Reproductive Medical Center, Senior Department of Obstetrics & Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China.
Reproductive Medicine Center, The First Affiliated Hospital of Xiamen University, No. 6 Guchengxi Road, Si Ming, Xiamen, 361003, China.
J Transl Med. 2021 Oct 9;19(1):416. doi: 10.1186/s12967-021-03080-1.
In vitro oocyte maturation (IVM) is being increasingly approached in assisted reproductive technology (ART). This study aimed to evaluate the quality of embryos generated by in-vitro matured immature follicles, as a guideline for further clinical decision-making.
A total of 52 couples with normal karyotypes underwent in vitro fertilization, and 162 embryos were donated for genetic screening. Embryos in IVF group were generated by mature follicles retrieved during gonadotrophin-stimulated in vitro fertilization (IVF) cycles. And embryos in IVM group were fertilized from IVM immature oocytes.
The average age of the women was 30.50 ± 4.55 years (range 21-42 years) with 87 embryos from IVF group and 75 embryos from IVM group. The rate of aneuploid with 28 of the 87 (32.2%) embryos from IVF group and 21 of the 75 (28%) embryos from IVM group, with no significant difference. The frequency of aneuploid embryos was lowest in the youngest age and increased gradually with women's age, whether in IVF group or IVM group and risen significantly over 35 years old. The embryos with morphological grade 1 have the lowest aneuploidy frequency (16.6%), and increase by the grade, especially in IVF group. In grade 3, embryos in IVM group were more likely to be euploid than IVF group (60% vs 40%, respectively).
IVM does not affect the quality of embryos and does not increase the aneuploidy rate of embryos. It is clinically recommended that women more than 35 years have a high aneuploidy rate and recommended to test by PGS (strongly recommended to screened by PGS for women more than 40 years). Women aged less than 35 years old for PGS according to their physical and economic conditions. Embryo with poor quality is also recommended to test by PGS, especially for grade III embryos.
体外卵母细胞成熟（IVM）在辅助生殖技术（ART）中越来越受到关注。本研究旨在评估从体外成熟的未成熟卵泡中产生的胚胎质量，作为进一步临床决策的指导。
共有 52 对正常核型的夫妇接受了体外受精，有 162 个胚胎进行了遗传筛查。IVF 组的胚胎是从促性腺激素刺激的体外受精（IVF）周期中取出的成熟卵泡中产生的。IVM 组的胚胎是从 IVM 不成熟卵母细胞中受精的。
女性的平均年龄为 30.50±4.55 岁（范围 21-42 岁），IVF 组有 87 个胚胎，IVM 组有 75 个胚胎。IVF 组 28 个（32.2%）胚胎和 IVM 组 21 个（28%）胚胎存在非整倍体，无显著差异。在 IVF 组或 IVM 组中，非整倍体胚胎的频率在最年轻的年龄最低，随着女性年龄的增加而逐渐增加，在 35 岁以上显著增加。形态学等级 1 的胚胎具有最低的非整倍体频率（16.6%），随着等级的升高而增加，尤其是在 IVF 组中。在等级 3 中，IVM 组的胚胎更有可能是整倍体，而不是 IVF 组（分别为 60%和 40%）。
IVM 不会影响胚胎质量，也不会增加胚胎的非整倍体率。临床上建议 35 岁以上的女性非整倍体率较高，建议进行 PGS 检测（强烈建议 40 岁以上的女性进行 PGS 筛查）。35 岁以下的女性根据自己的身体和经济状况进行 PGS 检测。建议对质量较差的胚胎进行 PGS 检测，尤其是对等级 III 的胚胎。
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