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在既往体外受精周期中有胚胎发育停滞病史的患者中,使用含粒细胞巨噬细胞集落刺激因子的培养基对活产率的影响。

The impact of using culture media containing granulocyte-macrophage colony-stimulating factor on live birth rates in patients with a history of embryonic developmental arrest in previous in vitro fertilization cycles.

作者信息

Sipahi Mehmet, Mümüşoğlu Sezcan, Coşkun Akçay Neslihan, Sever Ayten, Yeğenoğlu Hande, Bozdağ Gürkan, Karakoç Sökmensüer Lale

机构信息

Department of Obstetrics and Gynecology, Giresun University Faculty of Medicine, Giresun, Turkey

Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey

出版信息

J Turk Ger Gynecol Assoc. 2021 Aug 31;22(3):181-186. doi: 10.4274/jtgga.galenos.2021.2020.0168. Epub 2021 Feb 26.

Abstract

OBJECTIVE

To investigate the effect of using culture media containing granulocyte-macrophage colony-stimulating factor (GM-CSF) on embryological data and reproductive outcomes in patients with early embryonic developmental arrest.

MATERIAL AND METHODS

Retrospective case-control study. A total of 39 patients, whose embryos were incubated with culture media containing GM-CSF due to embryonic developmental arrest in two previous in vitro fertilization (IVF) cycles in-between January 2016 and November 2017 at Hacettepe University IVF Center, were enrolled. Control group was generated among patients with first IVF attempts due to tubal factor in the same time period. All embryos in the control group were incubated with single step culture medium (without GM-CSF). For the control group selection, matching was done 1:2 ratio considering female age, body mass index, number of M-II oocyte retrieved, and number of embryo transferred (n=80).

RESULTS

Demographic features and embryological data were comparable between two groups. Number of fertilized oocytes (2-pronuclear) was 3.7±2.0 in GM-CSF group and 3.9±2.5 in the control (p=0.576). Overall, number of embryos transferred (1.3±0.5 vs 1.3±0.5, respectively) and blastocyst transfer rate (67.6% vs 59.2%, respectively; p=0.401) were similar. For the reproductive outcomes, implantation rate (32.3% vs 33.1%, respectively; p=0.937), clinical pregnancy rate (33.3% vs 32.5%, respectively; p=0.770), and live birth rate (25.2% vs 26.2%, respectively; p=0.943) were similar.

CONCLUSION

Using GM-CSF-containing culture media in patients with two previous failed IVF attempts due to embryonic developmental arrest might rectify embryological data and reproductive outcomes. To make solid conclusion further randomized controlled trials are warranted.

摘要

目的

探讨使用含粒细胞巨噬细胞集落刺激因子(GM-CSF)的培养基对早期胚胎发育停滞患者胚胎学数据及生殖结局的影响。

材料与方法

回顾性病例对照研究。纳入2016年1月至2017年11月在哈杰泰佩大学体外受精(IVF)中心因前两个IVF周期胚胎发育停滞而将胚胎置于含GM-CSF培养基中培养的39例患者。对照组来自同期因输卵管因素首次进行IVF尝试的患者。对照组所有胚胎均在单步培养基(不含GM-CSF)中培养。在对照组选择中,考虑女性年龄、体重指数、获取的M-II期卵母细胞数量和移植胚胎数量,按1:2的比例进行匹配(n = 80)。

结果

两组的人口统计学特征和胚胎学数据具有可比性。GM-CSF组的受精卵母细胞(2原核)数量为3.7±2.0,对照组为3.9±2.5(p = 0.576)。总体而言,移植胚胎数量(分别为1.3±0.5和1.3±0.5)和囊胚移植率(分别为67.6%和59.2%;p = 0.401)相似。就生殖结局而言,着床率(分别为32.3%和33.1%;p = 0.937)、临床妊娠率(分别为33.3%和32.5%;p = 0.770)和活产率(分别为25.2%和26.2%;p = 0.943)相似。

结论

对于因胚胎发育停滞而前两次IVF尝试失败的患者,使用含GM-CSF的培养基可能会改善胚胎学数据及生殖结局。为得出确凿结论,有必要进一步开展随机对照试验。

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