选择性卵母细胞冷冻的使用和成本效益：一项回顾性观察研究。
Usage and cost-effectiveness of elective oocyte freezing: a retrospective observational study.
机构信息
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Number 8, Chung Shan South Road, Taipei City, 100, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Yunlin Branch, Yunlin County, 640, Taiwan.
出版信息
Reprod Biol Endocrinol. 2022 Aug 16;20(1):123. doi: 10.1186/s12958-022-00996-1.
BACKGROUND
The previous model-based cost-effectiveness analyses regarding elective oocyte cryopreservation remained debatable, while the usage rate may influence the cost per live birth. The aim of this study is to disclose the usage and cost-effectiveness of the planned cryopreserved oocytes after oocyte thawing in real-world situations.
METHODS
This was a retrospective single-center observational study. Women who electively cryopreserved oocytes and returned to thaw the oocytes were categorized as thawed group. The oocytes were fertilized at our center and the sperm samples for each individual was retrieved from their respective husbands. Clinical outcomes were traced and the cumulative live birth rate per thawed case was calculated. The costs from oocyte freezing cycles to oocyte thawing, and embryo transfer cycles were accordingly estimated. The cumulative cost per live birth was defined by the cumulative cost divided by the live births per thawed case.
RESULTS
We recruited 645 women with 840 oocyte retrieval cycles for elective oocyte freezing from November 2002 to December 2020. The overall usage rate was 8.4% (54/645). After the storage duration exceeded ten years, the probabilities of thawing oocytes were 10.6%, 26.6%, and 12.7% from women who cryopreserved their oocytes at the age ≤ 35 years, 36-39 years, and ≥ 40 years, respectively (P = 0.304). Among women who thawed their oocytes, 31.5% (17/54) of women achieved at least one live birth. For the age groups of ≤ 35 years, 36-39 years, and ≥ 40 years, the cumulative live birth rates per thawed case were 63.6%, 42.3%, and 17.6%, respectively (P = 0.045), and the cumulative costs for one live birth were $11,704, $17,189, and $35,642, respectively (P < 0.001).
CONCLUSIONS
The overall usage rate was 8.4% in our cohort. The cumulative live birth rate was greatest in the youngest group and the cumulative cost per live birth was highest in the oldest group, which was threefold greater than that in the group aged ≤ 35 years. The findings added to the limited evidence of the usage rate in real-world situations, which could hopefully aid future analysis and decision-making in public health policy and for women willing to preserve fertility.
TRIAL REGISTRATION
None.
背景
之前关于选择性卵母细胞冷冻保存的基于模型的成本效益分析仍存在争议，而使用率可能会影响每活产的成本。本研究旨在揭示实际情况下卵母细胞解冻后的计划冷冻保存卵母细胞的使用情况和成本效益。
方法
这是一项回顾性单中心观察性研究。选择冷冻保存卵母细胞并返回解冻卵母细胞的女性被分为解冻组。我们中心对卵母细胞进行受精，每个个体的精子样本均从各自的丈夫处采集。追踪临床结局，并计算每个解冻病例的累积活产率。相应地估算了从卵母细胞冷冻周期到卵母细胞解冻和胚胎移植周期的成本。通过将累积成本除以每个解冻病例的活产数来定义每活产的累积成本。
结果
我们招募了 2002 年 11 月至 2020 年 12 月期间因选择性卵母细胞冷冻而进行 840 次卵母细胞采集的 645 名女性。总体使用率为 8.4%（54/645）。在储存时间超过十年后，年龄≤35 岁、36-39 岁和≥40 岁的女性解冻卵母细胞的概率分别为 10.6%、26.6%和 12.7%（P=0.304）。在解冻卵母细胞的女性中，31.5%（17/54）的女性至少有一次活产。对于年龄组≤35 岁、36-39 岁和≥40 岁，每个解冻病例的累积活产率分别为 63.6%、42.3%和 17.6%（P=0.045），每活产的累积成本分别为 11704 美元、17189 美元和 35642 美元（P<0.001）。
结论
在我们的队列中，总体使用率为 8.4%。最年轻组的累积活产率最高，而最年长组的每活产成本最高，是≤35 岁组的三倍。这些发现增加了关于实际情况下使用率的有限证据，有望为未来的公共卫生政策分析和决策以及愿意保留生育能力的女性提供帮助。
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无。
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