不同体外受精周期所获生殖泡期卵母细胞体外成熟后结果比较

Comparing Results with Immature Germinal Vesicle Oocytes From Different In-vitro Fertilization Cycles

【目的】研究对比体外受精-单精子卵胞浆内注射(IVF-ICSI)周期所获生殖泡期(GV)不成熟卵母细胞以及体外成熟(IVM)周期所获GV期卵母细胞体外培养成熟后的胚胎发育情况。【方法】163个IVF-ICSI周期中所获987个成熟卵为Ⅰ组,所获GV期卵进行体外培养后成熟的132个卵为Ⅱ组,另有37个IVM周期中所获GV期卵体外培养后成熟的235个卵为Ⅲ组。对3组均进行ICSI,并对其受精率、卵裂率及胚胎发育进行比较。【结果】Ⅰ组的受精率、卵裂率以及优质胚胎率均显著高于Ⅱ组及Ⅲ组(分别为84.9%,98.1%和61.6%;72.0%,90.5%和22.1%;75.3%,94.4%和25.1%)。Ⅰ组的胚胎卵裂球数目及胚胎形态评分均显著优于Ⅱ组及Ⅲ组(P<0.05);Ⅱ组与Ⅲ组相比差异无统计学意义。【结论】体内成熟卵形成的胚胎形态好于生殖泡期卵体外培养成熟者,IVF-ICSI周期的生殖泡期不成熟卵形成的胚胎形态学上与IVM周期的类似。

[Objective] This study compared outcomes of in vitro maturation （IVM） and in vitro fertilization （IVF） intracytoplasmic sperm injection （ICSI） cycles after IVM of immature germinal vesicle （GV） oocytes. [ Methods] ICSI was performed on metaphase Ⅱ （MII） oocytes retrieved in 163 IVF-ICSI cycles （group Ⅰ; n = 987） or matured from GV stage oocytes in IVF-ICSI （ group Ⅱ; n = 132） and 37 IVM cycles （ group Ⅲ; n = 235）. Fertilization and cleavage rates and embryo quality were compared among the three groups. [Results] The fertilization rate, cleavage rate and top quality embryos rate were higher in group Ⅰ than group Ⅱ and group Ⅲ （84.9%, 98.1%, and 61.6%; 72.0%, 90.5% and 22.1%1; 75.3%, 94.4%, and 25.1%, respectively）. Blastomere numbers and morphology scores were highest in group Ⅰ （P 〈 0.05）, but no significant differences existed between group Ⅱ and group Ⅲ. [Conclusion] The morphology of embryos developed from in viva MII oocytes was superior to those from in vitro matured MII oocytes. No significant difference was observed in embryo morphology from immature GV oocytes in IVF and IVM cycles.