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何时应冷冻胚胎?新鲜胚胎和冷冻胚胎替代 IVF 周期的当前数据。

When Should We Freeze Embryos? Current Data for Fresh and Frozen Embryo Replacement IVF Cycles.

机构信息

Homerton Fertility Centre, Homerton University Hospital, London, UK.

3rd Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Reprod Sci. 2021 Nov;28(11):3061-3072. doi: 10.1007/s43032-021-00628-w. Epub 2021 May 25.

Abstract

Recent years have seen a dramatic rise in the number of frozen-thawed embryo replacement (FER) cycles. Along with the advances in embryo cryopreservation techniques, the optimization of endometrial receptivity has resulted in outcomes for FER that are similar to fresh embryo transfer. However, the question of whether the Freeze all strategy is for all is nowadays a hot topic. This review addresses this issue and describes current evidence based on randomized controlled trials and observational studies. To date, it is reasonable to perform FER in cases with a clear indication for the benefits of such strategy including impending ovarian hyperstimulation syndrome (OHSS) or preimplantation genetic testing for aneuploidy (PGT-A); however, this strategy does not fit for all. This review analyses the pros and cons of the freeze all strategy highlighting the need to follow a personalized plan in embryo transfer, avoiding a freeze all methodology for all patients in an unselected manner.

摘要

近年来,冷冻解冻胚胎移植(FER)周期的数量急剧增加。随着胚胎冷冻保存技术的进步,子宫内膜容受性的优化使得 FER 的结果与新鲜胚胎移植相似。然而,目前是否所有患者都适合采用“全冷冻”策略是一个热门话题。本综述针对这一问题,根据随机对照试验和观察性研究描述了现有证据。迄今为止,对于明确受益于该策略的病例,如即将发生的卵巢过度刺激综合征(OHSS)或胚胎植入前非整倍体遗传学检测(PGT-A),进行 FER 是合理的;然而,这种策略并不适合所有患者。本综述分析了“全冷冻”策略的利弊,强调需要在胚胎移植中遵循个体化方案,避免对所有患者不加选择地采用“全冷冻”方法。

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