Does oocyte banking for anticipated gamete exhaustion influence future relational and reproductive choices? A follow-up of bankers and non-bankers.
Does oocyte banking for anticipated gamete exhaustion influence future relational and reproductive choices? A follow-up of bankers and non-bankers.
复制标题
预期配子耗尽的卵母细胞储存是否会影响未来的关系和生殖选择？
作者：
Dominic Stoop;E. Maes;N. Polyzos;G. Verheyen;H. Tournaye;J. Nekkebroeck
研究问题
考虑或实际为预期配子耗尽(年龄)而执行卵母细胞库的先驱女性队列的关系状态、生殖选择和可能的遗憾的性质是什么？
摘要答案
在将卵子存入银行的女性中，只有一半的人预计未来会用到卵子，但人们对卵母细胞存库的体验是压倒性的，大多数年龄较小的银行家更愿意在更年轻的时候进行卵子存入。
已知的东西
选择冷冻卵母细胞以防止年龄相关的生育力下降的大多数女性都是单身，希望在寻找合适的伴侣时争取时间。目前尚不清楚，为什么一些候选人实际上开始了这种待遇，而另一些候选人最终却不愿冻结。既没有关于冷冻后关系状态变化的后续数据，也没有关于对所接受治疗和生殖结果的态度的后续数据。
研究设计、规模、持续时间
对2009年至2011年间来门诊就诊的140名女性进行了一项回溯性队列研究。所有女性(平均年龄36.7±SD2.62)考虑将卵母细胞保存用于年龄相关性不孕症。在第一次访问(12-45个月)至少一年后，通过电话联系妇女，让她们参加一份标准化问卷，以评估她们的实际关系和生殖状况、她们对银行和未来生育计划的态度。
参与者/材料、背景、方法
86名妇女(61.4%)至少完成了一次冷冻保存周期。非银行家包括54名女性，她们要么不愿接受治疗(n=51)，要么尝试刺激但因反应不佳而取消(n=3)。银行家的回应率为75.4%(65/86)，非银行家的回应率为55.8%(29/52)。
主要结果和机会的作用
在银行家中，50.8%的女性认为她们会在某个时候使用卵母细胞，而29.2%的女性表示，她们目前认为使用冷冻卵母细胞的可能性低于取卵时的预期。然而，尽管95.4%的人会决定再做一次，但大多数(76.0%)的人更愿意在更年轻的时候做。在银行家中，96.1%的人会向其他人推荐这种疗法。与非银行女性相比，银行女性接受的最高生育年龄更高(43.6岁比42.5岁；P<；0.05)。几乎所有的银行家和89.6%的非银行家仍然有生孩子的愿望。银行家和非银行家在经历稳定的关系(47.7%对55.2%)、尝试受孕(35.4%对44.8%)和一年内不怀孕(17.4%对15.4%)方面没有区别。
限制，谨慎的理由
这项研究的随访期有限，只有1-3年，因此没有提供有关冷冻保存的卵母细胞的生殖结果的信息。尽管大多数女性似乎对自己的怀孕机会持现实态度，但这种治疗的结果可能会影响女性对这种治疗的态度。此外，非银行家的发现不能推广到普通人群，因为在这项研究中，非银行家的控制组实际上访问了一个中心，作为潜在的银行业候选者。
这些发现的更广泛的影响
银行家和非银行家有着令人惊讶的一致的关系地位和生育选择，这表明冷冻卵母细胞似乎并没有影响女性的生活选择。这项研究提供了对预防性卵母细胞库相关的保证的重要心理方面的洞察，表现为在库后的高满意度和使用卵子的意愿的降低。
STUDY QUESTION
What is the nature of the relational status, reproductive choices and possible regret of a pioneer cohort of women that either considered or actually performed oocyte banking for anticipated gamete exhaustion (AGE)?
SUMMARY ANSWER
Only half of the women who banked oocytes anticipate using them in the future but the experience with oocyte banking is overwhelmingly positive, with the majority of AGE bankers preferring to have it performed at a younger age.
WHAT IS KNOWN ALREADY
Most women who choose to cryopreserve oocytes for the prevention of age-related fertility decline are single and are hoping to buy time in their search for a suitable partner. The question of why some candidates actually embark on such treatment while others eventually prefer not to freeze remains unclear. There are no follow-up data available either on post-freezing changes in relational status, or on attitude towards the undergone treatment and the reproductive outcome.
STUDY DESIGN, SIZE, DURATION
A retrospective cohort study was performed with 140 women who visited the outpatient clinic between 2009 and 2011. All women (mean age 36.7 ± SD 2.62) considered oocyte preservation for age-related infertility. At least 1 year after their initial visit (range 12-45 months), women were contacted by phone to participate in a standardized questionnaire developed to evaluate their actual relational and reproductive situation, their attitude towards banking and future reproductive plan.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Eighty-six women (61.4%) completed at least one cryopreservation cycle. The non-bankers included 54 women who either preferred no treatment (n = 51) or attempted stimulation but cancelled because of poor response (n = 3). The response rate among bankers was 75.4% (65/86) while 55.8% (29/52) of the non-bankers were reached for interview.
MAIN RESULTS AND THE ROLE OF CHANCE
Among bankers, 50.8% of women think they will use the oocytes at some point, while 29.2% indicated that they currently consider the use of frozen oocytes less likely than anticipated at time of oocyte retrieval. However, although 95.4% would decide to do it again, the majority (76.0%) would prefer to do it at a younger age. Among bankers, 96.1% would recommend the treatment to others. Women who banked accept a higher maximum age for motherhood when compared with non-bankers (43.6 versus 42.5 years; P < 0.05). Almost all bankers and 89.6% of the non-bankers still have a desire for a child. Bankers and non-bankers did not differ in terms of experiencing steady relations (47.7 versus 55.2%), attempting conception (35.4 versus 44.8%) and not conceiving within 1 year (17.4 versus 15.4%).
LIMITATIONS, REASONS FOR CAUTION
The study has a limited follow-up of 1-3 years and therefore does not provide information on the reproductive outcome of the cryopreserved oocytes. Although most women appear to be realistic about their chances of pregnancy, the outcome of such treatment could affect the attitude of women towards the treatment. Furthermore, the findings of non-bankers cannot be generalized to the general population because the control group of non-bankers in this study actually visited a centre as a potential candidate for banking.
WIDER IMPLICATIONS OF THE FINDINGS
Bankers and non-bankers have a surprising congruent relational status and reproductive choices, indicating that freezing oocytes does not appear to influence the life choices of the women. The study provides insights into the important psychological aspect of reassurance associated with preventive oocyte banking, expressed by high satisfaction after banking in combination with a decreased intention of ever using the eggs.