Hardy K, Wright C S, Franks S, Winston R M
Dept. of Reproductive Science and Medicine, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
Br Med Bull. 2000;56(3):588-602. doi: 10.1258/0007142001903391.
Only about 400 of the one million oocytes present at birth will be ovulated, while the rest will die by atresia. The ability to rescue oocytes destined to die and mature them in vitro would provide invaluable information about folliculogenesis and oocyte maturation, and could provide oocytes for infertile women. In vitro maturation (IVM) is challenging in the human because folliculogenesis is a lengthy process encompassing many complex cellular changes in the oocyte and its surrounding follicle cells. A few live births have resulted from the maturation and fertilization of immature human oocytes aspirated from small antral follicles. Furthermore, it is possible to grow primordial follicles to pre-antral stages in slices of ovarian tissue, and support antrum formation in isolated pre-antral follicles. However, we are still a considerable way from growing and maturing pre-antral follicles to pre-ovulatory stages in vitro. The importance of the follicular environment for producing a healthy and developmentally competent oocyte is illustrated by the oocyte's susceptibility to errors during meiosis. This counsels considerable caution in the development of IVM for clinical application.
出生时存在的100万个卵母细胞中，只有约400个会排卵，其余的将因闭锁而死亡。挽救注定要死亡的卵母细胞并使其在体外成熟的能力，将提供有关卵泡发生和卵母细胞成熟的宝贵信息，并可为不孕女性提供卵母细胞。体外成熟（IVM）在人类中具有挑战性，因为卵泡发生是一个漫长的过程，涉及卵母细胞及其周围卵泡细胞的许多复杂细胞变化。从未成熟的小窦卵泡中吸出的人类卵母细胞经成熟和受精后已有数例活产。此外，原始卵泡有可能在卵巢组织切片中生长到窦前阶段，并支持孤立的窦前卵泡形成腔。然而，我们距离在体外将窦前卵泡生长并成熟到排卵前阶段仍有很长的路要走。卵泡环境对于产生健康且具有发育能力的卵母细胞的重要性，体现在卵母细胞在减数分裂过程中容易出错。这就告诫在临床应用的IVM开发中要相当谨慎。
