未成熟卵体外成熟技术在卵巢反应不良和卵泡发育迟缓周期中的应用

In vitro maturation (IVM) rescues the poor responding of ovary and follicular developmental retardation in conventional in-vitro fertilization (IVF) cycles.

目的探讨利用未成熟卵体外成熟技术治疗卵巢反应不良和卵泡发育迟缓周期的可能性.方法2000年10月至2002年7月间,在南京医科大学第一附属医院生殖中心取在常规体外受精(IVF)刺激周期中卵巢反应不良和卵泡发育迟缓患者的生发泡期卵母细胞,体外成熟培养24～48h后,对排出第一极体的卵母细胞采用单精子卵浆内注射法(ICSI)受精,受精3d后移入患者子宫,移植后通过检查血清HCG含量和B超判断妊娠结局.结果8个周期共取生发泡期卵母细胞41枚,成熟培养后有33枚卵母细胞排出第一极体,体外成熟率为80.5%(33/41).ICSI后,正常受精率为78.8%(26/33).平均每周期移植胚胎2.5(20/8)枚,获得3例妊娠.结论未成熟卵体外成熟技术可以用来挽救常规IVF治疗中卵巢反应不良和卵泡发育迟缓的周期.

Objective To apply in vitro maturation (IVM) to poor responding of ovary and retardation of follicular development during conventional in vitro fertilization (IVF) cycle.Methods Between October 2000 and July 2002,the germinal vesicle stage oocytes were retrieved and cultured from the patients whose follicles poorly developed or retarded during the conventional IVF cycles in our center.Intracytoplasmic sperm injection (ICSI) were performed on the metaphaseⅡoocytes matured in vitro.Embryo transfer was performed on day 3 after ICSI.Serum HCG and B-ultrasonograph were used to identify the results of pregnancy.Results A total of 41 immature oocytes were picked up from 8 cycles.After cultured in maturating medium,33 oocytes extruded the first polar bodies,the in vitro maturation rate was 80.5%(33/41).26 oocytes were normal fertilized by ICSI.The normal fertilization rate was 78.8%(26/33).The mean 2.5 embryos were transferred to the patients on day 3 after ICSI.Three clinical pregnancies were found by elevated serum HCG and confirmed by ultrasound.Conclusion In vitro maturation technique can be used to rescue the poor responding of ovary and follicular developmental retardation cycles during rountine IVF process.