{"title":"改进的供体卵母细胞周期加热方案改善临床结果。","authors":"Chun-I Lee, Hsiu-Hui Chen, Shu-Hui Lin, Chun-Chia Huang, Pin-Yao Lin, Tsung-Hsien Lee, Ming-Jer Chen, Maw-Sheng Lee, Chien-Hong Chen","doi":"10.1186/s13048-025-01776-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"18 1","pages":"187"},"PeriodicalIF":4.2000,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357474/pdf/","citationCount":"0","resultStr":"{\"title\":\"Improved clinical outcomes with a modified warming protocol in donor oocyte cycles.\",\"authors\":\"Chun-I Lee, Hsiu-Hui Chen, Shu-Hui Lin, Chun-Chia Huang, Pin-Yao Lin, Tsung-Hsien Lee, Ming-Jer Chen, Maw-Sheng Lee, Chien-Hong Chen\",\"doi\":\"10.1186/s13048-025-01776-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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. 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引用次数: 0
摘要
背景：最近的研究试图通过缩短冷冻保存胚胎的加热时间来提高实验室效率，同时保持临床结果，尽管对卵母细胞的影响尚不清楚。因此，本研究旨在评估改良升温方案（MWP）对玻璃化供体卵母细胞胚胎发育和妊娠结局的影响。方法：本回顾性队列研究的数据收集自2019年1月至2024年8月在台湾李氏妇女医院接受供体周期（新鲜或玻璃化卵母细胞）的妇女。供体卵母细胞13103个，分为常规升温组（CWP） 8506个、MWP组（980个）和新鲜组（3617个）。结果：CWP组与MWP组卵母细胞升温后存活率相近（93.7% vs 93.9%, P < 0.05）。玻璃化加热卵母细胞和新鲜卵母细胞注射（ICSI）后卵母细胞变性率相似（2.7-3.4% vs. 2.8%）。经玻璃化加热的卵母细胞正常受精率较低（79.5-79.6% vs. 83.0%， P）。结论：本研究提示MWP提高了玻璃化加热的卵母细胞的囊胚形成潜力和妊娠结局，与新鲜卵母细胞相似。因此，MWP可以取代CWP作为优化供体周期结果的标准方案。临床试验号：不适用。
Improved clinical outcomes with a modified warming protocol in donor oocyte cycles.
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.
期刊介绍：
Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ.
Topical areas include, but are not restricted to:
Ovary development, hormone secretion and regulation
Follicle growth and ovulation
Infertility and Polycystic ovarian syndrome
Regulation of pituitary and other biological functions by ovarian hormones
Ovarian cancer, its prevention, diagnosis and treatment
Drug development and screening
Role of stem cells in ovary development and function.
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