挤压和冷冻,一种针对卵巢反应不良的定期连续卵母细胞回收方法,增加了生育的机会

Yasutaka Murata, Fumika Oda, M. Shirai, Nanako Sato, A. Sugita, T. Murata
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摘要

目的探讨连续三次以上的卵母细胞回收(OR)是否能有效获得适能胚胎成为婴儿。方法为使难治性不孕症患者的妊娠机会最大化,我们设计了一种新的治疗方案“挤压冷冻”。该方法在连续3个月的时间内,无论月经周期处于哪个阶段,只要超声能看到卵泡,就开始刺激卵巢,目的是回收所有可能的卵母细胞,收集最多数量的能态胚胎用于后续移植。88例患者共101个疗程,平均取药4.8次,疗程3个月。回顾性分析临床结果和产科结局。结果成熟卵母细胞、2PN胚胎、可得胚胎、每卵母细胞公平囊胚的比例以及每次可得胚胎或公平囊胚的数量在两次初始和后期尝试之间没有差异。同样,在卵泡期和黄体期的这些参数中也没有观察到显著差异。在随后的胚胎移植后,62例患者实现临床妊娠,49例持续妊娠,47例分娩健康婴儿,8例怀孕二胎。结论周期性连续手术是治疗难治性不孕症的有效方法。在这种方法中,在患者生命的最初阶段,在有限的时间内获得尽可能多的卵母细胞。连续3次以上,包括黄体期,可有效获得适能胚胎,增加了生育机会。
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Squeeze and Freeze, A Periodic Consecutive Oocyte Retrieval Method for Poor Ovarian Responders, Increases The Chance of Childbearing
Purpose To assess if consecutive oocyte retrieval (OR) of more than three times could be an effective method to obtain competent embryos becoming babies. Methods To maximize the chances of pregnancy for refractory infertile women, we designed a new treatment course, “Squeeze and freeze.” In this method, ovarian stimulation was initiated whenever the antral follicle was visible using ultrasound, regardless of the menstrual cycle stage for 3 months, aiming to retrieve all possible oocytes and collecting the maximum number of competent embryos for subsequent transfer. Eighty-eight patients underwent 101 treatment courses, in which retrievals at an average of 4.8 times were performed for 3 months. The clinical results and obstetric outcomes were retrospectively reviewed. Results The ratio of matured oocytes, 2PN embryos, available embryos, fair blastocysts per oocyte, and number of available embryos or fair blastocysts per retrieval did not differ between the two initial and later attempts. Similarly, no significant differences were observed in these parameters between the follicular- and luteal-phase retrievals. After subsequent embryo transfer, 62 patients achieved clinical pregnancy, 49 had an ongoing pregnancy, 47 delivered healthy babies, and 8 conceived a second baby. Conclusion Periodic consecutive OR is an efficient infertility treatment for refractory women. In this method, as many oocytes as possible are obtained from a patient in a limited period at the earliest stage of their life. More than three consecutive ORs, including luteal-phase ORs, could obtain competent embryos efficiently, increasing the chances of childbearing.
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