重复卵巢刺激中的卵母细胞成熟
Oocyte maturity in repeated ovarian stimulation.
作者信息
Lee Jae Eun, Kim Sang Don, Jee Byung Chul, Suh Chang Suk, Kim Seok Hyun
机构信息
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
出版信息
Clin Exp Reprod Med. 2011 Dec;38(4):234-7. doi: 10.5653/cerm.2011.38.4.234. Epub 2011 Dec 31.
OBJECTIVE
During stimulated IVF cycles, up to 15% of oocytes are recovered as immature. The purpose of this study was to investigate the trend of oocyte maturity in repeated ovarian stimulation for IVF.
METHODS
One hundred forty-eight patients were selected who underwent two consecutive IVF cycles using same stimulation protocol during 2008 to 2010. Ovarian stimulation was performed with FSH and human menopausal gonadotropin and flexible GnRH antagonist protocol in both cycles. Oocyte maturity was assessed according to presence of germinal vesicle (GV) and the first polar body. Immature oocyte was defined as GV stage or metaphase I oocyte (GV breakdown with no visible polar body) and cultured up to 48 hours. If matured, they were fertilized with ICSI.
RESULTS
Percentages of immature oocytes were 30.8% and 32.9% (p=0.466) and IVM rates of immature oocytes were 36.2% and 25.7% (p=0.077), respectively. A significant correlation was noted between percentage of immature oocytes in the two cycles (R=0.178, p=0.03). Women with >40% immaturity in both cycles (n=21) showed lower fertilization rate of in vivo matured oocytes (56.4% vs. 72.0%, p=0.005) and lower pregnancy rate (19.0% vs. 27.1%, p=0.454) after the second cycle when compared with women with <40% immaturity (n=70). In both groups, female age, number of total retrieved oocyte and embryos transferred were similar.
CONCLUSION
In repeated ovarian stimulation cycles for IVF, the immature oocyte tended to be retrieved repetitively in consecutive IVF cycles.
目的
在促排卵体外受精（IVF）周期中，高达15%的卵母细胞回收时为未成熟状态。本研究旨在探讨重复卵巢刺激用于IVF时卵母细胞成熟度的变化趋势。
方法
选取2008年至2010年期间连续进行两个IVF周期且采用相同刺激方案的148例患者。两个周期均使用促卵泡生成素（FSH）、人绝经期促性腺激素及灵活的促性腺激素释放激素（GnRH）拮抗剂方案进行卵巢刺激。根据生发泡（GV）和第一极体的存在情况评估卵母细胞成熟度。未成熟卵母细胞定义为GV期或中期I卵母细胞（GV破裂但未见极体），并培养48小时。若成熟，则采用卵胞浆内单精子注射（ICSI）进行受精。
结果
未成熟卵母细胞百分比分别为30.8%和32.9%（p = 0.466），未成熟卵母细胞的体外成熟（IVM）率分别为36.2%和25.7%（p = 0.077）。两个周期中未成熟卵母细胞百分比之间存在显著相关性（R = 0.178，p = 0.03）。与两个周期中未成熟率<40%的女性（n = 70）相比，两个周期中未成熟率>40%的女性（n = 21）在第二个周期后体内成熟卵母细胞的受精率较低（56.4%对72.0%，p = 0.005），妊娠率也较低（19.0%对27.1%，p = 0.454）。两组患者的年龄、回收的卵母细胞总数及移植胚胎数相似。
结论
在重复卵巢刺激的IVF周期中，未成熟卵母细胞在连续的IVF周期中倾向于被重复回收。
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