未促排卵的未成熟卵母细胞体外培养成熟治疗不孕症40例分析

Fifty-four cycles analysis of in vitro maturation of unstimulated immature oocyte for the treatment of infertility women

目的比较未促排卵的未成熟卵母细胞体外培养成熟(IVM)治疗多囊卵巢综合征(PCOS)和正常月经周期伴不孕患者的临床疗效。方法回顾性分析2004年8月至2005年1月温州医学院第一医院收治的40例不孕患者,接受54个周期的IVM治疗,其中难治性PCOS不孕患者26例35个周期(A组),月经周期正常且经其它辅助生育技术失败的不孕患者14例19个周期(B组),均未采用任何药物刺激。结果共有7个周期取消,其中A组1个,取消率为2.8%;B组6个,取消率为31.6%,差异有极显著性意义(P<0.01)。有胚胎移植的47个周期中,两组的平均获卵数、体外成熟率、正常受精率和卵裂率、平均移植胚胎数差异无显著性意义(P>0.05)。A组1例生化妊娠,15例临床妊娠,B组4例临床妊娠。两组每穿刺周期的临床妊娠率(42.9%、21.1%)差异有极显著性意义(P<0.01),每移植周期的临床妊娠率、种植率和多胎率差异无显著性意义(P>0.05)。结论未促排卵的IVM技术治疗不孕症,尤其对于难治性PCOS不孕更是一种有效的方法。

Objective To observe the clinical effectiveness of in vitro maturation （IVM） of immature oocytes from unstimulated infertility women in treating infertility with polycystic ovarian syndrome or regular menstrual cycle. Methods Between August 2004 and January 2005, 54 cycles of IVM in 40 infertility patients were enrolled in our center, including 26 women（35 cycles） with obstinate polycystic ovary syndrome （PCOS） as group A, 14 patients （19 cycles） with regular menstrual who have had the history of failed assisted reproductive technology （ART） as group B. The immature oocytes were retrived. without stimulation. Results Seven cycles were cancelled, one cycle in group A, and the cancellation rate was 2.8% ; six cycles in group B and the cancellation rate was 31.6% ;there were significant difference between the two groups （P 〈0. 01 ）. Among the 47 embryo - transfer cycles, the mean numbers of oocytes, maturation rate, fertilization rate and cleavage rate, and the mean numbers of embryos transferred were not significantly different between the two groups（P 〉0. 05）. The pregnancy rate per puncture was significantly different （42. 9% vs 21.1%, P 〈 0. 01 ）, while the pregnancy rate per transfer, implantation rate and multiple pregnancy rate showed no significant difference（P 〉 0. 05） between group A and B. Conclusion In vitro maturation technique of unstimulated protocols can be used to treat infertility, which is an especially effective method for the treatment of obstinate PCOS.