Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China..
Reprod Biomed Online. 2024 Mar;48(3):103571. doi: 10.1016/j.rbmo.2023.103571. Epub 2023 Oct 1.
Are blastocysts derived from in-vitro-matured metaphase I (MI) oocytes less likely to produce usable embryos for transfer compared with those derived from in-vivo-matured oocytes in cycles undergoing preimplantation genetic testing (PGT)?
The primary outcome was usable blastocyst rate, which was compared between blastocysts derived from in-vitro-matured MI oocytes after ovarian stimulation and from in-vivo-matured oocytes. Logistic regression analysis using generalized estimating equations was used to control for confounders in the analysis of factors that may influence the chance of a blastocyst being usable and in the comparison of embryological outcomes. Student's t-test, Mann-Whitney U test, chi-squared tests or Fisher's exact tests were used to compare clinical and pregnancy outcomes.
A total of 1810 injected metaphase II (MII) oocytes from 154 PGT cycles involving 154 couples were included in this study. A total of 1577 MII oocytes were in-vivo-matured and 233 were in-vitro-matured MI oocytes. The usable blastocyst rate was similar between the in-vitro-matured MI oocyte group and the in-vivo-matured oocyte group (adjusted RR 0.97, 95% CI 0.40 to 2.34). Three live births were achieved using usable blastocysts derived from in-vitro-matured MI oocytes.
If in-vitro-matured MI oocytes can be fertilized and develop into blastocysts, their ability to provide usable embryos for transfer is similar compared with those developed from in-vivo-matured oocytes. These blastocysts could be considered valuable for women with few viable embryos in assisted reproductive technology cycles.
与接受植入前遗传学检测（PGT）的周期中体内成熟的卵母细胞相比，体外成熟的中期 I（MI）卵母细胞产生可用于移植的胚胎的可能性是否更低？
主要结局为可利用囊胚率，通过比较卵巢刺激后体外成熟 MI 卵母细胞和体内成熟卵母细胞产生的囊胚率来评估。使用广义估计方程的逻辑回归分析用于控制分析中可能影响囊胚可利用性的因素以及胚胎发育结局比较中的混杂因素。使用 Student's t 检验、Mann-Whitney U 检验、卡方检验或 Fisher 确切概率检验来比较临床和妊娠结局。
共纳入 154 对夫妇的 154 个 PGT 周期中 1810 枚注射的中期 II（MII）卵母细胞。共有 1577 枚 MII 卵母细胞为体内成熟，233 枚为体外成熟的 MI 卵母细胞。体外成熟 MI 卵母细胞组和体内成熟卵母细胞组的可利用囊胚率相似（调整后的 RR 0.97，95%CI 0.40 至 2.34）。使用体外成熟 MI 卵母细胞获得的可利用囊胚共实现了 3 例活产。
如果体外成熟的 MI 卵母细胞能够受精并发育成囊胚，那么它们提供可用于移植的胚胎的能力与体内成熟的卵母细胞发育的胚胎相似。这些囊胚可被视为辅助生殖技术周期中具有少量有活力胚胎的女性的宝贵资源。
