Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany.
Department of Gynecological Endocrinology and Fertility Disorders, Inselspital Bern, Bern, Switzerland.
Acta Obstet Gynecol Scand. 2012 Jan;91(1):22-27. doi: 10.1111/j.1600-0412.2011.01299.x. Epub 2011 Nov 9.
Although some patients may benefit from reduced follicle-stimulating hormone (FSH) application, in-vitro maturation (IVM) belongs to the rare treatment options in assisted reproduction. We summarize our five-year IVM experience.
Retrospective, observational study.
Reproductive Medicine, University Hospital.
115 patients with polycystic ovary syndrome (PCOS) as well as patients after ovarian hyperstimulation syndrome (OHSS) from February 2005 to December 2009.
Stimulation started between day 3-10 of the menstrual cycle and FSH dosage was 125IU/day over three days. Ovulation was induced on the third day of FSH injection or one day afterwards and oocyte retrieval was performed 33-38 hours later. Oocytes were cultivated for 24 hours in IVM medium. Fertilization was carried out one day after oocyte retrieval and embryo transfer two days afterwards.
Pregnancy rates.
115 patients were included and 215 oocyte retrievals (intracytoplasmic sperm injection: n=125, 59%; in vitro fertilization: n=73, 34.4%) with 177 embryo transfers performed. The main reasons for IVM were: PCOS (71.7%) and OHSS (15.0%). Mean number of oocytes was 8.9/oocyte retrieval with 5.9 (64%) becoming mature, 2.8 (45.1%) being fertilized and 2.1 transferred. Pregnancy rate per transfer was 15.3% (n=27) with 13 live births (7.3%), one intrauterine death (0.6%), four miscarriages (2.3%) and nine biochemical pregnancies (5.1%). In 61 cases, fertilized oocytes were frozen and 32 cryotransfers were performed, resulting in three pregnancies.
Although the pregnancy rate was low, IVM is very convenient for patients due to low FSH dosages and few appointments at low cost.
虽然有些患者可能受益于降低卵泡刺激素（FSH）的应用，但体外成熟（IVM）属于辅助生殖中罕见的治疗选择。我们总结了我们五年的 IVM 经验。
回顾性、观察性研究。
生殖医学，大学医院。
2005 年 2 月至 2009 年 12 月期间患有多囊卵巢综合征（PCOS）的 115 名患者以及卵巢过度刺激综合征（OHSS）后的患者。
刺激从月经周期的第 3-10 天开始，FSH 剂量为 125IU/天，持续三天。注射 FSH 后的第三天或第二天诱导排卵，取卵在 33-38 小时后进行。卵母细胞在 IVM 培养基中培养 24 小时。取卵后一天进行受精，两天后进行胚胎移植。
妊娠率。
共纳入 115 例患者，进行了 215 次卵母细胞采集（胞浆内单精子注射：n=125，59%；体外受精：n=73，34.4%），共进行了 177 次胚胎移植。IVM 的主要原因是：PCOS（71.7%）和 OHSS（15.0%）。平均每例取卵数为 8.9/卵母细胞采集，其中 5.9（64%）个卵母细胞成熟，2.8（45.1%）个卵母细胞受精，2.1 个卵母细胞移植。每个移植周期的妊娠率为 15.3%（n=27），其中 13 例活产（7.3%），1 例宫内死亡（0.6%），4 例流产（2.3%），9 例生化妊娠（5.1%）。在 61 例中，受精的卵母细胞被冷冻，进行了 32 次冷冻转移，导致 3 例妊娠。
尽管妊娠率较低，但由于 FSH 剂量低，就诊次数少，成本低，IVM 对患者非常方便。
