Poli Maurizio, Capalbo Antonio
Igenomix Italy, Marostica, Italy.
Centrum voor Kinderwens, Dijklander Hospital, Purmerend, Netherlands.
Front Reprod Health. 2021 Sep 22;3:704283. doi: 10.3389/frph.2021.704283. eCollection 2021.
With an upward trend in delaying parenthood, women across the world face an increasing risk of age-related infertility and involuntary childlessness. Elective oocyte banking strategies offer women the possibility to protect part of their reproductive potential until personal finances, personal relationship, or career have stabilized. Timely collection and cryopreservation of oocytes when they are most competent and chromosomal abnormality rates have not yet escalated are crucial for achieving high live births through fertilization (IVF) treatment at a later stage. To promote reproductive autonomy, women shall be informed about the decrease in fertility rates that sharply intensifies from the age of 35 years and the strategies available to maintain their reproductive potential. Together with this information, women should also recognize the limitations of available strategies including expected live birth rates, costs of the procedures, and overall approach performance, which is mainly associated with age at cryopreservation, number of oocytes banked, and age at accessing the banked oocytes. Evidence-based statistics are not yet available due to the relatively short period in which oocyte cryopreservation has been offered for elective purposes and the scarce number of patients returning for accessing their oocytes. However, to evaluate the applicability of fertility cryopreservation on a large scale, several theoretical models have been proposed to assess the expected efficacy and overall cost-effectiveness of different oocyte banking strategies. In this study, we review current oocyte cryopreservation methodologies, their applications, and outcomes. Moreover, we summarize current evidence regarding known parameters affecting oocyte banking efficacy. Finally, we discuss key points that could play a role in improving access to the service and optimization of oocyte banking frameworks.
随着推迟生育的趋势上升,世界各地的女性面临与年龄相关的不孕和非自愿无子女的风险日益增加。选择性卵母细胞冷冻保存策略为女性提供了一种可能性,即保护其部分生殖潜能,直到个人财务、人际关系或职业稳定下来。在卵母细胞最具能力且染色体异常率尚未升高时及时收集和冷冻保存卵母细胞,对于后期通过体外受精(IVF)治疗实现高活产率至关重要。为了促进生殖自主权,应告知女性从35岁起生育率急剧下降的情况以及可用于维持其生殖潜能的策略。除了这些信息,女性还应认识到现有策略的局限性,包括预期活产率、程序成本和整体方法性能,这些主要与冷冻保存时的年龄、冷冻保存的卵母细胞数量以及取用冷冻保存卵母细胞时的年龄有关。由于选择性卵母细胞冷冻保存提供的时间相对较短,且返回取用其卵母细胞的患者数量稀少,目前尚无基于证据的统计数据。然而,为了大规模评估生育力冷冻保存的适用性,已经提出了几种理论模型来评估不同卵母细胞冷冻保存策略的预期疗效和总体成本效益。在本研究中,我们回顾了当前的卵母细胞冷冻保存方法、其应用和结果。此外,我们总结了关于影响卵母细胞冷冻保存效果的已知参数的现有证据。最后,我们讨论了在改善服务可及性和优化卵母细胞冷冻保存框架方面可能发挥作用的关键点。