Fertility and sterility · 2020
Reproductive outcomes after in vitro fertilization treatment in a cohort of Danish women transplanted with cryopreserved ovarian tissue.
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Dueholm Hjorth Ina Marie, Kristensen Stine Gry, Dueholm Margit, Humaidan Peter
Аннотация
OBJECTIVE: To evaluate ovarian stimulation regimens and reproductive outcomes in a cohort of women undergoing ovarian tissue cryopreservation (OTC) and ovarian tissue transplantation (OTT).
DESIGN: Retrospective cohort study.
SETTING: University hospital and fertility clinics.
PATIENTS: Twenty-eight women undergoing OTT and in vitro fertilization (IVF) from 2012 to 2017.
INTERVENTION: OTC, OTT, and IVF.
MAIN OUTCOME MEASURES: Ovarian stimulation and IVF outcomes.
RESULTS: In total, 99 cycles were performed in 28 patients. In 19 patients responding to stimulation, a median of 3.0 cycles per patient (range: 1-14 cycles) was performed, and 2.0 mature oocytes were retrieved per cycle. The empty follicle rate was 35.9%. Eleven women achieved 15 pregnancies, of which 60% were lost during the first or second trimester, resulting in 5 of 28 women having ≥1 live births, and seven healthy children being born. In breast cancer patients (mean age at OTC: 33.0 years), the pregnancy rates (PR) and live birth rates (LBR) were 35.0% and 5.0% per embryo transfer, respectively. Patients aged ≥34.5 years at OTC all had breast cancer and did not achieve any pregnancies. For all other diagnoses (mean age at OTC: 26.6 years), PR and LBR were 50.0% and 37.5% per embryo transfer, respectively. Collectively, 39% of patients conceived at least once, and 17.9% delivered. Frozen-thawed embryo transfer (FET) resulted in more pregnancies than did fresh embryo transfer.
CONCLUSION: Our results suggest that women of advanced maternal age undergoing OTC and IVF have a poor ovarian reserve, resulting in a poor reproductive outcome. Interestingly, FET appeared to be superior to fresh transfer.
DESIGN: Retrospective cohort study.
SETTING: University hospital and fertility clinics.
PATIENTS: Twenty-eight women undergoing OTT and in vitro fertilization (IVF) from 2012 to 2017.
INTERVENTION: OTC, OTT, and IVF.
MAIN OUTCOME MEASURES: Ovarian stimulation and IVF outcomes.
RESULTS: In total, 99 cycles were performed in 28 patients. In 19 patients responding to stimulation, a median of 3.0 cycles per patient (range: 1-14 cycles) was performed, and 2.0 mature oocytes were retrieved per cycle. The empty follicle rate was 35.9%. Eleven women achieved 15 pregnancies, of which 60% were lost during the first or second trimester, resulting in 5 of 28 women having ≥1 live births, and seven healthy children being born. In breast cancer patients (mean age at OTC: 33.0 years), the pregnancy rates (PR) and live birth rates (LBR) were 35.0% and 5.0% per embryo transfer, respectively. Patients aged ≥34.5 years at OTC all had breast cancer and did not achieve any pregnancies. For all other diagnoses (mean age at OTC: 26.6 years), PR and LBR were 50.0% and 37.5% per embryo transfer, respectively. Collectively, 39% of patients conceived at least once, and 17.9% delivered. Frozen-thawed embryo transfer (FET) resulted in more pregnancies than did fresh embryo transfer.
CONCLUSION: Our results suggest that women of advanced maternal age undergoing OTC and IVF have a poor ovarian reserve, resulting in a poor reproductive outcome. Interestingly, FET appeared to be superior to fresh transfer.
Предметные рубрики MeSH
Abortion, SpontaneousAdolescentAdultCancer SurvivorsCryopreservationDenmarkEmbryo TransferFemaleFertility PreservationFertilization in VitroHumansInfertility, FemaleLive BirthOocyte RetrievalOvarian ReserveOvaryOvulation InductionPregnancyPregnancy RateReproductive Techniques, AssistedRetrospective StudiesTransplantation, AutologousTreatment OutcomeYoung Adult