您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (9): 12-18.doi: 10.6040/j.issn.1671-7554.0.2022.0794

• 生育力保护专题 • 上一篇    下一篇

胚胎冷冻保存技术及进展

石玉华1,潘烨2,谢燕秋1   

  1. 1. 广东省人民医院生殖医学科, 广东省医学科学院, 广东 广州 510080;2.首都医科大学附属北京朝阳医院生殖医学中心, 北京 100020
  • 发布日期:2022-09-02
  • 通讯作者: 石玉华. E-mail:shiyuhua2003@126.com
  • 基金资助:
    国家重点研发计划项目(2021YFC2700404,2018YFC1003202)

Latest advances of embryo cryopreservation technology

SHI Yuhua1, PAN Ye2, XIE Yanqiu1   

  1. 1. Department of Reproductive Medicine, Guangdong Provincial Peoples Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China;
    2. Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Published:2022-09-02

摘要: 随着冷冻保存技术的发展,胚胎的冷冻保存在生殖医学中的地位越来越重要,已成为辅助生殖的核心步骤及生育力保存的重要方法。过去几年中,全球范围内胚胎冷冻周期数呈指数级增长。胚胎冷冻的优点不断凸显,冻胚移植越来越受人们的关注。如何完善胚胎冷冻技术及如何改善临床结局是目前关注的重点及努力的方向。因此,本文从胚胎冷冻技术的发展历程、应用、分类及目前研究进展几个方面进行全面述评。

关键词: 辅助生殖技术, 胚胎冷冻保存, 玻璃化冷冻, 生育力保存

Abstract: With the development of cryopreservation technology, embryo cryopreservation has become the core step of assisted reproduction and an important method of fertility preservation. The number of embryo freezing cycles has increased dramatically all over the world in the past few years. Thanks to the outstanding advantages of embryo freezing, frozen embryo transfer has attracted more and more attention. How to improve embryo freezing technology and improve clinical outcomes are the current research hotspots. Therefore, this paper will make a comprehensive review of the development history, application, classification and current research progress of embryo freezing technology.

Key words: Assisted reproductive technology, Embryo cryopreservation, Vitrification freezing, Fertility preservation

中图分类号: 

  • R711.6
[1] Jang TH, Park SC, Yang JH, et al. Cryopreservation and its clinical applications[J]. Integr Med Res, 2017, 6(1): 12-18.
[2] Kushnir VA, Barad DH, Albertini DF, et al. Systematic review of worldwide trends in assisted reproductive technology 2004—2013[J]. Reprod Biol Endocrinol, 2017, 15(1): 6.
[3] Zhang J, Tian Y. Housework division and second-child fertility anxiety among couples in China: the urban and rural differences[J]. Int J Environ Res Public Health, 2019, 16(20): E3910.
[4] Trottmann M, Becker AJ, Stadler T, et al. Semen quality in men with malignant diseases before and after therapy and the role of cryopreservation[J]. Eur Urol, 2007, 52(2): 355-367.
[5] Gracia CR, Chang J, Kondapalli L, et al. Ovarian tissue cryopreservation for fertility preservation in cancer patients: successful establishment and feasibility of a multidisciplinary collaboration[J]. J Assist Reprod Genet, 2012, 29(6): 495-502.
[6] 梁晓燕, 李晶洁. 女性生育力保存技术[J]. 中国实用妇科与产科杂志, 2022, 38(6): 596-599. LIANG Xiaoyan, LI Jingjie. Female fertility preservation technology[J]. ZhongGuo ShiYong FuKe Yu Chanke ZaZhi, 2022, 38(6): 596-599.
[7] Bedoschi G, Oktay K. Current approach to fertility preservation by embryo cryopreservation[J]. Fertil Steril, 2013, 99(6): 1496-1502.
[8] Nagy ZP, Shapiro D, Chang CC. Vitrification of the human embryo: a more efficient and safer in vitro fertilization treatment[J]. Fertil Steril, 2020, 113(2): 241-247.
[9] Archer DL. Freezing: an underutilized food safety technology?[J]. Int J Food Microbiol, 2004, 90(2): 127-138.
[10] Whittingham DG, Leibo SP, Mazur P. Survival of mouse embryos frozen to -196 degrees and -269 degrees C[J]. Science(New York, N.Y.), 1972, 178(4059): 411-414.
[11] Wilmut I, Rowson LE. The successful low-temperature preservation of mouse and cow embryos[J]. J Reprod Fertil, 1973, 33(2): 352-353.
[12] Bank H, Maurer RR. Survival of frozen rabbit embryos[J]. Exp Cell Res, 1974, 89(1): 188-196.
[13] Willadsen SM, Polge C, Rowson LE, et al. Deep freezing of sheep embryos[J]. J Reprod Fertil, 1976, 46(1): 151-154.
[14] Yamamoto Y, Oguri N, Tsutsumi Y, et al. Experiments in the freezing and storage of equine embryos[J]. J Reprod Fertil Suppl, 1982, 32: 399-403.
[15] Trounson A, Mohr L. Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo[J]. Nature, 1983, 305(5936): 707-709.
[16] Zeilmaker GH, Alberda AT, van Gent I, et al. Two pregnancies following transfer of intact frozen-thawed embryos[J]. Fertil Steril, 1984, 42(2): 293-296.
[17] Rall WF, Fahy GM. Ice-free cryopreservation of mouse embryos at -196 degrees C by vitrification[J]. Nature, 1985, 313(6003): 573-575.
[18] Trounson A, Peura A, Kirby C. Ultrarapid freezing: a new low-cost and effective method of embryo cryopreservation[J]. F Fertil Steril, 1987, 48(5): 843-850.
[19] Mukaida T, Wada S, Takahashi K, et al. Vitrification of human embryos based on the assessment of suitable conditions for 8-cell mouse embryos[J]. Human Reproduction, 1998, 13(10): 2874-2879.
[20] 王雁林, 朱桂金. 三种冻贮细管对人三原核卵裂期胚胎玻璃化冷冻的影响[J]. 生殖与避孕, 2006, 26(8): 500-503.
[21] Bosch E, De Vos M, Humaidan P. The future of cryopreservation in assisted reproductive technologies[J]. Front Endocrinol(Lausanne), 2020, 11(2): 67.
[22] Kalinderis M, Kalinderi K, Srivastava G, et al. When should we freeze embryos? current data for fresh and frozen embryo replacement IVF cycles[J]. Reprod Sci, 2021, 28(11): 3061-3072.
[23] Chen ZJ, Shi Y, Sun Y, et al. Fresh versus frozen embryos for infertility in the polycystic ovary syndrome[J]. N Engl J Med, 2016, 375(6): 523-533.
[24] Shi Y, Sun Y, Hao C, et al. Transfer of Fresh versus Frozen Embryos in Ovulatory Women[J]. N Engl J Med, 2018, 378(2): 126-136.
[25] Wei D, Liu JY, Sun Y, et al. Frozen versus fresh single blastocyst transfer in ovulatory women: a multicentre, randomised controlled trial[J]. The Lancet, 2019, 393(10178): 1310-1318.
[26] 全松, 黄国宁, 孙海翔, 等. 冷冻胚胎保存时限的中国专家共识[J]. 生殖医学杂志, 2018, 27(10): 925-931. QUAN Song, HUANG Guoning, SUN Haixiang, et al. CSRM committee opinions regarding the time limit of embryo cryopreservation[J]. Journal of Reproductive Medicine, 2018, 27(10): 925-931.
[27] Wang A, Santistevan A, Hunter Cohn K, et al. Freeze-only versus fresh embryo transfer in a multicenter matched cohort study: contribution of progesterone and maternal age to success rates[J]. Fertil Steril, 2017, 108(2): 254-261.
[28] Michelmann HW, Nayudu P. Cryopreservation of Human Embryos[J]. Cell Tissue Bank, 2006, 7(2): 135-141.
[29] Coates A, Kung A, Mounts E, et al. Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial[J]. Fertil Steril, 2017, 107(3): 723-730.
[30] Papaleo E, Pagliardini L, Vanni VS, et al. A direct healthcare cost analysis of the cryopreserved versus fresh transfer policy at the blastocyst stage[J]. Reprod Biomed Online, 2017, 34(1): 19-26.
[31] Roque M, Valle M, Guimarães F, et al. Cost-Effectiveness of the Freeze-All Policy[J]. JBRA Assist Reprod, 2015, 19(3): 125-130.
[32] Burns KC, Hoefgen H, Strine A, et al. Fertility preservation options in pediatric and adolescent patients with cancer[J]. Cancer, 2018, 124(9): 1867-1876.
[33] Donnez J, Dolmans MM. Fertility preservation in women[J]. N Engl J Med, 2017, 377(17): 1657-1665.
[34] Borgström B, Birgit B, Hreinsson J, et al. Fertility preservation in girls with turner syndrome: prognostic signs of the presence of ovarian follicles[J]. J Clin Endocrinol Metab, 2009, 94(1): 74-80.
[35] Karlsson JO, Toner M. Long-term storage of tissues by cryopreservation: critical issues[J]. Biomaterials, 1996, 17(3): 243-256.
[36] Pegg DE. Principles of cryopreservation[J]. Methods Mol Biol, 2007, 368: 39-57.
[37] Rodriguez-Wallberg KA, Waterstone M, Anastácio A. Ice age: cryopreservation in assisted reproduction-an update[J]. Reprod Biol, 2019, 19(2): 119-126.
[38] Edgar DH, Gook DA. A critical appraisal of cryopreservation(slow cooling versus vitrification)of human oocytes and embryos[J]. Hum Reprod Update, 2012, 18(5): 536-554.
[39] Barg PE, Barad DH, Feichtinger W. Ultrarapid freezing(URF)of mouse and human preembryos: a modified approach[J]. J In Vitro Fert Embryo Transf, 1990, 7(6): 355-357.
[40] Feichtinger W, Hochfellner C, Ferstl U. Clinical experience with ultra-rapid freezing of embryos[J]. Hum Reprod, 1991, 6(5): 735-736.
[41] Trounson A, Peura A, Freemann L, et al. Ultrarapid freezing of early cleavage stage human embryos and eight-cell mouse embryos[J]. Fertility and Sterility, 1988, 49(5): 822-826.
[42] van den Abbeel E, van der Elst J, van der Linden M, et al. High survival rate of one-cell mouse embryos cooled rapidly to -196 degrees C after exposure to a propylene glycol-dimethylsulfoxide-sucrose solution[J]. Cryobiology, 1997, 34(1): 1-12.
[43] AbdelHafez FF, Desai N, Abou-Setta AM, et al. Slow freezing, vitrification and ultra-rapid freezing of human embryos: a systematic review and meta-analysis[J]. Reprod Biomed Online, 2010, 20(2): 209-222.
[44] Mazur P. Freezing of living cells: mechanisms and implications[J]. Am J Physiol, 1984, 247(3 Pt 1): C125-142.
[45] Balaban B, Urman B, Ata B, et al. A randomized controlled study of human Day 3 embryo cryopreservation by slow freezing or vitrification: vitrification is associated with higher survival, metabolism and blastocyst formation[J]. Hum Reprod, 2008, 23(9): 1976-1982.
[46] Liebermann J. Chapter 11 Human Embryo Vitrification[J]. Methods Mol Biol, 2017, 1568: 141-159.
[47] Yurchuk T, Petrushko M, Fuller B. Science of cryopreservation in reproductive medicine-Embryos and oocytes as exemplars[J]. Early Hum Dev, 2018, 126: 6-9.
[48] Zheng X, Chen Y, Yan J, et al. Effect of repeated cryopreservation on human embryo developmental potential[J]. Reprod Biomed Online, Elsevier, 2017, 35(6): 627-632.
[49] Dolmans MM, Manavella DD. Recent advances in fertility preservation[J]. J Obstet Gynaecol Res, 2019, 45(2): 266-279.
[50] Stehlik E, Stehlik J, Katayama KP, et al. Vitrification demonstrates significant improvement versus slow freezing of human blastocysts[J]. Reprod Biomed Online, 2005, 11(1): 53-57.
[51] Mukaida T, Oka C. Vitrification of oocytes, embryos and blastocysts[J]. Best Pract Res Clin Obstet Gynaecol, 2012, 26(6): 789-803.
[52] Wale PL, Gardner DK. The effects of chemical and physical factors on mammalian embryo culture and their importance for the practice of assisted human reproduction[J]. Hum Reprod Update, 2016, 22(1): 2-22.
[53] Lovelock JE. The mechanism of the protective action of glycerol against haemolysis by freezing and thawing[J]. Biochim Biophys Acta, 1953, 11(1): 28-36.
[54] Bojic S, Murray A, Bentley BL, et al. Winter is coming: the future of cryopreservation[J]. BMC Biol, 2021, 19(1): 56.
[55] Correia LFL, Alves BRC, Batista RITP, et al. Antifreeze proteins for low-temperature preservation in reproductive medicine: A systematic review over the last three decades[J]. Theriogenology, 2021, 176: 94-103.
[56] Wowk B, Leitl E, Rasch CM, et al. Vitrification enhancement by synthetic ice blocking agents[J]. Cryobiology, 2000, 40(3): 228-236.
[57] Wowk B, Fahy GM. Inhibition of bacterial ice nucleation by polyglycerol polymers[J]. Cryobiology, 2002, 44(1): 14-23.
[58] Sun H, Glasmacher B, Hofmann N. Compatible solutes improve cryopreservation of human endothelial cells[J]. Cryo Letters, 2012, 33(6): 485-493.
[59] Hashimoto S, Amo A, Hama S, et al. A closed system supports the developmental competence of human embryos after vitrification: Closed vitrification of human embryos[J]. J Assist Reprod Genet, 2013, 30(3): 371-376.
[60] Papatheodorou A, Vanderzwalmen P, Panagiotidis Y, et al. How does closed system vitrification of human oocytes affect the clinical outcome? A prospective, observational, cohort, noninferiority trial in an oocyte donation program[J]. Fertil Steril, 2016, 106(6): 1348-1355.
[61] Bielanski A, Vajta G. Risk of contamination of germplasm during cryopreservation and cryobanking in IVF units [J]. Hum Reprod, 2009, 24(10): 2457-2467.
[62] 高洁, 姜啸, 崔琳琳. 配子及胚胎冷冻对子代远期健康影响的研究进展[J]. 现代妇产科进展, 2022, 31(4): 316-318.
[63] Cai H, Niringiyumukiza JD, Li Y, et al. Open versus closed vitrification system of human oocytes and embryos: a systematic review and meta-analysis of embryologic and clinical outcomes[J]. Reprod Biol Endocrinol, 2018, 16(1): 123.
[64] Hiraoka K, Hiraoka K, Kinutani M, et al. Blastocoele collapse by micropipetting prior to vitrification gives excellent survival and pregnancy outcomes for human day 5 and 6 expanded blastocysts[J]. Hum Reprod, 2004, 19(12): 2884-2888.
[65] Boyard J, Reignier A, Chtourou S, et al. Should artificial shrinkage be performed prior to blastocyst vitrification? A systematic review of the literature and meta-analysis[J]. Hum Fertil(Camb), 2022, 25(1): 24-32.
[1] 郝桂敏,罗卓野,王奕卓. 生育力保存的伦理问题及思考[J]. 山东大学学报 (医学版), 2022, 60(9): 47-52.
[2] 林芸,谢燕秋. 乳腺癌患者生育力保护及保存[J]. 山东大学学报 (医学版), 2022, 60(9): 42-46.
[3] 颜磊,岳彩欣,刘懿淳. 子宫内膜异位症的生育力保护[J]. 山东大学学报 (医学版), 2022, 60(9): 31-34.
[4] 石玉华,王秋敏,戚丹. 辅助生殖技术前沿研究热点及进展[J]. 山东大学学报 (医学版), 2021, 59(9): 97-102.
[5] 赵冰清,高选,李江夏. 基于辅助生殖人群的复发性流产夫妇染色体核型回顾性分析[J]. 山东大学学报 (医学版), 2021, 59(7): 26-31.
[6] 朱序理,周亮,王跃,孙庆云,曹明雅,杜元杰,曹金凤,赵志明,郝桂敏. 不同精子来源质量冷冻方式与妊娠结局的关联性分析[J]. 山东大学学报 (医学版), 2021, 59(6): 86-93.
[7] 杨璐恺,蒋利刚,崔妍婷,刘金,韩亦龙,陈超,邓晓惠. 槲皮素在羊卵巢组织玻璃化冻存中的卵泡保护及抗氧化作用[J]. 山东大学学报 (医学版), 2020, 1(9): 1-7.
[8] 曹明雅,赵晗洁,冯腾飞,贾蕊,赵志明,郝桂敏. 孕早期行减胎术对胚胎移植助孕患者围产期母婴的影响[J]. 山东大学学报 (医学版), 2020, 58(11): 65-70.
[9] 黄薇,刘冬. 子宫内膜异位症相关不孕的助孕策略[J]. 山东大学学报 (医学版), 2019, 57(6): 23-26.
[10] 韩婷,陈红蕾. 辅助生殖治疗中腹腔镜手术应用及注意问题[J]. 山东大学学报 (医学版), 2019, 57(10): 45-51.
[11] 张迎春. 人类辅助生殖技术子代安全性问题[J]. 山东大学学报 (医学版), 2019, 57(10): 52-59.
[12] 伍琼芳. 辅助生殖治疗中取卵后出血的可能原因及处理[J]. 山东大学学报 (医学版), 2019, 57(10): 33-37.
[13] 赵君利, 袁莹莹. 辅助生殖治疗中多胎妊娠的防治[J]. 山东大学学报 (医学版), 2019, 57(10): 20-26.
[14] 石玉华,蒋琪. 辅助生殖治疗中卵巢过度刺激综合征的防治[J]. 山东大学学报 (医学版), 2019, 57(10): 13-19.
[15] 郝桂敏,罗卓野,崔娜. 辅助生殖技术治疗中常见并发症的危害[J]. 山东大学学报 (医学版), 2019, 57(10): 7-12.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 索东阳,申飞,郭皓,刘力畅,杨惠敏,杨向东. Tim-3在药物性急性肾损伤动物模型中的表达及作用机制[J]. 山东大学学报 (医学版), 2020, 1(7): 1 -6 .
[2] 马青源,蒲沛东,韩飞,王超,朱洲均,王维山,史晨辉. miR-27b-3p调控SMAD1对骨肉瘤细胞增殖、迁移和侵袭作用的影响[J]. 山东大学学报 (医学版), 2020, 1(7): 32 -37 .
[3] 徐玉香,刘煜东,张蓬,段瑞生. 101例脑小血管病患者脑微出血危险因素的回顾性分析[J]. 山东大学学报 (医学版), 2020, 1(7): 67 -71 .
[4] 龙婷婷,谢明,周璐,朱俊德. Noggin蛋白对小鼠脑缺血再灌注损伤后学习和记忆能力与齿状回结构的影响[J]. 山东大学学报 (医学版), 2020, 1(7): 15 -23 .
[5] 李宁,李娟,谢艳,李培龙,王允山,杜鲁涛,王传新. 长链非编码RNA AL109955.1在80例结直肠癌组织中的表达及对细胞增殖与迁移侵袭的影响[J]. 山东大学学报 (医学版), 2020, 1(7): 38 -46 .
[6] 丁祥云,于清梅,张文芳,庄园,郝晶. 胰岛素样生长因子II在84例多囊卵巢综合征患者颗粒细胞中的表达和促排卵结局的相关性[J]. 山东大学学报 (医学版), 2020, 1(7): 60 -66 .
[7] 张宝文,雷香丽,李瑾娜,罗湘俊,邹容. miR-21-5p靶向调控TIMP3抑制2型糖尿病肾病小鼠肾脏系膜细胞增殖及细胞外基质堆积[J]. 山东大学学报 (医学版), 2020, 1(7): 7 -14 .
[8] 付洁琦,张曼,张晓璐,李卉,陈红. Toll样受体4抑制过氧化物酶体增殖物激活受体γ加重血脂蓄积的分子机制[J]. 山东大学学报 (医学版), 2020, 1(7): 24 -31 .
[9] 史爽,李娟,米琦,王允山,杜鲁涛,王传新. 胃癌miRNAs预后风险评分模型的构建与应用[J]. 山东大学学报 (医学版), 2020, 1(7): 47 -52 .
[10] 郭志华,赵大庆,邢园,王薇,梁乐平,杨静,赵倩倩. Ⅰ期端端吻合术治疗重度颈段气管狭窄临床分析[J]. 山东大学学报 (医学版), 2020, 1(7): 72 -76 .