pregnancy and live birth (Tucker et al., 1998b). The potential advantages associated with the ability to freeze Two important issues, however, remain to be resolved before and store human oocytes successfully have been well estabthe role of this technology in current practice can be fully lished for some time. Not only would it allow the circumvention elucidated. Firstly, it would be preferable if continuing research of moral, ethical and legal problems which arise as an inevitable could determine whether modifications to the above method consequence of embryo freezing, but also it would offer the could improve outcome. A tendency to adopt techniques widely prospect of broadening the fertility options available to women when they show promise often occurs at the expense of further who, for a variety of medical reasons, are likely to lose ovarian refinement. For example, a recent study has suggested that function prematurely. Banks of frozen donated oocytes would optimal survival of human oocytes may be achieved at an icefacilitate the donation process, which is often complicated by seeding temperature which is higher than that used in current a requirement for donor–recipient synchrony. More controclinical oocyte cryopreservation protocols (Trad et al., 1998). versially, oocyte storage would also open the door to the This is particularly important when we consider the second possibility of women, with no medical indications and no issue, which concerns the relative efficiency of oocyte and immediate plans to conceive, being able to store ‘young eggs’ embryo freezing. If we are to consider mature oocyte freezing for potential use at a later date. as an alternative to embryo freezing then we need to be aware Technically, the possibility of offering oocyte cryopreservof the likely return from the available material in each case. ation as a routine procedure had seemed somewhat remote In other words we need to ask ‘How many implantations can after failure to reproduce early reports of success with a we expect per 100 fresh oocytes available?’. Figures from our dimethylsulphoxide-based method in the 1980s (Chen, 1986; own unit suggest that ~90% of collected oocytes may be Al-Hasani et al., 1987; Van Uem et al., 1987). The difficulties expected to be mature, that ICSI would be expected to result encountered in achieving success with human mature (metain normal (dipronucleate) fertilization in ~60% of injected phase II) oocytes were postulated to arise mainly from inherent mature oocytes, and that ~90% of early cleavage stage (day problems associated with the susceptibility of the mammalian 2) embryos generated would be considered suitable for cryospindle to freezing induced damage. Such problems were preservation. This means that just under 50 embryos would highlighted by reports of elevated rates of post-thaw aneuploidy be frozen per 100 oocytes collected in a unit where embryo in cryopreserved mouse oocytes (Kola et al., 1988). However, utilization/cryopreservation rates are high. Our post-thaw work by our group using propanediol and sucrose as cryoresults suggest that, although only 15% of all embryos frozen protectants in conjunction with a slow freeze/rapid thaw fail to survive cryopreservation, only 55% of frozen embryos method based on that successfully used for post-fertilization will survive with all blastomeres intact after thawing. The stages in the human, suggested that this pessimism was not percentage of fully intact thawed embryos which develop to justified. We showed that oocytes could survive cryopreservthe fetal heart (FH) stage following transfer in our unit is ation without compromising spindle integrity (Gook et al., ~12%, a figure which is almost double the value for embryos 1993), that post-thaw fertilization was characterized by normal which have suffered blastomere loss as a result of cryopreservkaryotypes and an absence of stray chromosomes (Gook ation. Taking all the above into account would result in an et al., 1994), and that frozen/thawed oocytes fertilized by
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