Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Bern, Switzerland.
Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Bern, Switzerland.
Reprod Biomed Online. 2023 Apr;46(4):705-712. doi: 10.1016/j.rbmo.2022.11.008. Epub 2022 Nov 18.
Does high-dose gonadotrophin stimulation have an effect on oocyte and early-stage embryo development?
This was a retrospective study including 616 natural cycle IVF (NC-IVF) and 167 conventional IVF (cIVF) cycles. In total, 2110 oocytes were retrieved and analysed in fresh cycles. In NC-IVF, only human chorionic gonadotrophin was applied to trigger ovulation. In cIVF, antagonist protocols with daily 150-300 IU of human menopausal gonadotrophins were performed. The effect of gonadotrophins on oocyte and early-stage embryo development was analysed. Primary outcomes were the occurrence of mature (metaphase II) oocytes, zygotes and embryos with good morphology at the cleavage stage 2 days after oocyte retrieval.
The mature oocyte rate (number of mature oocytes/number of retrieved oocytes) was higher in NC-IVF than cIVF cycles (89% versus 82%, adjusted odds ratio [aOR] 1.79, P = 0.001), as was the zygote rate per oocyte retrieved (70% versus 58%, aOR 1.76, P = 0.001) and the zygote rate per mature oocyte (79% versus 71%, aOR 1.62, P = 0.001). The percentage of zygotes that developed into cleavage-stage embryos was no different. For the transferred embryos, the probability of having a good embryo morphology with four blastomeres and a fragmentation of <10% (score 0) in cleavage-stage embryos was found to be higher in NC-IVF (proportional aOR for four blastomeres 2.00, P < 0.001; aOR 1.87 for a fragmentation score of 0, P = 0.003).
Oocyte maturity, oocyte fertilization and morphology of the cleavage-stage embryo are affected by high-dose gonadotrophin stimulation in fresh IVF cycles.
高剂量促性腺激素刺激对卵母细胞和早期胚胎发育有影响吗？
这是一项回顾性研究，包括 616 个自然周期 IVF（NC-IVF）和 167 个常规 IVF（cIVF）周期。在新鲜周期中总共取回并分析了 2110 个卵母细胞。在 NC-IVF 中，仅应用人绒毛膜促性腺激素（hCG）触发排卵。在 cIVF 中，采用拮抗剂方案，每日给予 150-300IU 人绝经期促性腺激素。分析促性腺激素对卵母细胞和早期胚胎发育的影响。主要结局是卵母细胞取回后 2 天卵裂期胚胎具有良好形态的成熟（MII）卵母细胞、受精卵和胚胎的发生率。
NC-IVF 周期的成熟卵母细胞率（成熟卵母细胞数/取回卵母细胞数）高于 cIVF 周期（89%比 82%，调整后的优势比[aOR]1.79，P=0.001），每个取回的卵母细胞获得的受精卵率（70%比 58%，aOR 1.76，P=0.001）和每个成熟卵母细胞获得的受精卵率（79%比 71%，aOR 1.62，P=0.001）也更高。胚胎发育到卵裂期的胚胎比例没有差异。对于转移胚胎，在 NC-IVF 中具有良好胚胎形态的可能性更高，即具有四个卵裂球且碎片率<10%（评分 0）的胚胎比例更高（aOR 用于四个卵裂球的比例为 2.00，P<0.001；aOR 用于碎片评分 0 的比例为 1.87，P=0.003）。
高剂量促性腺激素刺激对新鲜 IVF 周期中的卵母细胞成熟、卵母细胞受精和卵裂期胚胎形态有影响。
