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.
Fertil Steril. 2022 Oct;118(4):680-687. doi: 10.1016/j.fertnstert.2022.07.008. Epub 2022 Sep 6.
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.
A retrospective cohort study.
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.
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。
回顾性队列研究。
学术医疗中心。
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。
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。
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。
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。