目标:为了检查趋势,特点,和供体卵母细胞胚胎移植周期的原始卵母细胞和结果胚胎状态的结果,并确定卵母细胞状态(新鲜或冷冻)是否与临床妊娠差异相关,活产,和条款,单胎活产中的正常出生体重新生儿。
方法:回顾性队列研究受试者:从2013-2020年向国家辅助生殖技术监测系统(NASS)报告的在美国接受供体卵母细胞胚胎移植周期的患者暴露:原始供体卵母细胞和由此产生的胚胎状态(新鲜或冷冻)主要结果指标:按卵母细胞周期和单个胚胎移植分层的年总供体卵母细胞胚胎移植周期和比例2013-2020年期间出生体重正常(≥2500g)的单身人士。活产率和足月率,还报告了2018-2020年单胎活产中正常出生体重的新生儿。相对风险(RR)检查供体卵母细胞状态与活产和足月之间的关联,供体卵母细胞胚胎移植周期导致的单胎活产中正常出生体重的新生儿。
结果:从2013-2020年,有135,085个供体卵母细胞胚胎移植周期,其中冷冻胚胎的比例增加(42.3%至76.6%),使用冷冻供体卵母细胞(19.9%至68.3%)和单胚胎移植(SET)(36.4%至85.5%)的新鲜胚胎。在2018-2020年期间,共有48,679个供体卵母细胞胚胎移植周期。与新鲜的供体卵母细胞相比,冷冻的活产率更低(46.2%,55.9%;RR0.83[95%CI0.79-0.87])和冷冻(41.3%,45.8%;ARR0.94[95%CI0.91-0.98])胚胎移植周期。在单胎活产中,交付期限的速度,在新鲜(77.3,77.2%;aRR1.01[95%CI0.98-1.03])和冷冻(75.6,75.1%;aRR1.02[95%CI0.99-1.04])胚胎中,冷冻正常出生体重新生儿与新鲜供体卵母细胞移植周期相似.
结论:在这项关于供体卵母细胞胚胎移植周期的全国性研究中,冷冻胚胎移植,使用冷冻卵母细胞的新鲜胚胎移植,SET增加了。尽管与新鲜卵母细胞相比,冷冻与活产率略有降低有关,利率的期限,单胎活产中正常出生体重的新生儿在供体卵母细胞状态之间具有可比性。
OBJECTIVE: To examine trends, characteristics, and outcomes of donor oocyte embryo transfer cycles by original oocyte and resultant embryo state and determine whether oocyte state (fresh or
frozen) is differentially associated with clinical pregnancy, live birth, and term, healthy birthweight neonates among singleton live births.
METHODS: Retrospective cohort study.
METHODS: National study.
METHODS: Patients undergoing donor oocyte embryo transfer cycles in the United States reporting to the National Assisted Reproductive Technology Surveillance System from 2013 to 2020. INTERVENTION(S): Original donor oocyte and resultant embryo state (fresh or
frozen).
METHODS: Annual numbers and proportions of total donor oocyte embryo transfer cycles stratified by oocyte and embryo state and single embryo transfer cycles resulting in the live birth of term (≥37 weeks gestation), healthy birthweight (≥2,500 g) singletons during 2013-2020. Rates of live birth and term, healthy birthweight neonates among singleton live births for 2018-2020 are also reported. Relative risks examine associations between donor oocyte state and live birth and term, healthy birthweight neonates among singleton live births resulting from donor oocyte embryo transfer cycles.
RESULTS: From 2013 to 2020, there were 135,085 donor oocyte embryo transfer cycles, of which the proportions increased for frozen embryos (42.3%-76.6%), fresh embryos using frozen donor oocytes (19.9%-68.3%) and single embryo transfers (36.4%-85.5%). During 2018-2020, there were 48,679 donor oocyte embryo transfer cycles. Rates of live birth were lower with frozen compared with fresh donor oocytes for both fresh (46.2%, 55.9%; adjusted relative risk [aRR], 0.83; 95% confidence interval [CI], 0.79-0.87) and
frozen (41.3%, 45.8%; aRR, 0.94; 95% CI, 0.91-0.98) embryo transfer cycles. Among singleton live births, rates of delivering a term, healthy birth weight neonate were similar for frozen compared with fresh donor oocyte transfer cycles among fresh (77.3, 77.2%; aRR, 1.01; 95% CI, 0.98-1.03) and frozen (75.6, 75.1%; aRR, 1.02; 95% CI, 0.99-1.04) embryos.
CONCLUSIONS: In this national study of donor oocyte embryo transfer cycles,
frozen embryo transfers, fresh embryo transfers using
frozen oocytes, and single embryo transfers increased. Although frozen compared with fresh oocytes were associated with a slightly reduced rate of live birth, rates of term, healthy birthweight neonates among singleton live births were comparable between donor oocyte states.