冷凍卵子並不明顯增加胚胎之畸形率，亦不降低胚胎之著床率‧
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.
Source
Reproductive Medicine Associates of New Jersey, Morristown, New Jersey; Division of Reproductive Endocrinology, Department of Obstetrics, Gynecology and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Abstract
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.
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