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Number needed to freeze: cumulative live birth rate after fertility preservation in women with endometriosis
Reproductive BioMedicine Online ( IF 3.7 ) Pub Date : 2021-01-08 , DOI: 10.1016/j.rbmo.2020.12.013
Ana Cobo 1 , Aila Coello 1 , María José de Los Santos 1 , Juan Giles 1 , Antonio Pellicer 1 , José Remohí 1 , Juan A García-Velasco 2
Affiliation  

Research question

How does the number of oocytes used affect the cumulative live birth rate (CLBR) in endometriosis patients who had their oocytes vitrified for fertility preservation?

Design

Retrospective observational study including data from 485 women with endometriosis who underwent fertility preservation from January 2007 to July 2018. Survival curves and Kaplan–Meier plots were used to analyse the CLBR according to the number of vitrified oocytes used. Endometriosis curves were compared with plots developed using elective fertility preservation (EFP) patients as control group. Log-rank, Breslow and Tarone–Ware tests were used to compare the survival curves.

Results

The CLBR increased as the number of oocytes used per patient rose, reaching 89.5% (95% confidence interval [CI] 80.0–99.1%) using 22 oocytes. Higher outcomes were observed in young women (≤35 years old versus >35 years old). In the younger group, the CLBR was 95.4% (95% CI 87.2–103.6%) using approximately 20 oocytes versus 79.6% (95% CI 58.1–101.1%) in older women (log-rank [Mantel–Cox] P = 0.002). The mean age was higher in EFP patients (37.2 ± 4.9 versus 35.7 ± 3.7; P < 0.001). The outcome was better in the endometriosis group as compared with EFP: a CLBR of 89.5% (95% CI 80.0–99.1%) versus 59.9% (95% CI 51.4–68.6%) when 22 oocytes were used (log-rank [Mantel–Cox] P < 0.00001).

Conclusion

The probability of live birth increases as the number of oocytes used increases in patients with endometriosis, but better outcomes were observed among young women. The information provided here may be of interest to both patients and treating physicians for counselling purposes.



中文翻译:

需要冻结的数量:子宫内膜异位症女性保留生育能力后的累计活产率

研究问题

使用的卵母细胞数量如何影响子宫内膜异位症患者的卵母细胞玻璃化以保存生育能力的累积活产率 (CLBR)?

设计

回顾性观察性研究包括 2007 年 1 月至 2018 年 7 月接受生育保留的 485 名子宫内膜异位症女性的数据。根据使用的玻璃化卵母细胞数量,使用生存曲线和 Kaplan-Meier 图分析 CLBR。将子宫内膜异位症曲线与使用选择性生育保留 (EFP) 患者作为对照组绘制的图进行比较。Log-rank、Breslow 和 Tarone-Ware 检验用于比较生存曲线。

结果

随着每位患者使用的卵母细胞数量增加,CLBR 增加,使用 22 个卵母细胞达到 89.5%(95% 置信区间 [CI] 80.0-99.1%)。在年轻女性中观察到更高的结果(≤ 35 岁与 > 35 岁)。在年轻组中,使用大约 20 个卵母细胞的 CLBR 为 95.4%(95% CI 87.2-103.6%),而在老年女性中为 79.6%(95% CI 58.1-101.1%)(log-rank [Mantel-Cox] P  = 0.002 )。EFP 患者的平均年龄较高(37.2 ± 4.9 对 35.7 ± 3.7;P  < 0.001)。与 EFP 相比,子宫内膜异位症组的结果更好:当使用 22 个卵母细胞时,CLBR 为 89.5%(95% CI 80.0-99.1%)与 59.9%(95% CI 51.4-68.6%)(对数秩 [Mantel –Cox] P  < 0.00001)。

结论

随着子宫内膜异位症患者使用的卵母细胞数量的增加,活产的可能性增加,但在年轻女性中观察到更好的结果。此处提供的信息可能对患者和治疗医生感兴趣,以用于咨询目的。

更新日期:2021-01-08
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