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Age-specific probability of live birth with oocyte cryopreservation: An individual patient data meta-analysis

机译:卵母细胞冷冻保存的特定年龄活产概率:个别患者数据的荟萃分析

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Objective: To estimate age-specific probabilities of live birth with oocyte cryopreservation in nondonor (ND) egg cycles. Design: Individual patient data meta-analysis. Setting: Assisted reproduction centers. Patient(s): Infertile patients undergoing ND mature oocyte cryopreservation. Intervention(s): PubMed was searched for clinical studies on oocyte cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen-thawed mature oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data. Main Outcome Measure(s): Live birth probabilities based on age, cryopreservation method, and the number of oocytes thawed, injected, or embryos transferred. Result(s): Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified oocytes, respectively. Estimated probabilities of live birth for vitrified oocytes were higher than those for slowly frozen. Conclusion(s): The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering oocyte cryopreservation. Given the success probabilities, we suggest that policy makers should consider oocyte freezing as an integral part of prevention and treatment of infertility.
机译:目的:评估在非供体(ND)卵周期中卵母细胞冷冻保存的活产的年龄特异性概率。设计:个体患者数据荟萃分析。地点:辅助生殖中心。患者:接受ND成熟卵母细胞冷冻保存的不育患者。干预措施:检索1996年1月至2011年7月间PubMed进行卵母细胞冷冻保存的临床研究。包括使用ND冻融成熟卵母细胞并具有妊娠结局的随机和非随机研究。与合格研究的作者联系以获得个人患者数据。主要观察指标:根据年龄,冷冻保存方法以及融化,注射或转移的卵母细胞数确定的活产概率。结果:10项研究的原始数据包括1,805例患者的2,265个周期。无论采用哪种冷冻技术,活产成功率均随着年龄的增长而下降。尽管有这种年龄引起的折衷,活产仍持续到42岁和44岁,分别是缓慢冷冻和玻璃化的卵母细胞。玻璃化卵母细胞的活产估计概率高于缓慢冷冻的卵母细胞。结论:我们计算的活产概率将为考虑卵母细胞冷冻保存的不育妇女提供更准确的咨询和明智的决定。考虑到成功的可能性,我们建议政策制定者应考虑将卵母细胞冷冻作为预防和治疗不孕症不可或缺的一部分。

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