De Vos A, Van de Velde H, Joris H, Van Steirteghem A
Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University (Vrije Universiteit Brussel), Laarbeeklaan 101, B-1090 Brussels, Belgium.
Hum Reprod. 1999 Jul;14(7):1859-63. doi: 10.1093/humrep/14.7.1859.
About 4% of all the oocytes denuded prior to intracytoplasmic sperm injection (ICSI) are in metaphase-I (MI). Frequently, these oocytes achieve meiosis after a few hours of in-vitro culture and are available for ICSI on the day of oocyte retrieval. In this retrospective study, the aim was to evaluate the fertilization rate and the developmental capacity of these in-vitro matured MI oocytes. After controlled ovarian stimulation using human menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG) in 896 ICSI cycles, 1210 MI-to-MII-matured oocytes were injected approximately 4 h after in-vitro culture and 8803 MII oocytes were injected immediately, or later, after denudation. The fertilization rate of in-vitro matured oocytes was significantly lower than that of mature MII oocytes (52.7 and 70.8% respectively, P < 0.00l). Embryo quality was only slightly different as regards the numbers of good quality embryos: 47.4% good quality embryos were obtained in the in-vitro matured oocyte group, whereas 53.2% good quality embryos were obtained in the MII oocyte group (P < 0.05). The same proportions of excellent (5.7 and 7.0%, NS) and fair quality (17.6 and 15.3%, NS) embryos were obtained for in-vitro matured and mature oocytes respectively. Embryos derived from in-vitro matured oocytes were transferred only if they were of better quality or if there were not enough mature oocyte derived embryos available. Fifteen transfers involved only embryos derived from in-vitro matured oocytes: 11 single embryo transfers and four transfers of two embryos, resulting in one singleton pregnancy and the birth of a healthy baby. It may be concluded that in cycles with few MII oocytes it might be worthwhile to inject in-vitro matured MI oocytes in order to increase the number of embryos available for transfer.
在卵胞浆内单精子注射(ICSI)前去除颗粒细胞的所有卵母细胞中,约4%处于减数分裂中期I(MI)。这些卵母细胞通常在体外培养数小时后完成减数分裂,并在取卵当天可用于ICSI。在这项回顾性研究中,目的是评估这些体外成熟的MI卵母细胞的受精率和发育能力。在896个ICSI周期中,使用人绝经期促性腺激素(HMG)和人绒毛膜促性腺激素(HCG)进行控制性卵巢刺激后,在体外培养约4小时后,对1210个从MI成熟为MII的卵母细胞进行注射,对8803个MII卵母细胞在去除颗粒细胞后立即或稍后进行注射。体外成熟卵母细胞的受精率显著低于成熟MII卵母细胞(分别为52.7%和70.8%,P<0.001)。就优质胚胎数量而言,胚胎质量仅有轻微差异:体外成熟卵母细胞组获得47.4%的优质胚胎,而MII卵母细胞组获得53.2%的优质胚胎(P<0.05)。体外成熟和成熟卵母细胞分别获得相同比例的优质胚胎(5.7%和7.0%,无显著性差异)和中等质量胚胎(17.6%和15.3%,无显著性差异)。仅当体外成熟卵母细胞来源的胚胎质量更好或没有足够的成熟卵母细胞来源的胚胎时,才会移植这些胚胎。15次移植仅涉及体外成熟卵母细胞来源的胚胎:11次单胚胎移植和4次双胚胎移植,结果是1次单胎妊娠并诞下一名健康婴儿。可以得出结论,在MII卵母细胞数量较少的周期中,为了增加可用于移植的胚胎数量,注射体外成熟的MI卵母细胞可能是值得的。