在控制性卵巢刺激周期中从优势卵泡获取的卵母细胞的发育能力。

The developmental competence of oocytes retrieved from the leading follicle in controlled ovarian stimulated cycles.

作者信息

Braga Daniela Paes de Almeida Ferreira, Bonetti Tatiana Carvalho de Souza, da Silva Ismael Dale Cotrim Guerreiro, Setti Amanda Souza, Iaconelli Assumpto Jr, Borges Edson Jr

机构信息

Fertility - Assisted Fertilization Center, Sao Paulo, Brazil ; Sapientiae Institute, Educational and Research Center in Assisted Reproduction, Sao Paulo, Brazil.

Molecular Gynecology Laboratory, Departament of Gynecology, University Federal of São Paulo, Sao Paulo - SP, Brazil.

出版信息

Int J Fertil Steril. 2013 Jan;6(4):272-7. Epub 2013 Mar 3.

PMID:24520451

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3850321/

Abstract

BACKGROUND

This study compares the developmental capacity of gametes retrieved from the largest follicle with small follicles of a cohort in controlled ovarian stimulated cycles.

MATERIALS AND METHODS

This prospective study performed in a private assisted fertilization center included 1016 follicles collected from 96 patients who underwent intra cytoplasmic sperm injection (ICSI). After follicular aspiration, oocytes were assigned to two groups according to the diameter of the derived follicle. The large follicle group (n=96) comprised oocytes derived from the leading follicle of the cohort and the small follicle group (n=920) consisted oocytes derived from the smaller follicles of the cohort. The fertilization and percentage of topquality embryos were compared between groups by Chi-square or Fisher's exact test, where appropriate. The effect of the follicular diameter on oocyte dimorphism was assessed by binary logistic regression.

RESULTS

A significantly higher percentage of oocytes derived from the leading follicle were in the metaphase II (MII) stage (100 vs. 70.0%, p<0.001). However we observed no significant differences regarding the percentage of degenerated oocytes between the large (6.25%) and small follicle (5.0%) groups (p=0.550). Regression analysis demonstrated a nearly two-fold increase in the incidence of vacuoles in oocytes derived from the largest follicle of the cohort (OR: 1.81, p=0.046). The fertilization rate (50.0 vs. 38.8%, p=0.038) and the percentage of top quality embryos (84.7 vs. 76.4%, p=0.040) were significantly higher for oocytes derived from the largest follicle. However, the percentage of abnormal fertilized oocytes was equally distributed between the large follicle (15.0%) and small follicle (12. 8%) groups (p=0.550).

CONCLUSION

Our data suggest that intrafollicular mechanisms within the larger follicle of the cohort may allow for these follicles to amplify the responsiveness to exogenous gonadotropin, which leads to the formation of more competent oocytes with higher fertilization and developmental capacities.

摘要

背景

本研究比较了在控制性卵巢刺激周期中，从一组卵泡中的最大卵泡与小卵泡中获取的配子的发育能力。

材料与方法

这项前瞻性研究在一家私立辅助生殖中心进行，纳入了96例行卵胞浆内单精子注射（ICSI）患者的1016个卵泡。卵泡抽吸后，根据所来源卵泡的直径将卵母细胞分为两组。大卵泡组（n = 96）包括来自该组主导卵泡的卵母细胞，小卵泡组（n = 920）由来自该组较小卵泡的卵母细胞组成。在适当情况下，通过卡方检验或Fisher精确检验比较两组之间的受精率和优质胚胎百分比。通过二元逻辑回归评估卵泡直径对卵母细胞二态性的影响。

结果

来自主导卵泡的卵母细胞处于中期II（MII）期的比例显著更高（100%对70.0%，p < 0.001）。然而，我们观察到在大卵泡组（6.25%）和小卵泡组（5.0%）之间，退化卵母细胞的百分比没有显著差异（p = 0.550）。回归分析表明，来自该组最大卵泡的卵母细胞中液泡发生率增加了近两倍（比值比：1.81，p = 0.046）。来自最大卵泡的卵母细胞的受精率（50.0%对38.8%，p = 0.038）和优质胚胎百分比（84.7%对76.4%，p = 0.040）显著更高。然而，异常受精的卵母细胞百分比在大卵泡组（15.0%）和小卵泡组（12.8%）之间分布相同（p = 0.550）。