Institute for Women's Health, University College London, London, United Kingdom.
Department of Obstetrics and Gynaecology, University College London Hospital, London, United Kingdom.
Fertil Steril. 2022 Jun;117(6):1266-1276. doi: 10.1016/j.fertnstert.2022.03.004. Epub 2022 Apr 19.
To compare obstetric outcomes in patients cryopreserving reproductive cells or tissues before gonadotoxic therapy.
A literature search was conducted following PRISMA guidelines on Embase, Medline, and Web of Science. Studies reporting obstetric outcomes in cancer patients who completed cryopreservation of oocyte, embryo, or ovarian tissue were included.
Not applicable.
PATIENT(S): Cancer patients attempting pregnancy using cryopreserved cells or tissues frozen before cancer therapy.
INTERVENTION(S): Oocyte, embryo, or ovarian tissue cryopreservation for fertility preservation in cancer.
MAIN OUTCOME MEASURE(S): The total numbers of clinical pregnancies, live births, and miscarriages in women attempting pregnancy using cryopreserved reproductive cells or tissues were calculated. A meta-analysis determined the effect size of each intervention.
RESULT(S): The search returned 4,038 unique entries. Thirty-eight eligible studies were analyzed. The clinical pregnancy rates were 34.9%, 49.0%, and 43.8% for oocyte, embryo, and ovarian tissue cryopreservation, respectively. No significant differences were found among groups. The live birth rates were 25.8%, 35.3%, and 32.3% for oocyte, embryo, and ovarian tissue cryopreservation, respectively, with no significant differences among groups. The miscarriage rates were 9.2%, 16.9%, and 7.5% for oocyte, embryo, and ovarian tissue cryopreservation, respectively. Significantly fewer miscarriages occurred with ovarian tissue cryopreservation than with embryo cryopreservation.
CONCLUSION(S): This enquiry is required to counsel cancer patients wishing to preserve fertility. Although the limitations of this study include heterogeneity, lack of quality studies, and low utilization rates, it serves as a starting point for comparison of reproductive and obstetric outcomes in patients returning for family-planning after gonadotoxic therapy.
比较性腺毒性治疗前冷冻保存生殖细胞或组织的患者的产科结局。
按照 PRISMA 指南，在 Embase、Medline 和 Web of Science 上进行文献检索。纳入报道癌症患者完成卵母细胞、胚胎或卵巢组织冷冻保存后产科结局的研究。
不适用。
试图通过冷冻保存的细胞或组织受孕的癌症患者，这些细胞或组织在癌症治疗前已经冷冻。
卵母细胞、胚胎或卵巢组织冷冻保存以保留癌症患者的生育能力。
使用冷冻保存的生殖细胞或组织尝试妊娠的女性的临床妊娠、活产和流产总数。通过荟萃分析确定每个干预措施的效应量。
检索返回 4038 个独特条目。分析了 38 项符合条件的研究。卵母细胞、胚胎和卵巢组织冷冻保存的临床妊娠率分别为 34.9%、49.0%和 43.8%。组间无显著差异。卵母细胞、胚胎和卵巢组织冷冻保存的活产率分别为 25.8%、35.3%和 32.3%，组间无显著差异。卵母细胞、胚胎和卵巢组织冷冻保存的流产率分别为 9.2%、16.9%和 7.5%。卵巢组织冷冻保存的流产率明显低于胚胎冷冻保存。
这是为了向希望保留生育能力的癌症患者提供咨询而进行的调查。尽管该研究存在异质性、缺乏高质量研究和低利用率等局限性，但它为比较性腺毒性治疗后返回进行计划生育的患者的生殖和产科结局提供了一个起点。
