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基于倾向评分匹配法的卵母细胞玻璃化冷冻与胚胎玻璃化冷冻的临床妊娠与围产结局比较分析。

A comparative analysis of the clinical pregnancy and perinatal outcomes between oocyte vitrification and embryo vitrification based on the propensity score matching method.

机构信息

The Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

J Assist Reprod Genet. 2024 Apr;41(4):875-883. doi: 10.1007/s10815-024-03055-3. Epub 2024 Feb 17.

DOI:10.1007/s10815-024-03055-3
PMID:38366240
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11052731/
Abstract

PURPOSE

This study investigated the safety and effectiveness of oocyte vitrification by comparing the clinical pregnancy and perinatal outcomes between transfer cycles of vitrified oocytes and those of vitrified embryos.

METHODS

A retrospective cohort study was conducted to analyze the clinical data of patients who underwent cleavage-stage embryo transfer at the Department of Reproductive Medicine between January 2011 and June 2021. Seventy-seven transfer cycles of fresh cleavage-stage embryos developed from vitrified-thawed oocytes (oocyte vitrification group) and 2170 transfer cycles of vitrified-thawed cleavage-stage embryos developed from fresh oocytes (embryo vitrification group) were included. Further, 293 cases were selected from the embryo vitrification group after applying propensity score matching at 1:4. The primary outcomes were miscarriage rate, live birth rate, and neonatal birth weight.

RESULTS

No statistically significant differences were observed in the baseline data, pregnancy, perinatal outcomes, or neonatal outcomes for either singleton or twin births between the two groups after matching. Backwards stepwise regression was used to analyze the length of gestation. The age of female participants (β =  - 0.410, 95% CI =  - 1.339 ~  - 0.620, P < 0.001) had a statistically significant effect.

CONCLUSION

Oocyte vitrification results in similar clinical pregnancy and perinatal outcomes as does embryo vitrification; hence, it is a relatively safe assisted reproductive technique.

摘要

目的

本研究通过比较玻璃化卵母细胞与玻璃化胚胎移植周期的临床妊娠和围产结局,来评估卵母细胞玻璃化的安全性和有效性。

方法

本回顾性队列研究分析了 2011 年 1 月至 2021 年 6 月在生殖医学科行卵裂期胚胎移植患者的临床数据。纳入了 77 个新鲜玻璃化解冻卵母细胞(卵母细胞玻璃化组)培养的卵裂期胚胎移植周期和 2170 个新鲜卵母细胞玻璃化解冻卵裂期胚胎(胚胎玻璃化组)培养的卵裂期胚胎移植周期。进一步按照 1:4 比例进行倾向评分匹配后,从胚胎玻璃化组中选择了 293 例患者。主要结局为流产率、活产率和新生儿出生体重。

结果

匹配后,两组的基本资料、妊娠、围产结局和新生儿结局(单胎或双胎)均无统计学差异。采用向后逐步回归分析了孕龄。女性参与者的年龄(β=-0.410,95%CI=-1.339~-0.620,P<0.001)有统计学意义。

结论

卵母细胞玻璃化技术与胚胎玻璃化技术具有相似的临床妊娠和围产结局,是一种相对安全的辅助生殖技术。

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A comparative analysis of the clinical pregnancy and perinatal outcomes between oocyte vitrification and embryo vitrification based on the propensity score matching method.基于倾向评分匹配法的卵母细胞玻璃化冷冻与胚胎玻璃化冷冻的临床妊娠与围产结局比较分析。
J Assist Reprod Genet. 2024 Apr;41(4):875-883. doi: 10.1007/s10815-024-03055-3. Epub 2024 Feb 17.
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本文引用的文献

1
The Effect of Freezing Twice during Assisted Reproductive Technology on Perinatal and Neonatal Outcomes.辅助生殖技术中两次冻融对围产儿及新生儿结局的影响。
Biomed Res Int. 2022 Apr 4;2022:5623462. doi: 10.1155/2022/5623462. eCollection 2022.
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Microdissection testicular sperm extraction (micro-TESE) in men with infertility due to nonobstructive azoospermia: summary of current literature.非梗阻性无精子症导致不育的男性中显微睾丸精子提取术(micro-TESE):当前文献综述。
Int Urol Nephrol. 2021 Nov;53(11):2193-2210. doi: 10.1007/s11255-021-02979-4. Epub 2021 Aug 19.
3
Risk Factors for Different Types of Pregnancy Losses: Analysis of 15,210 Pregnancies After Embryo Transfer.不同类型妊娠丢失的风险因素:胚胎移植后 15210 例妊娠分析。
Front Endocrinol (Lausanne). 2021 Jun 25;12:683236. doi: 10.3389/fendo.2021.683236. eCollection 2021.
4
Assisted reproductive technology and hypertensive disorders of pregnancy: systematic review and meta-analyses.辅助生殖技术与妊娠高血压疾病:系统评价和荟萃分析。
BMC Pregnancy Childbirth. 2021 Jun 28;21(1):449. doi: 10.1186/s12884-021-03938-8.
5
Fertility preservation in women for medical and social reasons: Oocytes vs ovarian tissue.医学和社会因素导致的女性生育力保存:卵母细胞与卵巢组织。
Best Pract Res Clin Obstet Gynaecol. 2021 Jan;70:63-80. doi: 10.1016/j.bpobgyn.2020.06.011. Epub 2020 Jul 21.
6
Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion.接受性腺毒性治疗或性腺切除术的患者的生育力保存:委员会意见。
Fertil Steril. 2019 Dec;112(6):1022-1033. doi: 10.1016/j.fertnstert.2019.09.013.
7
Meta-analysis of the use of hyaluronic acid gel to prevent intrauterine adhesions after miscarriage.流产后使用透明质酸凝胶预防宫腔粘连的荟萃分析。
Eur J Obstet Gynecol Reprod Biol. 2020 Jan;244:1-4. doi: 10.1016/j.ejogrb.2019.10.018. Epub 2019 Oct 22.
8
Activation Prior to Transplantation of Human Ovarian Tissue: Is It Truly Effective?人卵巢组织移植前的激活:它真的有效吗?
Front Endocrinol (Lausanne). 2019 Aug 2;10:520. doi: 10.3389/fendo.2019.00520. eCollection 2019.
9
The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention.国际妇产科联盟(FIGO)子痫前期倡议:早孕期筛查和预防的实用指南。
Int J Gynaecol Obstet. 2019 May;145 Suppl 1(Suppl 1):1-33. doi: 10.1002/ijgo.12802.
10
A brief history of oocyte cryopreservation: Arguments and facts.卵母细胞冷冻保存简史:争论与事实。
Acta Obstet Gynecol Scand. 2019 May;98(5):550-558. doi: 10.1111/aogs.13569. Epub 2019 Mar 25.