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十年选择性卵母细胞冷冻保存的生殖结局。

Reproductive outcomes from ten years of elective oocyte cryopreservation.

机构信息

Department of Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London NHS Trust, Du Cane Road, London, W12 OHS, UK.

Department of Cancer and Surgery, Imperial College London, London, W12 0NN, UK.

出版信息

Arch Gynecol Obstet. 2022 Nov;306(5):1753-1760. doi: 10.1007/s00404-022-06711-0. Epub 2022 Aug 21.

DOI:10.1007/s00404-022-06711-0
PMID:35988095
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9519701/
Abstract

RESEARCH QUESTION

To assess the relationship between the number of oocytes retrieved during elective oocyte cryopreservation (EOC) cycles with various clinical, biochemical, and radiological markers, including age, body mass index (BMI), baseline anti-Müllerian hormone (AMH), antral follicle count (AFC), Oestradiol level (E2) and total number of follicles ≥ 12 mm on the day of trigger. To also report the reproductive outcomes from women who underwent EOC.

METHODS

A retrospective cohort of 373 women embarking on EOC and autologous oocyte thaw cycles between 2008 and 2018 from a single London clinic in the United Kingdom.

RESULTS

483 stimulation cycles were undertaken amongst 373 women. The median (range) age at cryopreservation was 38 (26-47) years old. The median numbers of oocytes retrieved per cycle was 8 (0-37) and the median total oocytes cryopreserved per woman was 8 (0-45). BMI, E2 level and number of follicles ≥ 12 mm at trigger were all significant predictors of oocyte yield. Multivariate analysis confirmed there was no significant relationship between AFC or AMH, whilst on univariate analysis statistical significance was proven. Thirty six women returned to use their cryopreserved oocytes, of which there were 41 autologous oocyte thaw cycles undertaken. There were 12 successful livebirths achieved by 11 women. The overall livebirth rate was 26.8% per cycle. No livebirths were achieved in women who underwent EOC ≥ 40 years old, and 82% of all livebirths were achieved in women who had done so between 36 and 39 years old.

CONCLUSION

Clinical, biochemical and radiological markers can predict oocyte yield in EOC cycles. Reproductive outcomes are more favourable when cryopreservation is performed before the age of 36, with lower success rates of livebirth observed in women aged 40 years and above.

摘要

研究问题

评估在选择性卵母细胞冷冻保存(EOC)周期中取回的卵母细胞数量与各种临床、生化和影像学标志物之间的关系,包括年龄、体重指数(BMI)、基础抗苗勒管激素(AMH)、窦卵泡计数(AFC)、触发日的雌二醇水平(E2)和≥12mm 的总卵泡数。还报告了接受 EOC 的女性的生殖结局。

方法

这是一项回顾性队列研究,纳入了 2008 年至 2018 年期间在英国伦敦一家诊所接受 EOC 和自体卵母细胞解冻周期的 373 名女性。

结果

373 名女性共进行了 483 个刺激周期。冷冻保存时的中位(范围)年龄为 38(26-47)岁。每个周期取回的卵母细胞中位数为 8(0-37),每个女性冷冻保存的总卵母细胞中位数为 8(0-45)。BMI、E2 水平和触发时≥12mm 的卵泡数均是卵母细胞产量的重要预测因素。多变量分析证实 AFC 或 AMH 与卵母细胞产量之间无显著关系,而单变量分析则显示出统计学意义。36 名女性返回使用其冷冻保存的卵母细胞,其中有 41 个是自体卵母细胞解冻周期。11 名女性中有 12 名成功分娩。每个周期的总活产率为 26.8%。≥40 岁女性进行 EOC 后未获得活产,82%的活产发生在 36-39 岁女性。

结论

临床、生化和影像学标志物可预测 EOC 周期中的卵母细胞产量。冷冻保存在 36 岁之前进行时,生殖结局更有利,40 岁及以上女性的活产率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0786/9519701/4e97a151c187/404_2022_6711_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0786/9519701/4e97a151c187/404_2022_6711_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0786/9519701/4e97a151c187/404_2022_6711_Fig1_HTML.jpg

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Eur J Obstet Gynecol Reprod Biol X. 2019 May 13;3:100043. doi: 10.1016/j.eurox.2019.100043. eCollection 2019 Jul.
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Elective oocyte freezing for nonmedical reasons: a 6-year report on utilization and in vitro fertilization results from a Swedish center.
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