Fesahat Farzaneh, Dehghani Firouzabadi Razieh, Faramarzi Azita, Khalili Mohammad Ali
Department of Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Clin Exp Reprod Med. 2017 Jun;44(2):79-84. doi: 10.5653/cerm.2017.44.2.79. Epub 2017 Jun 30.
Optimizing maturation (IVM) media to achieve better outcomes has been a matter of interest in recent years. The aim of this prospective clinical trial was to investigate the effects of different media on the IVM outcomes of immature oocytes at the germinal vesicle (GV) stage.
A total of 400 immature oocytes at the GV stage with normal morphology were retrieved from 320 infertile women aged 31±4.63 years during stimulated intracytoplasmic sperm injection (ICSI) cycles. They were divided into groups of homemade IVM medium (I, n=100), cleavage medium (II, n=100), blastocyst medium (III, n=100), and Sage IVM medium (IV, n=100) and cultured for 24 to 48 hours at 37℃. ICSI was performed, and the rates of fertilization and embryo formation were compared across the four groups.
In the 400 retrieved GV oocytes, the total maturation rates showed significant differences in groups I to IV (55%, 53%, 78%, and 68%, respectively, <0.001). However, there were no significant differences in the fertilization, embryo formation, or arrest rates of metaphase II oocytes across these groups. In all groups, GV maturation was mostly completed after 24 hours, with fewer oocytes requiring 48 hours to mature (<0.01). Moreover, the rate of high-quality embryos was higher in group IV than in the other groups (=0.01).
The quality of the IVM medium was found to affect clinical IVM outcomes. Additionally, blastocyst medium may be a good choice in IVM/ICSI cycles as an alternative IVM medium.
优化成熟（IVM）培养基以获得更好的结果是近年来人们关注的问题。这项前瞻性临床试验的目的是研究不同培养基对生发泡（GV）期未成熟卵母细胞IVM结果的影响。
在320名年龄为31±4.63岁的不孕妇女的促排卵胞浆内单精子注射（ICSI）周期中，共获取了400个形态正常的GV期未成熟卵母细胞。将它们分为自制IVM培养基组（I组，n = 100）、卵裂期培养基组（II组，n = 100）、囊胚期培养基组（III组，n = 100）和Sage IVM培养基组（IV组，n = 100），并在37℃下培养24至48小时。进行ICSI，并比较四组的受精率和胚胎形成率。
在回收的400个GV卵母细胞中，I组至IV组的总成熟率有显著差异（分别为55%、53%、78%和68%，<0.001）。然而，这些组间中期II卵母细胞的受精率、胚胎形成率或阻滞率没有显著差异。在所有组中，GV成熟大多在24小时后完成，需要48小时成熟的卵母细胞较少（<0.01）。此外，IV组的优质胚胎率高于其他组（=0.01）。
发现IVM培养基的质量会影响临床IVM结果。此外，囊胚期培养基在IVM/ICSI周期中作为替代IVM培养基可能是一个不错的选择。
