Vanhoutte Leen, De Sutter Petra, Van der Elst Josiane, Dhont Marc
Infertility Centre, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
Reprod Biol Endocrinol. 2005 Dec 15;3:71. doi: 10.1186/1477-7827-3-71.
We studied the benefit of using in vitro matured metaphase I (MI) oocytes for ICSI in patients with a maximum of 6 mature metaphase II (MII) oocytes at retrieval.
In 2004, 187 ICSI cycles were selected in which maximum 6 MII oocytes and at least one MI oocyte were retrieved. MI oocytes were put in culture to mature until the moment of ICSI, which was performed between 2 to 11 hours after oocyte retrieval (day 0). In exceptional cases, when the patient did not have any mature oocyte at the scheduled time of ICSI, MI oocytes were left to mature overnight and were injected between 19 to 26 hours after retrieval (day 1). Embryos from MI oocytes were chosen for transfer only when no other good quality embryos from MII oocytes were available. Outcome parameters were time period of in vitro maturation (IVM), IVM and fertilization rates, embryo development, clinical pregnancy rates, implantation rates and total MI oocyte utilization rate.
The overall IVM rate was 43%. IVM oocytes had lower fertilization rates compared to in vivo matured sibling oocytes (52% versus 68%, P < 0.05). The proportion of poor quality embryos was significantly higher in IVM derived oocytes. One pregnancy and live birth was obtained out of 13 transfers of embryos exclusively derived from IVM oocytes. This baby originated from an oocyte that was injected after 22 hrs of IVM.
Fertilization of in vitro matured MI oocytes can result in normal embryos and pregnancy, making IVM worthwhile, particularly when few MII oocytes are obtained at retrieval.
我们研究了对于取卵时最多有6个成熟的中期II（MII）卵母细胞的患者，使用体外成熟的中期I（MI）卵母细胞进行卵胞浆内单精子注射（ICSI）的益处。
2004年，选取了187个ICSI周期，这些周期中最多取到6个MII卵母细胞且至少有1个MI卵母细胞。将MI卵母细胞进行培养直至ICSI时刻，ICSI在卵母细胞取出后2至11小时（第0天）进行。在特殊情况下，当患者在预定的ICSI时间没有任何成熟卵母细胞时，MI卵母细胞会过夜培养，并在取出后19至26小时（第1天）进行注射。仅当没有来自MII卵母细胞的其他优质胚胎可用时，才选择来自MI卵母细胞的胚胎进行移植。观察指标包括体外成熟（IVM）的时间段、IVM率和受精率、胚胎发育、临床妊娠率、着床率以及总的MI卵母细胞利用率。
总体IVM率为43%。与体内成熟的同胞卵母细胞相比，IVM卵母细胞的受精率较低（52%对68%，P<0.05）。IVM来源的卵母细胞中质量差的胚胎比例显著更高。在仅来自IVM卵母细胞的胚胎的13次移植中，获得了1次妊娠和1例活产。这个婴儿源自一个在IVM 22小时后注射的卵母细胞。
体外成熟的MI卵母细胞受精可产生正常胚胎并实现妊娠，这使得IVM是值得的，尤其是在取卵时获得的MII卵母细胞很少的情况下。
