Hum. Reprod. Advance Access published online on May 20, 2009
Human Reproduction, doi:10.1093/humrep/dep125
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Children born after cryopreservation of embryos or oocytes: a systematic review of outcome data
1 Perinatal Center, Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy, SE-416 85 East Hospital, Göteborg, Sweden 2 Väestöliitto Fertility Clinics Ltd, Fredrikinkatu 47, FI-00100 Helsinki, Finland 3 Reproductive Medicine, Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy, Sahlgrenska Hospital, SE-413 45 Göteborg, Sweden 4 Department of Clinical Genetics, Helsinki University Central Hospital, FI-00100 Helsinki, Finland 5 Volvat Medical Senter, 2 Borjenveien, NO-0303 Oslo, Norway 6 IVF Clinic, Queen Sophia Hospital, SE-114 86 Stockholm, Sweden 7 Center for Fetal Medicine K79, Department of Obstetrics and Gynecology, Karolinska Hospital, SE-141 52 Huddinge, Sweden 8 The Fertility Clinic, Copenhagen University Hospital, Rigshospitalet Section 4071, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
9 Correspondence address. Tel: +46-31-3435580; Fax: +46-31-258374; E-mail: ulla-britt.wennerholm{at}vgregion.se
BACKGROUND: An estimated 3.5 million children have been born to date using assisted reproduction technologies. We reviewed the data in order to evaluate current knowledge of medical outcome for IVF/ICSI children born after cryopreservation, slow freezing and vitrification of early cleavage stage embryos, blastocysts and oocytes.
METHODS: A systematic review was performed. We searched the PubMed, Cochrane and Embase databases from 1984 to September 2008. Inclusion criteria for slow freezing of early cleavage stage embryos were controlled studies reporting perinatal or child outcomes. For slow freezing and vitrification of blastocysts and oocytes, and vitrification of early cleavage stage embryos, case reports on perinatal or child outcomes were also included. Three reviewers independently read and evaluated all selected studies.
RESULTS: For early cleavage embryos, data from controlled studies indicated a better or at least as good obstetric outcome, measured as preterm birth and low birthweight for children born after cryopreservation, as compared with children born after fresh cycles. Most studies found comparable malformation rates between frozen and fresh IVF/ICSI. For slow freezing of blastocysts and for vitrification of early cleavage stage embryos, blastocysts and oocytes, limited neonatal data was reported. We found no long-term child follow-up data for any cryopreservation technique.
CONCLUSION: Data concerning infant outcome after slow freezing of embryos was reassuring. Properly controlled follow-up studies of neonatal outcome are needed after slow freezing of blastocysts and after vitrification of early cleavage stage embryos, blastocysts and oocytes. In addition, child long-term follow-up studies for all cryopreservation techniques are essential.
Key words: cryopreservation/slow freezing/vitrification/pregnancy outcome/birth defect
Submitted on February 6, 2009; resubmitted on April 1, 2009; accepted on April 7, 2009.
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