Zucker School of Medicine at Hofstra/Northwell, Northwell Fertility, New York, NY, 10065, USA.
J Assist Reprod Genet. 2021 Sep;38(9):2327-2332. doi: 10.1007/s10815-021-02262-6. Epub 2021 Jun 20.
To analyze donor oocyte (DE) data across 6 years for oocyte usage efficiency, trends, and whether changes impacted outcomes.
From 2014 to 2019, 323 DE embryo transfers were completed in 200 recipients using oocytes derived of 163 donors. We assessed data for oocytes being freshly retrieved (FRESH-EGG) vs. purchased frozen (FROZEN-EGG); embryos transferred fresh (FRESH-ET) vs. frozen (FROZEN-ET); cycles SHARED (two recipients) vs. SOLE (one recipient); single (SET) vs. double (DET) embryo transfers and usage of PGT-A. Primary outcome was ongoing pregnancy plus live birth (OP/LB) rate.
A total of 229 FRESH-EGG (70%) and 94 FROZEN-EGG (30%) cycles were completed. Overall, the use of FRESH-EGG yielded a higher OP/LB compared to FROZEN-EGG (49% vs. 30%, p = 0.001); within the FRESH-EGG group, OP/LB was similar when comparing FRESH-ET vs. FROZEN-ET (58% vs. 45%, p = 0.07). Within the FRESH-ET group, those using FRESH-EGG had a higher OP/LB than those using FROZEN-EGG (58% vs. 27%, p < 0.001). SHARED vs. SOLE cycles (p = 0.6), donor age (21-32 years; p = 0.4), and age of intended parents (maternal p = 0.3, paternal p = 0.2) did not significantly impact OP/LB. Notably, the use of PGT-A did not improve odds for an OP/LB (p = 0.7).
The use of FRESH-EGG with FRESH-ET without PGT-A remains superior to newer DE treatment combinations. Specifically, the use of FROZEN-EGG and PGT-A did not improve outcomes. Although changing DE practices may enhance experience and affordability, patients and providers must appreciate that choices do not always favorably impact success. Additionally, newly available genetic-ancestry testing may pose longer-term ramifications mandating change in treatment and/or counseling.
分析 6 年来供体卵母细胞（DE）数据，评估卵母细胞使用效率、趋势以及这些变化是否对结局产生影响。
2014 年至 2019 年，在 200 名接受治疗的患者中完成了 323 例 DE 胚胎移植，这些患者使用了 163 名供体获得的卵母细胞。我们评估了新鲜取出卵母细胞（FRESH-EGG）与冷冻购买卵母细胞（FROZEN-EGG）、新鲜胚胎移植（FRESH-ET）与冷冻胚胎移植（FROZEN-ET）、双受体（SHARED）与单受体（SOLE）、单胚胎移植（SET）与双胚胎移植（DET）以及 PGT-A 使用的数据。主要结局为持续妊娠加活产率（ongoing pregnancy plus live birth，OP/LB）。
共完成 229 例 FRESH-EGG（70%）和 94 例 FROZEN-EGG（30%）周期。总体而言，与 FROZEN-EGG 相比，FRESH-EGG 获得的 OP/LB 更高（49% vs. 30%，p=0.001）；在 FRESH-EGG 组中，FRESH-ET 与 FROZEN-ET 之间的 OP/LB 相似（58% vs. 45%，p=0.07）。在 FRESH-ET 组中，使用 FRESH-EGG 的患者 OP/LB 高于使用 FROZEN-EGG 的患者（58% vs. 27%，p<0.001）。SHARED 与 SOLE 周期（p=0.6）、供体年龄（21-32 岁；p=0.4）和预期父母年龄（母亲 p=0.3，父亲 p=0.2）对 OP/LB 没有显著影响。值得注意的是，PGT-A 的使用并不能提高 OP/LB 的几率（p=0.7）。
使用 FRESH-EGG 联合 FRESH-ET 且不进行 PGT-A 仍然优于新的 DE 治疗组合。具体而言，使用 FROZEN-EGG 和 PGT-A 并不能改善结局。尽管改变 DE 实践可能会增强经验和可负担性，但患者和提供者必须认识到，选择并不总是有利于成功。此外，新出现的遗传谱系检测可能会带来更长期的后果，需要改变治疗和/或咨询。
