Kalyoncu Şenol, Başbuğ Alper, Hatırnaz Ebru, Ellibeş Kaya Aşkı, Dokuzeylül Güngör Nur, Ürkmez Sebati Sinan, Civil Ürkmez Yeşim, Hatırnaz Şafak
Department of Obstetrics and Gynecology, Hasan Kalyoncu University Faculty of Medicine, Gaziantep, Turkey
Department of Obstetrics and Gynecology, Düzce University Faculty of Medicine, Düzce, Turkey
J Turk Ger Gynecol Assoc. 2024 Dec 10;25(4):219-223. doi: 10.4274/jtgga.galenos.2024.2023-10-9. Epub 2024 Jul 29.
The aim of this study was to investigate the developmental potential of immature oocytes and evaluate whether unstimulated in vitro maturation (IVM) could serve as a treatment option for women with oocyte maturation abnormalities (OMAs).
This cohort study was conducted between September 2019 and December 2022, and included women who underwent unstimulated, non-human chorionic gonadotropin (hCG) priming IVM. Oocytes were incubated with IVM medium for 26-48 hours and evaluated to compare their maturation profiles with the immature oocytes retrieved from the same patients in their previous in vitro fertilization cycles.
Among the twelve women in the study, eleven (91.6%) underwent whole exome sequencing analysis. Of these, 18 variants were identified in 10 individuals, excluding case 1, who had no previous mutation analysis. Of the mutations identified, 9 (50%) were located in , 5 (27.8%) in , 1 (5.6%) in , 1 (5.6%) in , 1 (5.6%) in , and 1 (5.6%) in . Apart from one woman with resistant ovary syndrome (ROS), none treated with unstimulated IVM had oocyte maturation. Remarkably, the only patient to achieve oocyte maturation in an unstimulated IVM cycle was case 11, who had ROS and a single variant.
Unstimulated, non-hCG primed IVM does not appear to be effective in the treatment of OMAs, perhaps with the exception of women with ROS. However, this study led our team to develop novel treatment options based on physiological mechanisms for some subtypes and supraphysiological approach for other subtypes of OMAs.
本研究旨在探讨未成熟卵母细胞的发育潜能，并评估未刺激的体外成熟（IVM）是否可作为卵母细胞成熟异常（OMA）女性的一种治疗选择。
本队列研究于2019年9月至2022年12月进行，纳入接受未刺激、非人绒毛膜促性腺激素（hCG）预处理IVM的女性。卵母细胞与IVM培养基孵育26 - 48小时，并进行评估，以将其成熟情况与同一患者先前体外受精周期中获取的未成熟卵母细胞进行比较。
研究中的12名女性中，11名（91.6%）接受了全外显子测序分析。其中，在10名个体中鉴定出18个变异，不包括病例1，其之前未进行突变分析。在鉴定出的突变中，9个（50%）位于 ，5个（27.8%）位于 ，1个（5.6%）位于 ，1个（5.6%）位于 ，1个（5.6%）位于 ，1个（5.6%）位于 。除一名患有抵抗性卵巢综合征（ROS）的女性外，接受未刺激IVM治疗的患者均未出现卵母细胞成熟。值得注意的是，在未刺激IVM周期中唯一实现卵母细胞成熟的患者是病例11，她患有ROS且有一个单一的 变异。
未刺激、非hCG预处理的IVM似乎对OMA治疗无效，患有ROS的女性可能除外。然而，本研究促使我们的团队基于某些亚型的生理机制和其他亚型的超生理方法开发新的治疗选择。
