Wang Hui-Tian, Gao Jing, Ou Jianping, Li Hai-Yang, Hong Ping-Ping, Shu Yi-Min, Li Tao
Reproductive Medicine Center, The Third Affiliated Hospital of Sun Yat-sen University, 6# East Longkou Road, Gangding, Tianhe District, Guangzhou 510630, PR China.
Division of Reproductive Endocrinology and Infertility, Women & Infants Hospital/The Warren Alpert Medical School of Brown University. Providence, RI, USA.
J Gynecol Obstet Hum Reprod. 2024 Apr;53(4):102738. doi: 10.1016/j.jogoh.2024.102738. Epub 2024 Feb 7.
Although abnormally fertilized zygotes with three or multiple pronuclei (3 PN/MPN) are commonly believed to be associated with improper maturation of the oocyte cytoplasm in conventional IVF cycles, no studies investigated the association between the proportion of MPN zygotes and the maturation state of the oocyte cohort. We compared the cytoplasmic maturity of oocytes from conventional IVF cycles with different proportions of 3 PN/MPN zygotes. A total of 1428 conventional IVF patients with ≥6 oocytes retrieved and fresh embryos transferred were divided into 4 groups according to the proportions of 3 PN/MPN zygotes. The pregnancy outcomes and the proportion of nuclear immature oocytes were analyzed to suggest the cytoplasmic maturation state of the oocyte cohort. Our results showed that the group with a low proportion of 3 PN/MPN zygotes had a higher clinical pregnancy rate (CPR) than those without 3 PN/MPN zygotes (P < 0.05). However, the live birth rate (LBR) was not significantly different between the two groups. The implantation rate (IR), CPR, and LBR did not differ between the low-proportion and high-proportion 3 PN/MPN groups. The proportion of nuclear immature oocytes on day 1 was highest in the group without 3 PN/MPN zygotes (23.8 %) and gradually decreased with an increased proportion of 3 PN/MPN zygotes (P < 0.001). Therefore, the presence of 3 PN/MPN zygotes after conventional IVF may indicate a more mature cytoplasmic state of the oocyte cohort, and the increased proportion of 3 PN/MPN zygotes is associated with an increased maturation state of the whole oocyte cohort. The occurrence and proportion of 3 PN/MPN zygotes may serve as an indicator for the cytoplasmic maturity of the oocyte cohort and help clinicians evaluate the efficiency of ovarian stimulation and optimize the stimulation protocols in subsequent cycles.
尽管在传统体外受精（IVF）周期中，通常认为具有三个或多个原核（3PN/MPN）的异常受精合子与卵母细胞胞质成熟异常有关，但尚无研究调查MPN合子比例与卵母细胞群体成熟状态之间的关联。我们比较了来自传统IVF周期、具有不同比例3PN/MPN合子的卵母细胞的胞质成熟度。共有1428例回收≥6个卵母细胞并进行新鲜胚胎移植的传统IVF患者，根据3PN/MPN合子的比例分为4组。分析妊娠结局和核未成熟卵母细胞的比例，以提示卵母细胞群体的胞质成熟状态。我们的结果显示，3PN/MPN合子比例低的组比没有3PN/MPN合子的组临床妊娠率（CPR）更高（P<0.05）。然而，两组的活产率（LBR）没有显著差异。低比例和高比例3PN/MPN组之间的着床率（IR）、CPR和LBR没有差异。第1天核未成熟卵母细胞的比例在没有3PN/MPN合子的组中最高（23.8%），并随着3PN/MPN合子比例的增加而逐渐降低（P<0.001）。因此，传统IVF后出现3PN/MPN合子可能表明卵母细胞群体的胞质状态更成熟，并且3PN/MPN合子比例的增加与整个卵母细胞群体成熟状态的增加相关。3PN/MPN合子的出现和比例可能作为卵母细胞群体胞质成熟的指标，并有助于临床医生评估卵巢刺激的效率以及优化后续周期的刺激方案。
