Esbert Marga, Reig Andrés, Ballestros Agustín, Seli Emre
IVIRMA Global Research Alliance, IVI Barcelona, 45 Mallorca, 08017, Barcelona, Spain.
IVIRMA Global Research Alliance, RMA New Jersey, 140 Allen, Basking Ridge, NJ, 07920, USA.
J Assist Reprod Genet. 2025 Mar;42(3):773-780. doi: 10.1007/s10815-024-03353-w. Epub 2025 Jan 9.
This study aimed to identify demographic and clinical factors associated with low maturation rates and to investigate if the rate of immature oocytes impacts the outcomes of mature sibling oocytes.
Women undergoing their first IVF-ICSI cycle between 2018 and 2022 at a fertility clinic were included. Cycles were classified into five groups according to the proportion of Metaphase II stage oocytes (MII): Null (0% MII, n = 46), Poor (1-25% MII, n = 44), Low (26-50% MII, n = 453), Acceptable (51-75% MII, n = 1641), and Optimal (76-100% MII, n = 2642). Demographic characteristics and clinical outcomes were compared between the five groups. In patients with a Null/Poor maturation rate, subsequent cycle outcomes were also evaluated.
A total of 4826 cycles were included in the study; 69,909 oocytes were recovered, and 53,065 were MIIs (75.9%). The Null group was older, had lower levels of anti-Müllerian hormone (AMH), needed more gonadotropins and days of stimulation, had higher follicle stimulating hormone (FSH) levels on day 3, and had less follicles > 15 mm on the day of trigger. When the outcomes of mature oocytes were compared, fertilization, usable blastocyst, aneuploidy, and life birth rates were comparable among groups. A binary logistic regression model using number of oocytes, paternal age, and trigger type with live birth rate endpoint found no differences between the categories and the base line Poor category. When patients whose maturation rate was Null/Poor, 42 (47.0%) carried out a second cycle; the maturation rate increased (56.9 ± 31.5 vs. 11.6 ± 11.2%, P < 0.0001).
Our data suggest that poor responders are more likely to have low rates of oocyte maturation. The proportion of immature oocytes does not impact the outcomes of mature sibling oocytes. In patients with Null/Poor maturation in their first cycle, the subsequent cycle is often associated with improved maturation rates.
本研究旨在确定与低成熟率相关的人口统计学和临床因素，并调查未成熟卵母细胞的比例是否会影响成熟同胞卵母细胞的结局。
纳入2018年至2022年在一家生育诊所进行首次体外受精-卵胞浆内单精子注射（IVF-ICSI）周期的女性。根据中期II期卵母细胞（MII）的比例将周期分为五组：无（0% MII，n = 46）、差（1-25% MII，n = 44）、低（26-50% MII，n = 453）、可接受（51-75% MII，n = 1641）和最佳（76-100% MII，n = 2642）。比较五组之间的人口统计学特征和临床结局。对于成熟率为无/差的患者，还评估了后续周期的结局。
本研究共纳入4826个周期；回收了69909个卵母细胞，其中53065个为MII（75.9%）。无组年龄更大，抗苗勒管激素（AMH）水平更低，需要更多的促性腺激素和刺激天数，第3天的卵泡刺激素（FSH）水平更高，扳机日直径>15mm的卵泡更少。比较成熟卵母细胞的结局时，各组之间的受精、可用囊胚、非整倍体和活产率相当。使用卵母细胞数量、父亲年龄和扳机类型作为活产率终点的二元逻辑回归模型发现，各分类与基线差分类之间没有差异。当成熟率为无/差的患者进行第二个周期时，42例（47.0%）；成熟率有所提高（56.9±31.5 vs. 11.6±11.2%，P < 0.0001）。
我们的数据表明，反应不良者更有可能卵母细胞成熟率低。未成熟卵母细胞的比例不会影响成熟同胞卵母细胞的结局。在第一个周期成熟率为无/差的患者中，后续周期的成熟率通常会提高。
