Department of Obstetrics and Gynecology, TriHealth, and the Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio.
Obstet Gynecol. 2022 Jul 1;140(1):102-105. doi: 10.1097/AOG.0000000000004825. Epub 2022 Jun 7.
As oocyte cryopreservation use increases among reproductive-aged women, health care professionals are challenged with counseling patients on fertility-sparing technology based on limited high-quality research. Since the first successful slow freezing of mouse embryos in England in 1972, reproductive scientists have employed various protocols for successful cryopreservation and warming of gametes. From outdated slow-freeze technologies to improved vitrification methods, science has successfully shifted the pendulum from cryoinjury-related cell death to the preservation of cellular immortality. The clinical applications of oocyte cryopreservation first increased among oncofertility patients faced with limited fertility-sparing options. Breakthroughs in oncofertility opened a window of opportunity for the transgender community, which also led to an entirely new frontier-planned oocyte cryopreservation for potential future use. Reasons for cryopreservation are complex and often overlap. Socially, these can include not having a support person to share childcare responsibilities, prioritizing career goals and aspirations, and the financial constraints of the ever-rising cost of childrearing. Medically, reasons can include diseases, primary ovarian insufficiency, traumatic injury, planned female to male gender transition, and fertility loss that occurs with aging. Women are faced with many, if not all, of the above scenarios during their "ideal" reproductive window. These women are presenting to fertility centers in hopes of allowing for future reproductive freedom. Owing to media influence, women may be misled of the success potential of cryopreserved oocytes as a guarantee of future biological children. Here, we review current literature and propose guidelines for counseling patients on planned oocyte cryopreservation.
随着生殖年龄段女性对卵母细胞冷冻保存的应用增加，医疗保健专业人员面临着根据有限的高质量研究为患者提供生育保留技术咨询的挑战。自 1972 年英国首次成功冷冻小鼠胚胎以来，生殖科学家已经采用了各种方案来成功冷冻和解冻配子。从过时的慢速冷冻技术到改进的玻璃化方法，科学成功地将重点从与冷冻损伤相关的细胞死亡转移到了细胞不朽的保存上。卵母细胞冷冻保存的临床应用首先在面临有限生育保留选择的肿瘤生育患者中增加。肿瘤生育方面的突破为跨性别群体开辟了机会之窗，这也导致了一个全新的领域——计划进行卵母细胞冷冻保存，以备将来使用。冷冻保存的原因复杂且往往重叠。从社会角度来看，这些原因可能包括没有一个可以分担育儿责任的人、优先考虑职业目标和愿望，以及不断上升的育儿成本带来的经济限制。从医学角度来看，原因可能包括疾病、原发性卵巢功能不全、创伤性损伤、计划中的女性到男性的性别转变，以及随着年龄增长而导致的生育能力丧失。在“理想”的生殖窗口期间，女性可能会面临上述所有或大多数情况。这些女性正在生育中心寻求未来生育自由的机会。由于媒体的影响，女性可能会对冷冻保存的卵母细胞的成功潜力产生误解，认为这是未来生育孩子的保证。在这里，我们回顾了当前的文献，并提出了为计划进行卵母细胞冷冻保存的患者提供咨询的指南。
