Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82 Gumiro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, Korea 13620; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul Korea 03080; Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul Korea 06125.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82 Gumiro 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, Korea 13620; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul Korea 03080.
Reprod Biomed Online. 2020 Jun;40(6):827-834. doi: 10.1016/j.rbmo.2020.01.028. Epub 2020 Feb 5.
RESEARCH-QUESTION: What is the clinical usefulness of oocyte cryopreservation for fertility preservation in women with ovarian endometriosis?
Clinical characteristics were retrospectively analysed in 34 women with endometrioma before a planned ovarian cystectomy. Ovarian stimulation outcomes were compared according to laterality. A one-to-one propensity score-matched analysis was conducted to compare ovarian stimulation outcomes of the first cycle in patients with endometrioma undergoing fertility preservation with those in infertile patients without endometrioma who underwent IVF treatment. The number of oocytes cryopreserved in repeated ovarian stimulation cycles was analysed.
The mean endometrioma size at diagnosis was 6.0 ± 2.5 cm. The mean age, serum anti-Mullerian hormone levels and number of oocytes cryopreserved were 30.7 ± 5.9 years, 1.85 ± 1.14 ng/ml, and 4.8 ± 3.2, respectively. The number of oocytes cryopreserved in bilateral endometrioma compared with unilateral endometrioma patients was 4.1 ± 2.9 versus 5.7 ± 3.4 (P = 0.600). In the propensity score-matched cohort (n = 22 per group), the number of oocytes retrieved was significantly lower in the patients with endometrioma undergoing fertility preservation compared with that in infertile patients without endometrioma (5.4 ± 3.8 versus 8.1 ± 4.8; P = 0.045). A total of 13 (38.2%) patients with endometrioma underwent repeated stimulation. The median (interquartile range) number of cryopreserved oocytes at the first and the second cycle were 3.0 (2.5-6.0) and 5.0 (2.5-7.5), respectively.
Women with endometrioma should be counselled about oocyte cryopreservation for fertility preservation before surgery. The number of cryopreserved oocytes can be increased by repeated oocyte retrieval.
在患有卵巢子宫内膜异位症的女性中，卵母细胞冷冻保存用于保留生育力的临床实用性如何？
回顾性分析了 34 例计划行卵巢囊肿切除术的子宫内膜瘤患者的临床特征。根据侧别比较卵巢刺激结局。对行生育力保存的子宫内膜瘤患者的首次周期卵巢刺激结局与行 IVF 治疗的无子宫内膜异位症不孕患者进行了一对一倾向评分匹配分析。分析了在重复卵巢刺激周期中冷冻保存的卵母细胞数量。
诊断时平均子宫内膜瘤大小为 6.0 ± 2.5 cm。平均年龄、血清抗苗勒管激素水平和冷冻保存的卵母细胞数量分别为 30.7 ± 5.9 岁、1.85 ± 1.14ng/ml 和 4.8 ± 3.2。双侧子宫内膜瘤患者的冷冻保存卵母细胞数量为 4.1 ± 2.9 个，单侧子宫内膜瘤患者为 5.7 ± 3.4 个（P=0.600）。在倾向评分匹配队列中（每组 n=22），行生育力保存的子宫内膜瘤患者的获卵数明显少于无子宫内膜异位症的不孕患者（5.4 ± 3.8 个 vs. 8.1 ± 4.8 个；P=0.045）。共有 13 例（38.2%）子宫内膜瘤患者行重复刺激。第一次和第二次周期冷冻保存的卵母细胞中位数（四分位距）分别为 3.0（2.5-6.0）个和 5.0（2.5-7.5）个。
在手术前，应向患有子宫内膜瘤的女性提供关于卵母细胞冷冻保存以保留生育力的咨询。通过重复取卵可以增加冷冻保存的卵母细胞数量。
