自然周期未成熟卵体外培养、受精和胚胎移植研究

In vitro maturation,fertilization and embryo transfer of immature oocytes derived from nature cycles

目的:探讨自然周期未成熟卵体外成熟培养(In vitro maturation,IVM)、受精和胚胎移植技术在治疗不育症中的应用。方法:选取30对接受体外授精/卵胞浆内单精子显微注射-胚胎移植(In vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)助孕的不育夫妇为对象,在自然月经周期卵泡直径>10mm、内源性LH(Luteinizing hormone)峰出现之前采卵。采卵当日成熟卵(MetaphaseⅡ,MⅡ)行IVF授精,未成熟卵进行体外培养24～48h,成熟至MⅡ期后行ICSI授精,受精后72h行胚胎移植。结果:30个IVM周期中,2个周期取卵未获卵。另28个周期共获卵113个,其中成熟卵29个,退化卵10个,未成熟卵74个,体外培养后成熟60个,成熟率81.08%。20个周期有胚胎移植,6例临床妊娠。其中5例成功分娩足月健康婴儿(1例来自成熟卵、4例来自未成熟卵),1例临床妊娠流产。结论:自然周期未成熟卵IVM、受精和胚胎移植技术可以用于治疗不育患者。

Objective： To investigate the effect of in vitro maturation （IVM） ,fertilization and embryo transfer of immature oocytes derived from nature cycles in infertility couples. Methods： 30 IVF/ICSI-ET cycles were involved in this study. Oocytes retrieval performed after follicle larger than 10 mm and before endogenesis Luteinizing hormone （LH） surge occurrence in nature cycle. Mature oocytes （Metaphase Ⅱ） were inseminated by standard in vitro fertilization （IVF） on the oocytes pick-up day. Immature oocytes （Metaphase I and germinal vesicle stage） were cultured for 24-48 hours and fertilized by intracytoplasmic sperm injection （ICSI） as soon as it developed to Metaphase Ⅱ stage. Embryo transfer was performed 72 h after fertilization. Results： 2 of 30 IVM cycles brought no oocytes in this study. 113 oocytes were obtained among other 28 oocyte retrieval cycles,74 of which were immature,29 were mature,and 10 were degenerated. 60 of 74 immature oocytes developed to M 11 after IVM （maturation rate 81.08% ）. 6 cases of clinical pregnancy were obtained in the 20 embryo transfer cycles, five of which brought healthy babies（one came from immature oocyte and four came from mature oocyte） and one was abortive. Concision： IVM, fertilization and embryo transfer of immature oocytes derived from nature cycles is a feasible treatment for women with infertility.