Kaneko T, Saito H, Takahashi T, Ohta N, Saito T, Hiroi M
Department of Obstetrics and Gyenecology, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata 990-9585, Japan.
J Assist Reprod Genet. 2000 Nov;17(10):580-5. doi: 10.1023/a:1026439409584.
The aim was to investigate which ovarian hyperstimulation protocol performed in the same patients causes development of oocytes of good quality.
Twenty normo-ovulatory women underwent three different controlled ovarian hyperstimulation protocols for in vitro fertilization-embryo transfer. Patients underwent follicle aspiration after administration of human chorionic gonadotropin (hCG). The total number of retrieved oocytes, the number of mature oocytes, and the rate of mature oocytes were examined. Recovered granulosa cells were stained with Hoechst 33258 and examined by fluorescence microscopy to estimate the incidence of apoptotic cells.
The total number of oocytes and the number of mature oocytes in gonadotropin-releasing hormone agonist (GnRHa) + human menopausal gonadotropin (hMG) + hCG and hMG + hCG cycles were higher than those in the natural cycle (P < 0.0001). The rate of mature oocytes in hMG + hCG cycle was the highest among the three protocols (P < 0.04). In the mural granulosa cells, the incidence of apoptotic cells in the GnRHa + hMG + hCG cycle was significantly higher than those of the natural (P < 0.002) and hMG + hCG cycles (P = 0.0002). The incidence of apoptotic cumulus granulosa cells in the GnRHa + hMG + hCG cycle was significantly higher than those of natural and hMG + hCG cycles (P < 0.002). Moreover, the incidence of apoptotic cumulus granulosa cells in the hMG + hCG cycle was significantly lower than that in the natural cycle (P < 0.01).
These results indicated that hMG + hCG is the most appropriate controlled ovarian hyperstimulation protocol among the three examined with regard to oocyte quality.
本研究旨在调查在同一患者中采用哪种卵巢过度刺激方案可促使优质卵母细胞发育。
20名排卵正常的女性接受了三种不同的控制性卵巢过度刺激方案以进行体外受精 - 胚胎移植。患者在注射人绒毛膜促性腺激素（hCG）后进行卵泡抽吸。检查回收的卵母细胞总数、成熟卵母细胞数量以及成熟卵母细胞率。回收的颗粒细胞用Hoechst 33258染色，并通过荧光显微镜检查以评估凋亡细胞的发生率。
促性腺激素释放激素激动剂（GnRHa）+人绝经期促性腺激素（hMG）+ hCG组和hMG + hCG组的卵母细胞总数和成熟卵母细胞数量高于自然周期组（P < 0.0001）。hMG + hCG组的成熟卵母细胞率在三种方案中最高（P < 0.04）。在壁层颗粒细胞中，GnRHa + hMG + hCG组的凋亡细胞发生率显著高于自然周期组（P < 0.002）和hMG + hCG组（P = 0.0002）。GnRHa + hMG + hCG组的卵丘颗粒细胞凋亡发生率显著高于自然周期组和hMG + hCG组（P < 0.002）。此外，hMG + hCG组的卵丘颗粒细胞凋亡发生率显著低于自然周期组（P < 0.01）。
这些结果表明，就卵母细胞质量而言，hMG + hCG是三种检测方案中最合适的控制性卵巢过度刺激方案。
