Slow freezing, vitrification and ultra-rapid freezing of human embryos: a systematic review and meta-analysis
Slow freezing, vitrification and ultra-rapid freezing of human embryos: a systematic review and meta-analysis
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DOI：
10.1016/j.rbmo.2009.11.013
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发表时间：
2010-02-01
影响因子：
4
通讯作者：
Goldfarb, James
中科院分区：
文献类型：
--
作者：
AbdelHafez, Faten F.;Desai, Nina;Goldfarb, James
胚胎冷冻保存是辅助生殖技术的一个重要方面。许多方法已被描述，但它们在随机试验中的研究很少，突出了对文献进行系统综述的必要性。进行MEDICAL电子/手动检索，以查找比较胚胎冷冻保存方法的随机试验（RCT）。主要结果是临床妊娠率（CPR）和先天性畸形的发生率。次要结局包括活产率（LBR）、持续妊娠率（OPR）、着床率（IR）和流产率（MR）。提取数据以进行意向治疗分析，并使用随机效应模型进行分析。文献检索显示11项RCT，其中5项被排除。纳入研究的质量各不相同，但普遍较差。玻璃化冷冻组的CPR、OPR和IR显著高于慢速冷冻组（OR = 1.55，95%CI = 1.03-2.32，OR = 1.82，95%CI = 1.04-3.20和OR = 1.49，95%CI = 1.03-2.15）。此外，超快速冷冻胚胎的CPR和OPR均显著低于传统冷冻（OR = 0.35，95% CI = 0.16-0.76和OR = 0.37，95% CI = 0.17-0.81）。玻璃化冷冻上级堆装冷冻，堆装冷冻又上级超快速冷冻。然而，需要更多设计良好和有把握的研究来进一步证实这些发现。(C)2010年，爱思唯尔有限公司出版的生殖保健有限公司。版权所有。
Embryo cryopreservation is an important aspect of assisted reproduction. Many methods have been described, but they have been poorly investigated in randomized trials, highlighting the need for a systematic review of the literature. Meticulous electronic/hand searches were performed to locate randomized trials (RCT) comparing embryo cryopreservation methods. Primary outcomes were clinical pregnancy rate (CPR) and incidence of congenital abnormalities. Secondary outcomes included live-birth (LBR), ongoing pregnancy (OPR), implantation (IR), and miscarriage (MR) rates. Data were extracted to allow for an intention-to-treat analysis and analysed using a random-effects model. Literature search revealed 11 RCT, of which five were excluded. The quality of the included studies was variable, but generally poor. There was a significantly higher CPR, OPR and IR with vitrification compared with slow freezing (odds ratio (OR) = 1.55, 95% confidence interval (CI) = 1.03-2.32, OR = 1.82, 95% Cl = 1.04-3.20 and OR = 1.49, 95% CI = 1.03-2.15, respectively). In addition, there was a significantly tower CPR and OPR with embryo ultra-rapid freezing compared with stow freezing (OR = 0.35, 95% Cl = 0.16-0.76 and OR = 0.37, 95% CI = 0.17-0.81, respectively). Vitrification is superior to stow freezing, which in turn is superior to ultra-rapid freezing. However, more well-designed and powered studies are needed to further corroborate these findings. (C) 2010, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.