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卵母细胞成熟率低与体外受精和胞浆内单精子注射活产率降低有关。

Low oocyte maturity ratio is associated with a reduced in vitro fertilization and intracytoplasmic sperm injection live birth rate.

机构信息

Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, USA.

Department of Obstetrics and Gynecology, Monument Health, Spearfish, South Dakota.

出版信息

Fertil Steril. 2022 Oct;118(4):680-687. doi: 10.1016/j.fertnstert.2022.07.008. Epub 2022 Sep 6.

Abstract

OBJECTIVE

To determine whether a low oocyte maturity ratio in a cohort of oocytes from an in vitro fertilization cycle predicts outcomes and to examine clinical factors associated with oocyte maturity.

DESIGN

A retrospective cohort study.

SETTING

An academic medical center.

INTERVENTION(S): Determination of oocyte maturity immediately after the retrieval and 6 hours later if intracytoplasmic sperm injection was performed.

MAIN OUTCOME MEASURE(S): The primary outcome was live birth rate after the first embryo transfer. Secondary outcomes included clinical pregnancy, miscarriage, and fertilization rates.

RESULT(S): After adjusting for age, preimplantation genetic testing, and number of embryos transferred, we found that a low oocyte maturity ratio was associated with a decreased live birth rate (adjusted odds ratio [AOR], 0.41; 95% confidence interval [CI], 0.22-0.77) and clinical pregnancy rate (AOR, 0.32; 95% CI, 0.17-0.61). We did not find a relationship between oocyte maturity and miscarriage rate (AOR, 0.25; 95% CI, 0.03-1.91) or fertilization rate (Welch test). The number of 2 pronuclei embryos per retrieved oocyte was found to be associated with the maturity ratio at retrieval. Patients with anovulation had slightly reduced oocyte maturity compared with other diagnostic groups.

CONCLUSION(S): Low oocyte maturity ratio is an important factor related to poor in vitro fertilization outcomes, including decreased pregnancy and live birth rates.

摘要

目的

确定体外受精周期中卵母细胞成熟率低是否预测结局,并研究与卵母细胞成熟相关的临床因素。

设计

回顾性队列研究。

地点

学术医疗中心。

干预

取卵后即刻和卵胞浆内单精子注射后 6 小时测定卵母细胞成熟度。

主要观察指标

首次胚胎移植后的活产率为主要结局。次要结局包括临床妊娠率、流产率和受精率。

结果

校正年龄、植入前遗传学检测和胚胎移植数后,我们发现卵母细胞成熟率低与活产率降低相关(校正优势比 [AOR],0.41;95%置信区间 [CI],0.22-0.77)和临床妊娠率(AOR,0.32;95%CI,0.17-0.61)降低相关。我们未发现卵母细胞成熟度与流产率(AOR,0.25;95%CI,0.03-1.91)或受精率(Welch 检验)之间存在相关性。每个获卵的 2 原核胚胎数与取卵时的成熟度比值相关。与其他诊断组相比,排卵障碍患者的卵母细胞成熟度略有降低。

结论

卵母细胞成熟率低是体外受精结局不良的重要因素,包括妊娠率和活产率降低。

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