在供体卵母细胞周期中采用改良的升温方案可改善临床结局。

Improved clinical outcomes with a modified warming protocol in donor oocyte cycles.

作者信息

Lee Chun-I, Chen Hsiu-Hui, Lin Shu-Hui, Huang Chun-Chia, Lin Pin-Yao, Lee Tsung-Hsien, Chen Ming-Jer, Lee Maw-Sheng, Chen Chien-Hong

机构信息

Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.

Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.

出版信息

J Ovarian Res. 2025 Aug 16;18(1):187. doi: 10.1186/s13048-025-01776-2.

DOI:10.1186/s13048-025-01776-2

PMID:40819040

Abstract

BACKGROUND

Recent studies have attempted to improve laboratory efficiency while preserving clinical outcomes by shortening the time to warm cryopreserved embryos, though it is still unclear for oocytes. This study thus aimed to evaluate the effects of a modified warming protocol (MWP) on embryonic development and pregnancy outcomes of vitrified donor oocytes.

METHODS

The data of this retrospective cohort study were collected from women who underwent donor cycles (fresh or vitrified oocytes) at Lee Women's Hospital, Taiwan, from January 2019 to August 2024. The sample included 13,103 donor oocytes, divided into three groups: conventional warming protocol (CWP) group (n = 8506), MWP group (n = 980), and fresh group (n = 3617).

RESULTS

Survival rates after oocyte warming were similar between the CWP and MWP groups (93.7% vs. 93.9%, P > 0.05). Oocyte degeneration rates post-intracytoplasmic sperm injection (ICSI) were similar for vitrified-warmed and fresh oocytes (2.7-3.4% vs. 2.8%). Normal fertilization was lower for vitrified-warmed oocytes (79.5-79.6% vs. 83.0%, P < 0.05), while abnormal fertilization was higher (9.1-10.1% vs. 3.3%). Blastocyst formation and usable blastocyst formation were lower in the CWP group (57.5% and 35.4%) compared to MWP (77.3% and 51.4%) and fresh groups (69.2% and 48.5%). Ongoing pregnancy/live birth was higher in the MWP group than in the CWP group (66.7% vs. 50.4%, P < 0.05). Multivariate analysis showed a positive association between MWP and usable blastocyst formation (adjusted incidence rate ratio = 1.423, 95% CI = 1.268 to 1.597, P < 0.001), as well as ongoing pregnancy/live birth (adjusted odds ratio = 1.899, 95% CI = 1.002 to 3.6, P < 0.05).

CONCLUSIONS

This study suggests that the MWP enhances the blastocyst formation potential and pregnancy outcomes of vitrified-warmed oocytes, making it similar to that of fresh oocytes. Thus, the MWP may replace the CWP as the standard protocol for optimizing donor cycle outcomes.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

近期研究试图通过缩短冷冻胚胎解冻时间来提高实验室效率，同时维持临床结局，不过卵母细胞方面仍不明确。因此，本研究旨在评估改良解冻方案（MWP）对玻璃化冷冻供体卵母细胞胚胎发育及妊娠结局的影响。

方法

本回顾性队列研究的数据收集自2019年1月至2024年8月在台湾李女子医院接受供体周期治疗（新鲜或玻璃化冷冻卵母细胞）的女性。样本包括13103个供体卵母细胞，分为三组：传统解冻方案（CWP）组（n = 8506）、MWP组（n = 980）和新鲜组（n = 3617）。

结果

CWP组和MWP组卵母细胞解冻后的存活率相似（93.7%对93.9%，P > 0.05）。玻璃化冷冻解冻卵母细胞和新鲜卵母细胞在卵胞浆内单精子注射（ICSI）后的卵母细胞退化率相似（2.7 - 3.4%对2.8%）。玻璃化冷冻解冻卵母细胞的正常受精率较低（79.5 - 79.6%对83.0%，P < 0.05），而异常受精率较高（9.1 - 10.1%对3.3%）。与MWP组（77.3%和51.4%）及新鲜组（69.2%和48.5%）相比，CWP组的囊胚形成率和可用囊胚形成率较低（57.5%和35.4%）。MWP组的持续妊娠/活产率高于CWP组（66.7%对50.4%，P < 0.05）。多因素分析显示MWP与可用囊胚形成之间存在正相关（调整发病率比 = 1.423，95%置信区间 = 1.268至1.597，P < 0.001），以及与持续妊娠/活产之间存在正相关（调整优势比 = 1.899，95%置信区间 = 1.002至3.6，P < 0.05）。