Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei 230031, China; Reproductive Medicine Center, the 901(th) Hospital of the Joint Logistics Support Force of People's Liberation Army, 424 West Changjiang Rd, Hefei, 230031, China.
Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei 230031, China; Reproductive Medicine Center, the 901(th) Hospital of the Joint Logistics Support Force of People's Liberation Army, 424 West Changjiang Rd, Hefei, 230031, China.
Reprod Biomed Online. 2020 Apr;40(4):511-517. doi: 10.1016/j.rbmo.2019.12.012. Epub 2019 Dec 24.
Maximizing the number of oocytes and embryos obtained in the shortest possible time is of considerable potential clinical significance for women with poor prognosis. The aim of this study was to develop a clinically applicable strategy to obtain more oocytes and viable embryos in one menstrual cycle for poor-prognosis women.
Prospective cohort study of 146 women with poor prognosis who received rescue in-vitro maturation (IVM) (n = 50) or double ovarian stimulation (DuoStim) (n = 96) between December 2015 and February 2018. Outcomes, number of oocytes retrieved and matured, and embryo developmental potential were compared between the two groups.
The rates of mature oocytes, available embryos and top-quality embryos from luteal phase stimulation (LPS) of DuoStim were all significantly higher than those derived from the immature oocytes of rescue IVM (P < 0.05). The relative contributions of LPS in the DuoStim group for proportion of mature oocytes, available embryos and top-quality embryos were all significantly higher than IVM in the rescue IVM group (P < 0.001). The overall cancellation rate of no oocyte or available embryo significantly decreased from 30.21% to 9.38% (P < 0.001) when DuoStim was carried out, which decreased from 24.00% to 12.00% with no significant difference in the rescue IVM group when immature sibling oocytes were matured in vitro.
Rescue IVM and DuoStim can contribute more competent oocytes and viable embryos in the shortest possible time for poor-prognosis women, of which DuoStim may be more efficient.
对于预后不良的女性，在尽可能短的时间内获得尽可能多的卵子和胚胎具有重要的潜在临床意义。本研究旨在为预后不良的女性制定一种可行的策略，以在一个月经周期内获得更多的卵子和可存活的胚胎。
2015 年 12 月至 2018 年 2 月，对 146 名预后不良的接受挽救性体外成熟（IVM）（n=50）或双卵巢刺激（DuoStim）（n=96）的患者进行前瞻性队列研究。比较两组患者的结局、获卵数和成熟卵数、胚胎发育潜能。
DuoStim 黄体期刺激（LPS）获得的成熟卵、可利用胚胎和优质胚胎的比率均明显高于挽救性 IVM 的未成熟卵（P<0.05）。DuoStim 组 LPS 对成熟卵、可利用胚胎和优质胚胎的相对贡献均明显高于挽救性 IVM 组的 IVM（P<0.001）。当进行 DuoStim 时，无卵或可利用胚胎的总取消率从 30.21%显著降低至 9.38%（P<0.001），而在体外成熟未成熟姐妹卵的挽救性 IVM 组中，该比率从 24.00%降低至 12.00%，无显著差异。
挽救性 IVM 和 DuoStim 可在最短时间内为预后不良的女性提供更多有能力的卵子和可存活的胚胎，其中 DuoStim 可能更有效。
