Livet, GeneraLife IVF, Turin, Italy.
Clinica Valle Giulia, GeneraLife IVF, Rome, Italy.
J Assist Reprod Genet. 2022 Apr;39(4):873-882. doi: 10.1007/s10815-022-02405-3. Epub 2022 Feb 4.
Few studies explored whether prolonged cryo-storage after vitrification affects embryo competence and perinatal outcomes. This systematic review and meta-analysis aims at highlighting any putative impact of cryo-storage duration on cryo-survival, miscarriage, live birth and major malformations.
A systematic review was performed using MEDLINE (PubMed), ISI Web of Knowledge, Scopus and Embase databases up to June 2021. Data were combined to obtain a pooled OR, and meta-analysis was conducted using a random effects model. Out of 1,389 screened abstracts, 22 papers were assessed for eligibility, and 5 studies were included (N = 18,047 embryos). Prolonged cryo-storage was defined as > 12 months (N = 3389 embryos). Subgroup analysis was performed for untested vitrified cleavage stage embryos (N = 1739 embryos) and for untested and euploid vitrified blastocysts (N = 13,596 and 2712 embryos, respectively).
Survival rate, miscarriage, live birth and major malformation rates were all similar in the two groups.
These data further support the safety of long-term cryo-storage of human embryos beyond 12 months. This is reassuring for good prognosis patients with surplus embryos, couples seeking a second child from supernumerary embryos and women postponing the transfer for clinical or personal reasons.
鲜有研究探讨玻璃化冷冻后长时间储存是否会影响胚胎的活力和围产期结局。本系统评价和荟萃分析旨在强调储存时间对冷冻存活率、流产、活产和主要畸形的潜在影响。
使用 MEDLINE（PubMed）、ISI Web of Knowledge、Scopus 和 Embase 数据库进行系统综述，检索时间截至 2021 年 6 月。合并数据以获得汇总比值比，并使用随机效应模型进行荟萃分析。在 1389 篇筛选的摘要中，有 22 篇进行了资格评估，有 5 项研究符合纳入标准（N=18047 个胚胎）。长时间储存定义为>12 个月（N=3389 个胚胎）。对未经检测的玻璃化分裂期胚胎（N=1739 个胚胎）和未经检测的整倍体玻璃化囊胚（N=13596 个和 2712 个胚胎）分别进行了亚组分析。
两组的存活率、流产率、活产率和主要畸形率相似。
这些数据进一步支持人类胚胎在 12 个月后进行长期冷冻储存的安全性。这对于预后良好、有多余胚胎的患者、希望从多余胚胎中获得二胎的夫妇以及因临床或个人原因推迟移植的妇女来说是令人安心的。
