Racowsky C, Prather A L, Johnson M K, Olvera S P, Gelety T J
Department of Obstetrics and Gynecology, College of Medicine, University of Arizona, Tucson 85724, USA.
Fertil Steril. 1997 May;67(5):932-8. doi: 10.1016/s0015-0282(97)81410-0.
To investigate the incidence of meiotic abnormalities, aneuploidy, and prematurely condensed sperm chromosomes in failed fertilized oocytes after controlled ovarian hyperstimulation (COH).
Retrospective analysis of air-dried preparations of unfertilized oocytes.
University hospital-based infertility clinic.
PATIENT(S): Thirty-three patients undergoing IVF having only tubal factor as the cause of infertility. Twelve patients (13 cycles) underwent treatment with hMG alone (-GnRH agonist [GnRH-a]), and 21 patients (24 cycles) underwent treatment with leuprolide acetate (LA) and hMG (+GnRH-a group).
INTERVENTION(S): Standard IVF-ET treatment cycle for ovarian stimulation using hMG with or without LA.
MAIN OUTCOME MEASURE(S): The meiotic stage, ploidy, and the presence of prematurely condensed sperm chromosomes were determined in 161 air-dried preparations of unfertilized oocytes.
RESULT(S): Significantly more unfertilized oocytes were at metaphase II in the -GnRH-a group as compared with the +GnRH-a group, with significantly fewer exhibiting meiotic aberrations. Aneuploidy rates did not differ between groups. However, significantly more oocytes in the +GnRH-a group revealed prematurely condensed sperm chromosomes than in the -GnRH-a group.
CONCLUSION(S): The use of GnRH-a for COH does not have an impact on aneuploidy rates in failed fertilized oocytes. However, the higher incidence of meiotic aberrations and prematurely condensed sperm chromosomes in the unfertilized population indicates that some retrieved oocytes exhibit incomplete nuclear and cytoplasmic maturation after the use of this agonist.
研究控制性卵巢过度刺激（COH）后未受精卵子中减数分裂异常、非整倍体及精子染色体过早凝缩的发生率。
对未受精卵母细胞的空气干燥制片进行回顾性分析。
大学附属医院的不孕不育门诊。
33例接受体外受精（IVF）的患者，仅输卵管因素为不孕原因。12例患者（13个周期）仅接受人绝经期促性腺激素（hMG）治疗（-促性腺激素释放激素激动剂[GnRH-a]），21例患者（24个周期）接受醋酸亮丙瑞林（LA）和hMG联合治疗（+GnRH-a组）。
采用含或不含LA的hMG进行标准IVF-ET治疗周期的卵巢刺激。
在161份未受精卵母细胞的空气干燥制片中确定减数分裂阶段、倍性及精子染色体过早凝缩情况。
与+GnRH-a组相比，-GnRH-a组未受精卵母细胞处于中期II的比例显著更高，减数分裂异常的比例显著更低。两组间非整倍体率无差异。然而，+GnRH-a组显示精子染色体过早凝缩的卵母细胞显著多于-GnRH-a组。
COH中使用GnRH-a对未受精卵子的非整倍体率无影响。然而，未受精群体中减数分裂异常及精子染色体过早凝缩的发生率更高，表明使用该激动剂后部分回收的卵母细胞表现出不完全的核成熟和细胞质成熟。
