卵子冷凍後解凍再做ICSI之臨床結果與新鮮卵子做ICSI之臨床結果相同
玻璃化冷凍約於HCG施打完後37-40h施行
解凍完2h施行ICSI
http://humrep.oxfordjournals.org/content/25/1/66.full
Cumulative ongoing pregnancy rate achieved with oocyte vitrification and cleavage stage transfer without embryo selection in a standard infertility program
- Filippo Ubaldi1,
- Reno Anniballo2,
- Stefania Romano1,
- Elena Baroni1,
- Laura Albricci1,
- Silvia Colamaria1,
- Antonio Capalbo1,
- Fabio Sapienza1,
- Gábor Vajta3 and
- Laura Rienzi1,*
+Author Affiliations
- *Correspondence address. E-mail: rienzi@generaroma.it
- Received December 9, 2009.
- Revision received January 13, 2010.
- Accepted January 20, 2010.
Abstract
BACKGROUND Recent advancement of minimum volume vitrification methods has resulted in a dramatic increase in the efficiency of the process. The aim of this study was to estimate the cumulative reproductive outcome of a cohort of infertile couples undergoing ICSI and oocyte vitrification in restrictive legal conditions, where only a limited number of oocytes could be inseminated per cycle and embryo selection and cryopreservation were forbidden.
METHODS In this prospective longitudinal cohort study, the cumulative ongoing pregnancy rates obtained by the insemination of fresh and vitrified oocytes from the same cohort were calculated as primary outcome measures. Moreover, the effect of basal and cycle characteristics on clinical outcomes were assessed.
RESULTS Between September 2008 and May 2009, 182 ICSI cycles were performed where oocyte vitrification was possible. A total of 104 first and 11 second oocyte warming cycles were then performed in non-pregnant patients of the same cohort. The overall ongoing pregnancy rates obtained in the fresh, and first and second warming cycles were 37.4, 25.0 and 27.3%, respectively. The overall cumulative ongoing clinical pregnancy rate observed per stimulation cycle was 53.3%. Maternal age was the only characteristic found to influence the reproductive outcome, with an inverse correlation between the age >40 and the ongoing pregnancy rates (P = 0.04, by Cox regression analysis).
Embryo development of fresh ‘versus’ vitrified metaphase II oocytes after ICSI: a prospective randomized sibling-oocyte study
Table III
Primary and secondary outcomes measures: fertilization, pronuclear morphology, embryo development and embryo morphology of fresh and vitrified sibling oocytes
| Fresh ICSI | Vitrified/Warmed ICSI (%) | Absolute difference (%) (95% CI) | OR (95% CI) | P | |
|---|---|---|---|---|---|
| Fertilization (2PN) per sibling oocyte | 100/120 (83.3)b | 95/124 (76.6)a | −6.73 (−16.6 to 3.39) | 0.65 (0.33 to 1.29) | 0.20 |
| Fertilization (2PN) per injected oocyte | 100/120 (83.3)b | 95/120 (79.2)b | −4.17 (−14.0 to 5.7) | 0.76 (0.37 to 1.53) | 0.50 |
| Normal 2PN morphology | 96/100 (96.0)c | 86/95 (90.5)c | −5.47 (−13.4 to 1.84) | 0.39 (0.08 to 1.49) | 0.16 |
| 1PN oocytes | 3/120 (2.5)b | 6/120 (5.0)b | 2.5 (−2.82 to 8.22) | 2.05 (0.42 to 12.9) | 0.50 |
| 3PN | 1/120 (0.83)b | 2/120 (1.66)b | 0.83 (−3.09 to 5.1) | 2.01 (0.10 to 119.9) | 1 |
| Degenerated oocytes post-ICSI | 1/120 (0.83)b | 4/120 (3.34)b | 2.51 (−1.75 to 7.47) | 4.08 (0.39 to 203.5) | 0.37 |
| Day 2 embryo development | 100/100 (100)c | 93/95 (97.9)c | −2,11 (−7.3 to 1.9) | 0.0 (0.00 to 0.23) | 0.24 |
| Excellent quality embryos | 52/100 (52.0)d | 49/95 (51.6)d | −0.43 (−14.2 to 13.3) | 0.98 (0.53 to 1.79) | 0.90 |
| Good quality embryos | 38/100 (38.0)d | 41/95 (43.2)d | 5.16 (−8.49 to 18.6) | 1.24 (0.67 to 2.28) | 0.47 |
| Fair/poor quality embryos | 10/100 (10.0)d | 3/95 (3.16)d | −6.84 (−14.6 to 0.42) | 0.29 (0.05 to 1.19) | 0.10 |
- aPercentages, expressed per warmed oocyte.
- bPercentages, expressed per inseminated oocyte.
- cPercentages, expressed per 2PN fertilized oocyte.
- dPercentages, expressed per cleaved oocyte.
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