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女同性恋伴侣共用 IVF:接受伴侣卵子(ROPA)方法的临床结局。

Shared IVF among female couples: clinical outcomes of the Reception of Oocytes from the Partner (ROPA) method.

机构信息

Department of Reproductive Medicine, Ginemed Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.

Stanford University, Stanford, California, USA.

出版信息

Reprod Biomed Online. 2023 Oct;47(4):103284. doi: 10.1016/j.rbmo.2023.103284. Epub 2023 Jul 8.

Abstract

RESEARCH QUESTION

What is the population undergoing the ROPA (Reception of Oocytes from Partner) method and what are the outcomes of the technique?

DESIGN

Case series of all ROPA treatments carried out between 2011 and 2020 in 18 fertility clinics in Spain. Demographic characteristics, cycle features, laboratory and clinical outcomes, and the intentions regarding the disposition of surplus embryos were analysed.

RESULTS

Donor patients were on average 3.5 years younger than recipients (P = 0.001). No significant differences were found in body mass index or anti-Müllerian hormone. In 13% of cases, fertility issues were found: poor ovarian reserve (6.8%); endometriosis (2.9%); and polycystic ovary syndrome (2.2%). Including cases of advanced age (38 years old or older), more than one-half of couples (53.6%) had some condition that could affect fertility. Mean number of mature oocytes per cycle was 10 (+/- 5.7), and fertilization rate was 74.5% (+/- 18.8). Mean number of viable embryos was 3.2 (+/- 1.5). Surplus embryos were cryopreserved in 50.4% of cycles. Outcomes after embryo transfers from ROPA, and subsequent frozen cycles were as follows: positive pregnancy test (61.0%), clinical pregnancy (54.1%) and miscarriage rate (16.1%). Other outcomes were live birth rate per embryo transfer (44.7%); multiple pregnancy rate (5.4%); per cumulative ROPA cycle (48.6%); and per couple (61.6%).

CONCLUSION

The outcomes of the ROPA method are reassuring. About one-half of the ROPA cycles resulted in a live birth and one-quarter of the cycles had surplus embryos after achieving a live birth. Main neonatal outcomes were also reassuring.

摘要

研究问题

接受卵母细胞来自伴侣(ROPA)方法的人群是什么,以及该技术的结果是什么?

设计

这是一项在西班牙 18 家生育诊所于 2011 年至 2020 年间进行的所有 ROPA 治疗的病例系列。分析了人口统计学特征、周期特征、实验室和临床结果,以及对剩余胚胎处置的意图。

结果

供体患者比受体患者平均年轻 3.5 岁(P=0.001)。体重指数或抗苗勒管激素无显著差异。在 13%的病例中发现了生育问题:卵巢储备不良(6.8%);子宫内膜异位症(2.9%);多囊卵巢综合征(2.2%)。包括高龄(38 岁或以上)病例在内,超过一半的夫妇(53.6%)存在可能影响生育的某种情况。每个周期成熟卵母细胞的平均数量为 10(+/-5.7),受精率为 74.5%(+/-18.8)。可存活胚胎的平均数量为 3.2(+/-1.5)。50.4%的周期冷冻保存了剩余胚胎。ROPA 胚胎移植后的后续冷冻周期的结果如下:妊娠试验阳性(61.0%);临床妊娠(54.1%);流产率(16.1%)。其他结果包括每个胚胎移植的活产率(44.7%);多胎妊娠率(5.4%);每个累积 ROPA 周期(48.6%);每对夫妇(61.6%)。

结论

ROPA 方法的结果令人放心。大约一半的 ROPA 周期导致活产,四分之一的周期在实现活产后有剩余胚胎。主要新生儿结局也令人放心。

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