Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
J Assist Reprod Genet. 2024 Aug;41(8):1939-1950. doi: 10.1007/s10815-024-03211-9. Epub 2024 Jul 24.
To assess the developmental competence of oocytes matured following rescue in vitro maturation (IVM).
PubMed, EmBASE, and SCOPUS were systematically searched for peer-reviewed original papers using relevant keywords and Medical Subject Heading terms. Study quality was assessed using the Newcastle-Ottawa Scale. Odds ratios with a 95% confidence interval were calculated by applying a random effects model. The primary outcomes were fertilization and blastulation rates. Secondary outcomes included abnormal fertilization, cleavage, euploidy, clinical pregnancy, and live-birth rates.
Twenty-four studies were included in the meta-analysis. The oocytes matured following rescue IVM showed significantly reduced fertilization, cleavage, blastulation, and clinical pregnancy rates compared to sibling in vivo-matured oocytes. No significant differences were found for the euploidy and live-birth rates in euploid blastocyst transfer. In poor responders, a reduced fertilization rate was observed using in vitro-matured GV but not with in vitro-matured MI. A reduced cleavage rate in MI matured overnight compared to < 6 incubation hours was found.
Our results showed compromised developmental competence in oocytes matured following rescue IVM. However, in poor responders, rescue IVM could maximize the efficiency of the treatment. Notably, our data suggests using in vitro MI matured within 6 incubation hours.
CRD42023467232.
评估体外成熟（IVM）后成熟卵母细胞的发育能力。
系统检索 PubMed、EmBASE 和 SCOPUS 数据库，使用相关关键词和医学主题词搜索同行评审的原始论文。使用纽卡斯尔-渥太华量表评估研究质量。应用随机效应模型计算优势比及其 95%置信区间。主要结局指标为受精率和囊胚形成率。次要结局指标包括异常受精、卵裂、整倍体率、临床妊娠率和活产率。
共有 24 项研究纳入荟萃分析。与体内成熟的同胞卵母细胞相比，体外成熟后成熟的卵母细胞显示出显著降低的受精率、卵裂率、囊胚形成率和临床妊娠率。整倍体囊胚转移的整倍体率和活产率无显著差异。在卵巢反应不良者中，体外成熟的GV 显示出降低的受精率，但体外成熟的 MI 则没有。与孵育<6 小时相比，过夜培养的 MI 成熟的卵裂率降低。
我们的研究结果表明，体外成熟后成熟的卵母细胞发育能力受损。然而，在卵巢反应不良者中，体外成熟 IVM 可以最大限度地提高治疗效率。值得注意的是，我们的数据表明使用体外 MI 成熟并在 6 小时内孵育。
CRD42023467232。
