfers. Frozen embryo transfer, especially when coupled with preimplantation genetic testing allows for highly efficient single embryo transfers that translate to more singleton and therefore safer pregnancies, as well as healthier babies. Additionally, vitrification has also opened new options for patients, most notably fertility preservation (through oocyte cryopreservation), and donor egg banking.
冷冻保存已成为辅助生殖的核心支柱，这反映在过去几年中“全部冷冻”周期的指数增长上。玻璃化使冷却和加热人类卵子和胚胎成为可能，与“慢速冷冻”相比，冷冻损伤要小得多，而且几乎可以完整地保存胚胎，卵子的存活率也非常高。这导致我们如何管理体外受精患者的治疗方式发生了彻底的转变。可以避免新鲜胚胎移植而不影响结果，实际上，通过连续进行选择性“冷冻”单个胚胎移植，累积妊娠/分娩率可能会提高。一些最近的证据表明，与新鲜胚胎移植相比，以前冷冻的胚胎会带来更好的围产期结局。冷冻胚胎移植，尤其是与着床前基因检测相结合，可以实现高效的单胚胎移植，从而实现更多的单胎妊娠，因此更安全，婴儿也更健康。此外，玻璃化还为患者提供了新的选择，尤其是生育力保存（通过卵母细胞冷冻保存）和供卵银行。
