自然周期未成熟卵体外培养卵母细胞成熟率与临床结局的关系

Oocyte maturation rate of in vitro maturation treatment affects outcomes in vitro fertilization-embryo transfer

目的探讨在自然周期未成熟卵体外培养后行体外受精与胚胎移植（IVF—ET），所获卵母细胞的成熟比例与胚胎发育及妊娠结局的关系。方法2008年1月至2011年4月接受自然周期未成熟卵体外培养治疗的PCOS患者183个周期，按卵母细胞成熟比例分为70％～100％（Ⅰ组）、55％～69％（Ⅲ组）、40％～54％（Ⅲ组）、〈40％（Ⅳ组），分析4组的胚胎发育情况及妊娠结局。结果4组的平均获卵数、受精率、卵裂率、平均胚胎移植数差异均无统计学意义（均P〉0．05）。Ⅳ组的胚胎种植率（7．14％）和妊娠率（13.51％）明显低于前3组（24．53％、22．93％、16.77％）和（48．65％、44．64％、33．96％），均P〈0．05，而其流产率（60％）则明显高于前3组（27．78％、20％、33．33％），均P〈0．05。结论卵母细胞成熟比例低组，胚胎的发育潜能及最终的妊娠结局也偏弱，流产率增加。

Objective To investigate the relationship between oocyte maturation rate and outcomes of in vitro fertiliza- tion-embryo transfer （IVF-ET）. Methods A total of 183 cycles from patients with polycystic ovary syndrome （PCOS） underwent in vitro maturation treatment in our center from January 2008 to April 2011. According to the oocyte maturation rate the cycles were divided into 4 groups： group I （70%tol00%）,group II （55%- 69%）,group III （40%- 54%） and group IV （〈40%）. Embryo development and pregnancy outcomes were compared among 4 groups. Results There were no significant differences in fertilization rate, cleavage rate ancl embryo transfer number among 4 groups. The embryo implantation rate and pregnancy rate in group IV （7.1%, 13.5%） was significantly lower than those of other 3 groups （24.5% and 48.7% in group I, 22.9% and 44.6% in group II, 16.8% and 34.0% in group III）（P〈0.05）. The abortion rate in group IV （60.0%） was significantly higher than those of other 3 groups （27. 8% ,20.0% ,33.3% in group I,II,lll,respectively）（P〈0.05）. Conclusion Low oocyte maturation rate might result in decreased embryo development potential, lower pregnancy rate and higher abortion rate in IVF-ET.