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自然周期体外受精中未成熟卵母细胞的受精、胚胎发育和临床结局。

Fertilization, embryo development, and clinical outcome of immature oocytes obtained from natural cycle in vitro fertilization.

机构信息

MUHC reproductive center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, H3A 1A1, Canada.

出版信息

J Assist Reprod Genet. 2013 Jan;30(1):43-7. doi: 10.1007/s10815-012-9889-5. Epub 2012 Nov 21.

Abstract

PURPOSE

To analyze the fertilization, embryo development, and clinical outcome of immature oocytes obtained from natural cycle IVF in women with regular cycles.

METHODS

Natural cycle IVF was performed in 28 patients who had normal ovaries, > 6 antral follicle counts and were less than 40 years old (n=28 cycles). An hCG trigger of 10,000 IU was administered 36 h before oocyte collection when the diameter of the dominant follicle (DF) was over 12 mm. Oocytes were retrieved from DF as well as from the cohort of smaller follicles. Embryological aspects of the mature and immature oocytes retrieved from these cycles as well as the implantation and clinical pregnancy rates depending on the origin of the embryos transferred were evaluated.

RESULT(S): Overall clinical pregnancy and implantation rates were 20.8 % and 6.7 %, respectively. There were no differences in in vitro maturation (IVM), fertilization and embryo development between immature oocytes retrieved with and without in vivo matured oocytes. However, the clinical and implantation rates in cycles with embryos produced from in vivo matured oocytes transferred were better than the cycles where only IVM embryos were transferred (30.8 %, 9.1 % vs. 9.1 %, 3.2 %).

CONCLUSION(S): Although our results show that immature oocytes from natural cycle IVF can fertilize normally and can be used to increase the number of embryos available for transfer, the embryos derived from the immature oocytes in natural cycles IVF have a poorer reproductive potential.

摘要

目的

分析自然周期 IVF 中获取的正常周期女性未成熟卵母细胞的受精、胚胎发育和临床结局。

方法

对 28 名卵巢正常、>6 个窦卵泡计数且年龄<40 岁的患者(n=28 个周期)进行自然周期 IVF。当优势卵泡(DF)直径>12mm 时,于 hCG 扳机前 36 小时给予 10,000IU hCG。从 DF 以及较小卵泡的队列中获取卵母细胞。评估这些周期中成熟和未成熟卵母细胞的胚胎学特征以及取决于胚胎来源的着床和临床妊娠率。

结果

总体临床妊娠率和着床率分别为 20.8%和 6.7%。未成熟卵母细胞的体外成熟(IVM)、受精和胚胎发育在有和没有体内成熟卵母细胞的情况下没有差异。然而,来源于体内成熟卵母细胞的胚胎转移的周期中的临床和着床率优于仅转移 IVM 胚胎的周期(30.8%,9.1%比 9.1%,3.2%)。

结论

尽管我们的结果表明,自然周期 IVF 中的未成熟卵母细胞可以正常受精并可用于增加可供转移的胚胎数量,但自然周期 IVF 中未成熟卵母细胞衍生的胚胎具有较差的生殖潜力。

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