Wittmaack F M, Kreger D O, Blasco L, Tureck R W, Mastroianni L, Lessey B A
Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Fertil Steril. 1994 Dec;62(6):1205-10. doi: 10.1016/s0015-0282(16)57186-6.
To determine the effect of follicular size, including the size of the leading follicle, on oocyte retrieval, fertilization, cleavage, and embryo quality in IVF cycles based on a large data collection.
Retrospective analysis of 1,109 IVF cycles between 1987 and 1993 at the Hospital of the University of Pennsylvania including 606 patients ranging in age from 23 to 49 years.
Follicles with a volume < or = 1 mL show a significantly lower oocyte recovery rate than follicles with a volume of > 1 mL. The highest recovery rate (83.5%) was found in follicles with a volume of 3 to 4 mL. Above a follicular volume of 7 mL, the oocyte recovery drops below that observed for follicles between 1 and 7 mL. Fertilization and cleavage rates were also higher in oocytes obtained from follicles > 1 mL compared with follicles < or = 1 mL. Although fertilization rates were fairly stable above volumes of 1 mL, cleavage rates continued to rise to a peak percentage of 92% with volumes between 6 and 7 mL. Leading follicle size did not have an effect on fertilization and cleavage rates of cohort oocytes. Embryo quality was not influenced significantly by follicular volume.
Based on this evaluation of a large number of follicles, follicular size is a useful indicator of oocyte recovery, fertilization, and cleavage in IVF cycles. For optimal results, the follicular fluid volume in gonadotropin- and hCG-stimulated cycles should be > 1 mL, which corresponds to a follicle diameter of > 12 mm, and not larger than 7 mL (24 mm). For timing of hCG administration, the number of adequate size follicles appears to be more important than the size of the leading follicle(s).
基于大量数据收集，确定卵泡大小，包括主导卵泡大小，对体外受精（IVF）周期中卵母细胞采集、受精、卵裂及胚胎质量的影响。
对1987年至1993年宾夕法尼亚大学医院的1109个IVF周期进行回顾性分析，其中包括606例年龄在23至49岁之间的患者。
体积≤1 mL的卵泡，其卵母细胞回收率显著低于体积＞1 mL的卵泡。体积为3至4 mL的卵泡回收率最高（83.5%）。卵泡体积超过7 mL时，卵母细胞回收率低于体积在1至7 mL之间的卵泡。与体积≤1 mL的卵泡相比，从体积＞1 mL的卵泡中获得的卵母细胞的受精率和卵裂率也更高。虽然体积超过1 mL时受精率相当稳定，但卵裂率在体积为6至7 mL时持续上升至峰值92%。主导卵泡大小对同期卵母细胞的受精率和卵裂率没有影响。卵泡体积对胚胎质量没有显著影响。
基于对大量卵泡的评估，卵泡大小是IVF周期中卵母细胞采集、受精和卵裂的有用指标。为获得最佳结果，促性腺激素和人绒毛膜促性腺激素（hCG）刺激周期中的卵泡液体积应＞1 mL，这相当于卵泡直径＞12 mm，且不大于7 mL（24 mm）。对于hCG给药时间，合适大小卵泡的数量似乎比主导卵泡的大小更重要。
