Reproductive Medical Center, Senior Department of Obstetrics and Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing 100700, China.
Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing 102206, China.
Aging (Albany NY). 2022 Jun 7;14(11):4728-4738. doi: 10.18632/aging.204106.
It is commonly believed that the oocytes from small follicles are unhealthy when a dominant follicle (DF) is recruited in the ovaries, especially when the DF is ovulated. This study aims to confirm whether the presence or ovulation of DF at the time of retrieval affects the clinical outcome of the natural cycle IVF with maturation (NC-IVF/M) treatment.
Data were collected from 446 women with regular menstrual cycle and 536 retrieval cycles using NC-IVF/M treatment. The cycles were divided into three groups based on the results of the oocyte retrieval cycle. Group A covers the collection of oocytes from the DF and small follicles; Group B incorporates failed oocyte retrieval from DF and then the oocytes are retrieved only from small follicles; and Group C includes the retrieval of oocytes only from small follicles accompanied with an ovulated DF. Furthermore, Group B and C have subgroups to include whether matured oocytes were obtained from small follicles. Following aspiration of DF and small follicles, mature oocytes were inseminated on the date of retrieval by intracytoplasmic sperm injection (ICSI) and the immature oocytes were matured . If the immature oocytes were matured , they were inseminated using ICSI, and then the embryos obtained from and matured oocytes were transferred accordingly.
The oocytes from DF were successfully retrieved in 445 cycles (83.0%), failed to be retrieved in 54 cycles (10.1%) and ovulated in 37 cycles (6.9%). In Group A, an average of 2.0 ± 1.7 mature oocytes were retrieved, which was significantly higher than the average of Group B, with 1.3 ± 1.3 matured oocytes and Group C, with an average of 1.1 ± 1.5 matured oocytes ( < 0.01). However, the average number of immature oocytes retrieved from each group show no difference among the three groups. There was no significant difference in maturation rates of immature oocytes, fertilization rates among the three groups. The clinical pregnancy rate per transfer cycle is 34.5%, 34.6% and 25.7% in Group A, B and C, respectively. No significant differences were observed in embryonic development and implantation capacity in Group B and C in comparison to Group A. And there was no significant difference in clinical pregnancy, implantation, live birth and miscarriage rates among the three groups. No significant differences were observed in the developmental and implantation capacity according to with or without matured oocytes were retrieved in Group B and Group C.
The presence or ovulation of the dominant follicle from the ovaries does not significantly influence the developmental and implantation capacity of immature oocytes retrieved from small follicles, suggesting that NC-IVF/M is a promising treatment option for women without ovarian stimulation.
人们普遍认为，当卵巢募集优势卵泡（DF）时，尤其是当 DF 排卵时，来自小卵泡的卵母细胞不健康。本研究旨在确认在自然周期 IVF 取卵时 DF 的存在或排卵是否会影响自然周期 IVF 取卵（NC-IVF/M）治疗的临床结局。
本研究收集了 446 名月经周期正常的妇女和 536 个采用 NC-IVF/M 治疗的取卵周期的数据。根据取卵周期的结果，将这些周期分为三组。A 组涵盖了从 DF 和小卵泡中采集卵母细胞；B 组包括从 DF 中取卵失败，然后仅从小卵泡中采集卵母细胞；C 组包括仅从小卵泡中采集卵母细胞，同时伴有排卵的 DF。此外，B 组和 C 组还包括是否从小卵泡中获得成熟卵母细胞的亚组。DF 和小卵泡抽吸后，于取卵日通过胞浆内单精子注射（ICSI）使成熟卵母细胞受精，不成熟卵母细胞成熟。如果不成熟卵母细胞成熟，则通过 ICSI 使它们受精，然后相应地转移从成熟卵母细胞和不成熟卵母细胞获得的胚胎。
445 个周期（83.0%）成功采集到 DF 卵母细胞，54 个周期（10.1%）未采集到卵母细胞，37 个周期（6.9%）DF 排卵。在 A 组中，平均采集到 2.0±1.7 个成熟卵母细胞，明显高于 B 组的 1.3±1.3 个和 C 组的 1.1±1.5 个（<0.01）。然而，三组中每组采集到的不成熟卵母细胞的平均数量没有差异。三组之间不成熟卵母细胞的成熟率、受精率均无显著差异。A、B、C 组的每移植周期临床妊娠率分别为 34.5%、34.6%和 25.7%。B 组和 C 组的胚胎发育和着床能力与 A 组相比无显著差异。三组的临床妊娠率、着床率、活产率和流产率无显著差异。B 组和 C 组中无论是否采集到成熟卵母细胞，其发育和着床能力均无显著差异。
卵巢中优势卵泡的存在或排卵并不会显著影响从小卵泡中采集的不成熟卵母细胞的发育和着床能力，这表明 NC-IVF/M 是一种很有前途的无卵巢刺激女性的治疗选择。
