CAJ | 학술논문

目的探讨卵母细胞冷冻技术在临床应用.方法将258例接受体外受精-胚胎移植(IVF-ET)和单精子卵浆内注射(ICSI)治疗,取卵数≥20枚的258个周期,分为部分卵母细胞冷冻组(简称冻卵组)84个周期和胚胎冷冻组(简称冻胚组)174个周期,比较两组新鲜周期受精率和临床妊娠率.总结了23个卵母细胞冷冻复苏周期及19个移植周期(其中4个周期为捐赠周期)的复苏率,受精率,卵裂率,胚胎种植率,临床妊娠率,比较冻胚组冻胚复苏移植的临床结局.结果冻卵组和冻胚组新鲜周期的受精率和临床妊娠率差异无统计学意义(P>0.05);19个卵母细胞冷冻复苏的移植周期与56个冷冻胚胎复苏的移植周期的胚胎种植率和临床妊娠率差异亦无统计学意义(P>0.05);卵母细胞冷冻复苏的移植周期妊娠率为47.4%(9/19),其中冻卵捐赠4个移植周期,2例临床妊娠(1例已分娩).结论对于接受IVF/ICSI治疗的不孕妇女,由卵巢刺激产生的较多卵母细胞,无论是否选择冷冻部分卵母细胞,对其新鲜周期的受精率和妊娠率没有影响;冻卵移植周期与冻胚移植周期的妊娠率差异也无统计学意义;但是卵母细胞冷冻在生育力保存和分享捐赠方面较冻胚具有显著的优势.
목적 탐토란모세포냉동기술재림상응용.방법 장258례접수체외수정-배태이식(IVF-ET)화단정자란장내주사(ICSI)치료,취란수≥20매적258개주기,분위부분란모세포냉동조(간칭동란조)84개주기화배태냉동조(간칭동배조)174개주기,비교량조신선주기수정솔화림상임신솔.총결료23개란모세포냉동복소주기급19개이식주기(기중4개주기위연증주기)적복소솔,수정솔,란렬솔,배태충식솔,림상임신솔,비교동배조동배복소이식적림상결국.결과 동란조화동배조신선주기적수정솔화림상임신솔차이무통계학의의(P>0.05);19개란모세포냉동복소적이식주기여56개냉동배태복소적이식주기적배태충식솔화림상임신솔차이역무통계학의의(P>0.05);란모세포냉동복소적이식주기임신솔위47.4%(9/19),기중동란연증4개이식주기,2례림상임신(1례이분면).결론 대우접수IVF/ICSI치료적불잉부녀,유란소자격산생적교다란모세포,무론시부선택냉동부분란모세포,대기신선주기적수정솔화임신솔몰유영향;동란이식주기여동배이식주기적임신솔차이야무통계학의의;단시란모세포냉동재생육력보존화분향연증방면교동배구유현저적우세.
Objective To investigate the clinical effects of oocyte cryopreservation in assistedreproduction technology (ART). Methods 258 patients undergoing retrieval of more than 20 oocytes duringin vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) were divided into 2 groups: Group A,undergoing surplus oocytes cryopreservation (84 cycles) and Group B undergoing embryo cryopreservation(174 cycles) according to the patients' choices. Fertilization rate and clinical pregnancy rate of fresh embryotransfer cycle were compared between these two groups. Twenty-three infertile couples' frozen oocytes werethawed for further ART treatment. Among them, fifteen couples received embryo transfer using their ownfrozen-thawed oocytes, and other four couples used donated frozen-thawed oocytes. The survival rate,fertilization rate, cleavage rate, implantation rate, and clinical pregnancy rate of these 19 cycles werecompared to the outcome of 56 frozen-thawed embryo transfer cycles. Results The fertilization rate of GroupA who underwent IVF was 65.9% , not significantly different from that of Group B who received IVF(66.9%, P > 0. 05 ), and the fertilization rate of Group A who underwent ICSI was 71.6%, notsignificantly different from that of Group B who received ICSI (64.1% , P >0. 05). The clinical pregnancyrate (per embryo transfer cycle) of Group A who received IVF was 52. 9%, not significantly different fromthat of Group B who received IVF (42. 3%, P > 0. 05 ), and the clinical pregnancy rate (per embryotransfer cycle) of Group A who received ICSI was 35.5%, not significantly different from that of Group Bwho received ICSI ( 34.4%, P > 0.05 ). The clinical pregnancy rate of frozen-thawed oocyte group ( perembryo transfer cycle) was 47.4% (9/19). Four couples used donated frozen-thawed oocytes, two of themgot clinical pregnancy and one of them had term delivery. Conclusion For women who undergo retrieval ofmore than 20 oocytes in IVF/ICSI, the clinical outcome of fresh embryo transfer cycle, such as fertilizationrate and clinical pregnancy rate, are not influenced by oocyte cryopreservation and embryocryopreservation. There is no significant difference in the clinical pregnancy rate (per embryo transfer cycle)between frozen-thawed oocyte group and frozen-thawed embryo group. Compared with embryocryopreservation, oocyte cryopreservation has obvious advantages in fertility preservation and oocytedonation.