Le Bras Anne, Hesters Laetitia, Gallot Vanessa, Tallet Cathie, Tachdjian Gerard, Frydman Nelly
a AP-HP, Antoine Béclère Hospital, Reproductive Biology Unit , Clamar , France.
b Reproductive Medicine Unit , Clamart , France.
Syst Biol Reprod Med. 2017 Oct;63(5):331-337. doi: 10.1080/19396368.2017.1336581. Epub 2017 Jun 20.
Short gamete co-incubation (SGCO) consists in decreasing the duration of contact between oocytes and sperm from the standard overnight insemination (SOI) toward 2 hours. However, the effectiveness of this technique to improve in vitro fertilization and embryo transfer (IVF-ET) outcomes remains controversial. Our study was designed to evaluate the efficiency of SGCO in a poor prognosis population with a history of fragmented embryos defined by the presence of at least 50% of the embryos with more than 25% of cytoplasmic fragments. From January 2010 to January 2014, 97 couples were included in a SGCO protocol. We separated women into 2 subgroups: younger and older than 35 years. Compared to SOI, after SGCO, 2-cell stage embryos were higher in all women (p<0.001) and less fragmented in women over 35 years (p<0.05). On day 2, top quality embryos obtained and transferred were higher with SCGO than with SOI, independently of the age of the women (p<0.001). Moreover, the number of embryos with less than 25% of fragmentation was higher after SGCO than SOI (p<0.001) whereas the number of multinucleated embryos was lower (p<0.001). We observed that after fresh ET, independently of the age of the women, the clinical pregnancy rate was 3 times higher after SGCO than after SOI. However, the live-birth rate was 4 times higher with SGCO than with SOI in women above 35 years but 3 times higher with SGCO than with SOI in women younger than 35 years. The present results indicate that for a particular indication, reducing the time of oocytes and sperm co-incubation may improve IVF-ET outcomes in terms of live-birth rate.
AMH: anti mullerian hormone; COC: cumulus-oocytes complex; E2: estradiol; ET: embryo transfer; FET: frozen embryo transfer; FSH: follicle stimulating hormone; GnRH: gonadotrophin releasing hormone; hCG: human chorionic gonadotropin hormone; hMG: human menopausal gonadotropin hormone; IRB: institutional review board; IVF: in vitro fertilization; IVF-ET: in vitro fertilization and embryo transfer; MNB: multinucleated blastomere; mRNA: messanger ribonucleic acid; OC: oocyte retrieval; O2: oxygen; ROS: reactive oxygen species; SGCO: short gamete co-incubation; SOI: standard overnight insemination.
短配子共孵育（SGCO）是指将卵母细胞与精子的接触时间从标准的过夜授精（SOI）缩短至2小时。然而，该技术改善体外受精和胚胎移植（IVF-ET）结局的有效性仍存在争议。我们的研究旨在评估SGCO在预后不良人群中的效率，这些人群有胚胎碎片化史，定义为至少50%的胚胎有超过25%的细胞质碎片。从2010年1月至2014年1月，97对夫妇纳入了SGCO方案。我们将女性分为2个亚组：年龄小于35岁和大于35岁。与SOI相比，SGCO后，所有女性的2细胞期胚胎比例更高（p<0.001），35岁以上女性的胚胎碎片化程度更低（p<0.05）。在第2天，无论女性年龄如何，SGCO获得并移植的优质胚胎数量均高于SOI（p<0.001）。此外，SGCO后碎片化程度小于25%的胚胎数量高于SOI（p<0.001），而多核胚胎数量更低（p<0.001）。我们观察到，新鲜胚胎移植后，无论女性年龄如何，SGCO后的临床妊娠率比SOI高3倍。然而，35岁以上女性中SGCO后的活产率比SOI高4倍，35岁以下女性中SGCO后的活产率比SOI高3倍。目前的结果表明，对于特定适应症，缩短卵母细胞与精子的共孵育时间可能会提高IVF-ET的活产率。
AMH：抗苗勒管激素；COC：卵丘-卵母细胞复合体；E2：雌二醇；ET：胚胎移植；FET：冷冻胚胎移植；FSH：卵泡刺激素；GnRH：促性腺激素释放激素；hCG：人绒毛膜促性腺激素；hMG：人绝经期促性腺激素；IRB：机构审查委员会；IVF：体外受精；IVF-ET：体外受精和胚胎移植；MNB：多核卵裂球；mRNA：信使核糖核酸；OC：取卵；O2：氧气；ROS：活性氧；SGCO：短配子共孵育；SOI：标准过夜授精
