Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Health Care Centre, 888 Boul de Maisonneuve E #200, Montreal, QC, H2L 4S8, Canada.
Reprod Sci. 2020 Dec;27(12):2257-2264. doi: 10.1007/s43032-020-00245-z. Epub 2020 Jul 2.
To assess the added value of maturing immature oocytes collected during fertility preservation treatments in women with malignancy. A retrospective case-control study analyzing the results of 327 cancer patients undergoing fertility preservation treatments. Oocyte maturation rates and cycle parameters were compared between 3 types of fertility preservation treatments: (1) stimulated IVF cycle (n = 143), (2) non-stimulated IVM cycle (n = 158), (3) follicle aspiration and oocyte collection from ovarian tissue prepared for ovarian tissue cryopreservation followed by in vitro maturation of the immature oocytes (n = 48). The primary outcome measure was the maturation rate and the number of mature oocytes. The secondary outcomes were oocyte fertilization and embryo development rates. The mean maturation rate in IVF cycles was 38% and in the non-stimulated IVM cycles was 55%. In women who chose to cryopreserve their embryos, similar fertilization and embryo cleavage rates were found in oocytes that matured after stimulated IVF cycles compared to non-stimulated IVM cycles. Gonadotropin-releasing hormone agonist triggering, treatment with aromatase inhibitor, or oral contraceptives use before the cycle did not affect the maturation rate. Ovarian stimulation yields the highest number of oocytes or embryos for cryopreservation. Although the maturation rate of immature oocytes collected in stimulated IVF cycles is low, it is still a viable source of oocytes that can be used to improve the efficacy of fertility preservation treatments by increasing the number of mature oocytes available for freezing or fertilization.
评估在患有恶性肿瘤的女性的生育力保存治疗中采集的未成熟卵母细胞成熟的附加价值。这是一项回顾性病例对照研究，分析了 327 名接受生育力保存治疗的癌症患者的结果。比较了 3 种生育力保存治疗方法的卵母细胞成熟率和周期参数：（1） 刺激 IVF 周期（n=143），（2） 非刺激 IVM 周期（n=158），（3） 从为卵巢组织冷冻保存而准备的卵巢组织中抽吸和采集卵母细胞，然后进行体外成熟（n=48）。主要结局指标是成熟率和成熟卵母细胞数。次要结局指标是卵母细胞受精和胚胎发育率。在 IVF 周期中，平均成熟率为 38%，在非刺激 IVM 周期中为 55%。在选择冷冻保存胚胎的女性中，与非刺激 IVM 周期相比，在刺激 IVF 周期中成熟的卵母细胞的受精和胚胎分裂率相似。促性腺激素释放激素激动剂触发、在周期前使用芳香化酶抑制剂或口服避孕药不会影响成熟率。卵巢刺激产生最多的卵母细胞或胚胎进行冷冻保存。尽管在刺激 IVF 周期中采集的未成熟卵母细胞的成熟率较低，但它仍然是卵母细胞的可行来源，可以通过增加可用于冷冻或受精的成熟卵母细胞数量来提高生育力保存治疗的效果。
