Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Brigham & Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Reprod Biol Endocrinol. 2022 Jan 7;20(1):10. doi: 10.1186/s12958-021-00884-0.
The utilization of oocyte cryopreservation (OC) has become popularized with increasing numbers of reproductive-aged patients desiring to maintain fertility for future family building. OC was initially used for fertility preservation in postmenarchal patients prior to gonadotoxic therapies; however, it is now available to patients to circumvent age-related infertility and other diagnoses associated with early loss of ovarian reserve. The primary aim of this paper is to provide a narrative review of the most recent and robust data on the utilization and outcomes of OC in both patient populations. OC results in similar oocyte yield in patients facing gonadotoxic therapies and patients undergoing planned OC. Available data are insufficient to predict the live birth rates or the number of oocytes needed to result in live birth. However, oocyte yield and live birth rates are best among patients < 37.5 years old or with anti-mullerian hormone levels > 1.995 ng/dL, at the time of oocyte retrieval. There is a high 'no use' rate (58.9%) in patients using planned OC with 62.5% returning to use frozen oocytes with a spouse. The utilization rate in medical OC patients is < 10%. There is currently no data on the effects of BMI, smoking, or ethnicity on planned OC outcomes.
It is too early to draw any final conclusions on outcomes of OC in medical OC and planned OC; however, preliminary data supports that utilization of OC in both groups result in preservation of fertility and subsequent live births in patients who return to use their cryopreserved eggs. Higher oocyte yield, with fewer ovarian stimulation cycles, and higher live birth rates are seen in patients who seek OC at younger ages, reinforcing the importance of age on fertility preservation. More studies are needed in medical OC and planned OC to help guide counseling and decision-making in patients seeking these services.
随着越来越多有生育需求的育龄患者希望为未来的家庭建设保留生育能力，卵母细胞冷冻保存（OC）的应用已经普及。OC 最初用于青春期前患者接受性腺毒性治疗前的生育力保存；然而，现在它也可用于避免与年龄相关的不孕和其他与早期卵巢储备丧失相关的诊断。本文的主要目的是提供关于 OC 在这两种患者人群中的应用和结果的最新和最有力数据的叙述性综述。OC 在面临性腺毒性治疗的患者和计划进行 OC 的患者中，均可获得相似的卵母细胞产量。目前尚无足够的数据来预测活产率或获得活产所需的卵母细胞数量。然而，在卵母细胞采集时，<37.5 岁或抗苗勒管激素水平>1.995ng/dL 的患者的卵母细胞产量和活产率最高。计划 OC 的患者中有 58.9%的“未使用”率，其中 62.5%的患者与配偶一起返回使用冷冻卵母细胞。在医学 OC 患者中的使用率<10%。目前尚无 BMI、吸烟或种族对计划 OC 结果影响的数据。
目前对于医学 OC 和计划 OC 中 OC 的结果下任何最终结论还为时过早；然而，初步数据支持两组患者中 OC 的应用均能保留生育能力，并使随后返回使用冷冻卵子的患者获得活产。在寻求 OC 的患者中，年龄较小的患者卵母细胞产量更高，卵巢刺激周期更少，活产率更高，这进一步强调了年龄对生育力保存的重要性。需要在医学 OC 和计划 OC 中进行更多的研究，以帮助指导寻求这些服务的患者的咨询和决策。
