Fu Xiao, Zhang Yiting, Gao Shuli, Gao Shuzhe, Zhang Meng, Gao Shanshan, Ma Jinlong, Chen Zi-Jiang
Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China.
Front Endocrinol (Lausanne). 2023 Oct 5;14:1221308. doi: 10.3389/fendo.2023.1221308. eCollection 2023.
To evaluate the effectiveness and safety of utilizing the small number of remaining vitrified oocytes after the failure of adequate fresh sibling oocytes. The outcome of present study would provide more comprehensive information about possible benefits or disadvantage to cryopreserve supernumerary oocytes for patients who have plenty oocytes retrieved.
This retrospective cohort study included 791 IVF/ICSI cycles using 6344 oocytes that had been vitrified in the Reproductive Hospital affiliated to Shandong University between January 2013 and December 2019.They were divided into three groups: SOC group (supernumerary oocytes cryopreservation), relative-MOC group (relative male factor-oocyte cryopreservation), and absolute-MOC group (absolute male factor-oocyte cryopreservation). Laboratory and clinical outcomes were analysed, and multivariate regression analysis was used to study the effect of different indications of vitrification on CLBR.
The CLBR was highest in absolute-MOC, and lowest in SOC (39.0% vs 28.9%, P=0.006); however, after adjusting for confounding factors, the difference was not statistically significant. Multivariable regression analysis showed no impact of indications of vitrified oocytes on CLBR according to controlled age, BMI, preservation duration, use of donor sperm or not, use of PESA/TESA or not, number of oocytes retrieved, number of oocytes thawed, and oocyte survival rate. The preliminary data of safety showed no significant differences in the perinatal and neonatal outcoms after ET and FET between the SOC and MOC groups.
Different indications of vitrification did not affect CLBR. The CLBR of vitrified oocytes for different indications was correlated with age and number of warmed oocytes. For women who have plenty oocytes retrieved, the strategy of cryopreserving a small number of oocytes is a valuable option and might benefit them in the future. Additional data from autologous oocyte vitrification research employing a large-scale and variable-controlled methodology with extending follow-up will complement and clarify the current results.
评估在新鲜的同胞卵母细胞数量不足而失败后，利用少量剩余玻璃化卵母细胞的有效性和安全性。本研究结果将为那些获取了大量卵母细胞的患者冷冻多余卵母细胞可能带来的益处或弊端提供更全面的信息。
这项回顾性队列研究纳入了2013年1月至2019年12月期间在山东大学附属生殖医院进行的791个体外受精/卵胞浆内单精子注射（IVF/ICSI）周期，共使用了6344个已玻璃化的卵母细胞。它们被分为三组：超数卵母细胞冷冻保存组（SOC组）、相对男性因素-卵母细胞冷冻保存组（relative-MOC组）和绝对男性因素-卵母细胞冷冻保存组（absolute-MOC组）。分析了实验室和临床结局，并采用多因素回归分析研究不同玻璃化指征对累积活产率（CLBR）的影响。
绝对男性因素-卵母细胞冷冻保存组的CLBR最高，SOC组最低（39.0%对28.9%，P=0.006）；然而，在调整混杂因素后，差异无统计学意义。多变量回归分析显示，根据年龄、体重指数、保存时间、是否使用供精、是否使用经皮附睾精子抽吸术/睾丸精子抽吸术（PESA/TESA）、获取的卵母细胞数量、解冻的卵母细胞数量和卵母细胞存活率进行控制后，玻璃化卵母细胞的指征对CLBR没有影响。安全性的初步数据显示，SOC组和MOC组在胚胎移植（ET）和冻融胚胎移植（FET）后的围产期和新生儿结局方面没有显著差异。
不同的玻璃化指征不影响CLBR。不同指征的玻璃化卵母细胞的CLBR与年龄和复苏卵母细胞数量相关。对于获取了大量卵母细胞的女性，冷冻少量卵母细胞的策略是一个有价值的选择，可能在未来使她们受益。采用大规模、可变控制方法并延长随访时间的自体卵母细胞玻璃化研究的更多数据将补充和阐明当前结果。
