Clinical outcomes of vitrified-warmed autologous oocyte cycles with 15-year follow-up at a single UK centre: consistent and predictable results.

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2024-07-17 DOI:10.1016/j.rbmo.2024.104376

Jemma Garratt, Trina Shah, Anna Mclaughlin, Balsam Al-Hashimi, Nick Macklon, Elena Linara-Demakakou, Kamal K Ahuja

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Abstract

Research question: What were the clinical outcomes from 332 autologous vitrified- warmed oocyte cycles derived from 3182 elective autologous oocyte freeze cycles carried out between 2008 and 2022 in a single-centre series?

Design: In this retrospective observational study, outcomes in 299 patients returning to use their frozen oocytes between 2015 and 2023 were analysed.

Results: A total of 3328 elective oocyte vitrification cycles were performed in 2280 patients. The return rate to use oocytes was 14% (299/2171). Mean ages were 37.6 years at storage and 40 at warming. Ninety-three clinical pregnancies and 77 healthy live births were recorded. The live birth rate (LBR) was 24% (39/163) per fresh transfer and 17% (39/227) per embryo transferred. Stratified by age at freezing, the LBR per embryo transferred was 26% (12/47) in participants under 35 years, 20% (24/118) in those 35-39 years and 5% (3/62) in those 40+ years. Frozen embryo transfers (FET) achieved a 30% (24/80) LBR per embryo transfer and a 27% (24/90) LBR per embryo transferred. PGT-A for embryo selection doubled the LBR compared with FET from an untested embryo after one attempt (40% versus 21%). In patients aged over 40 years, the cumulative LBR reached 42% per patient in euploid FET.

Conclusion: The proportion of patients who returned to use their stored oocytes and the clinical outcomes were consistent with other recent reports and challenges the prevalent critical narrative regarding elective oocyte freezing for fertility preservation. The results are now comparable to routine IVF. Not everyone who returns to use their oocytes will conceive, but for those choosing to preserve their fertility, oocyte freezing can provide reproducible and reassuring results.

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英国一家中心对玻璃化温育自体卵母细胞周期进行 15 年随访的临床结果：一致且可预测的结果。

研究问题：在一项单中心系列研究中，从2008年至2022年期间实施的3182个选择性自体卵母细胞冷冻周期中得出的332个自体玻璃化-加温卵母细胞周期的临床结果如何？在这项回顾性观察研究中，分析了2015年至2023年间299名患者返回使用其冷冻卵母细胞的结果：2280名患者共进行了3328次选择性卵母细胞玻璃化周期。返回使用卵母细胞的比例为 14%（299/2171）。储存时的平均年龄为 37.6 岁，升温时的平均年龄为 40 岁。共记录了 93 例临床妊娠和 77 例健康活产。每次新鲜移植的活产率（LBR）为 24%（39/163），每次胚胎移植的活产率（LBR）为 17%（39/227）。按冷冻时的年龄分层，35 岁以下参与者每次胚胎移植的活产率为 26%（12/47），35-39 岁为 20%（24/118），40 岁以上为 5%（3/62）。冷冻胚胎移植（FET）每移植一个胚胎的长存活率为 30%（24/80），每移植一个胚胎的长存活率为 27%（24/90）。与使用未经检验的胚胎进行一次冷冻胚胎移植相比，使用 PGT-A 进行胚胎选择的 LBR 提高了一倍（40% 对 21%）。在 40 岁以上的患者中，优倍体 FET 的累积 LBR 达到 42%：返回使用其储存的卵母细胞的患者比例和临床结果与近期的其他报告一致，并对有关选择性卵母细胞冷冻用于生育力保存的普遍批评意见提出了质疑。现在的结果可与常规试管婴儿相媲美。不是每个返回使用卵母细胞的人都能受孕，但对于那些选择保留生育能力的人来说，卵母细胞冷冻可以提供可重复和令人放心的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.