Oocyte vitrification does not increase the risk of embryonic aneuploidy or diminish the implantation potential of blastocysts created after intracytoplasmic sperm injection: a novel, paired randomized controlled trial using DNA fingerprinting
Oocyte vitrification does not increase the risk of embryonic aneuploidy or diminish the implantation potential of blastocysts created after intracytoplasmic sperm injection: a novel, paired randomized controlled trial using DNA fingerprinting
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DOI：
10.1016/j.fertnstert.2012.04.028
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发表时间：
2012-09-01
影响因子：
6.7
通讯作者：
Scott, Richard T., Jr.
中科院分区：
文献类型：
--
作者：
Forman, Eric J.;Li, Xinying;Scott, Richard T., Jr.
目的：通过比较单个患者在单个周期和单次新鲜移植中的玻璃化卵母细胞和对照卵母细胞，评估卵母细胞玻璃化冷冻对非整倍体和生殖潜力的影响。设计：配对随机对照试验，其中每个患者的成熟卵母细胞队列被分为两个偶数组，一半接受Cryotop玻璃化冷冻和快速升温，一半作为对照。设置：生殖医学学术中心。患者：44例患者，平均年龄29.9 ± 2.3岁，卵巢储备正常。干预：一半成熟卵母细胞的Cryotop玻璃化冷冻。滋养外胚层活检与单核苷酸多态性微阵列分析倍性和DNA fingerprinting.Main结局措施：率的非整倍体（主要结果），受精，卵裂，囊胚形成，并在来自玻璃化和对照卵母细胞的胚胎植入。在玻璃化冷冻后存活的卵母细胞中，卵胞浆内单精子注射的受精率较低（77.9% vs. 90.5%;相对风险[RR]，0.86; 95%置信区间[CI]，0.80-0.93），较低的卵裂率（90.9% vs. 99.2%; RR，0.92; 95%CI，0.87-0.96），以及每两个原核的可用囊胚形成率较低（34.8% vs. 50.8%; RR，0.68; 95%CI，0.54-0.86）。胚胎非整倍体率无差异（玻璃化冷冻，29.1% vs.对照，26.4%）。在配对囊胚移植中，每个移植胚胎的持续妊娠率相似（玻璃化冷冻，53.9%与对照，57.7%）。结论：尽管卵母细胞玻璃化冷冻后IVF过程效率较低，但植入率相当，并且没有增加非整倍体的风险。鉴于缺乏其他可行的选择，这项研究为应用卵母细胞玻璃化冷冻保存生育能力的患者和临床医生提供了极大的保证。（Fertil Steril（R）2012; 98：644-9. (C)美国生殖医学会（American Society for Reproductive Medicine）
Objective: To assess the impact of oocyte vitrification on aneuploidy and reproductive potential by comparing vitrified and control oocytes from a single patient within a single cycle and a single fresh transfer.Design: Paired randomized controlled trial in which each patient's cohort of mature oocytes was divided into two even groups with half undergoing Cryotop vitrification and rapid warming and half serving as controls.Setting: Academic center for reproductive medicine.Patient(s): Forty-four patients with a mean age of 29.9 +/- 2.3 years and normal ovarian reserve.Intervention(s): Cryotop vitrification of half of mature oocytes. Trophectoderm biopsy with single nucleotide polymorphism microarray analysis for ploidy and DNA fingerprinting.Main Outcome Measure(s): Rate of aneuploidy (primary outcome), fertilization, cleavage, blastulation, and implantation in embryos derived from vitrified and control oocytes.Result(s): A total of 588 mature oocytes were randomized, with 240/294 (81.6%) surviving vitrification. Among surviving vitrified oocytes, there was a lower fertilization rate with intracytoplasmic sperm injection (77.9% vs. 90.5%; relative risk [RR], 0.86; 95% confidence interval [CI], 0.80-0.93), a lower cleavage rate (90.9% vs. 99.2%; RR, 0.92; 95% CI, 0.87-0.96), and a lower usable blastocyst formation rate per two pronuclei (34.8% vs. 50.8%; RR, 0.68; 95% CI, 0.54-0.86). There was no difference in the rate of embryonic aneuploidy (vitrified, 29.1% vs. control, 26.4%). In paired blastocyst transfers, the ongoing pregnancy rate per embryo transferred was similar (vitrified, 53.9% vs. control, 57.7%).Conclusion(s): Although the IVF process is less efficient after oocyte vitrification, implantation rates are equivalent and there is no increased risk of aneuploidy. Given the lack of other viable options, this study provides great reassurance to patients and clinicians applying oocyte vitrification for fertility preservation. (Fertil Steril (R) 2012; 98: 644-9. (C) 2012 by American Society for Reproductive Medicine.)