卵母细胞成熟障碍4例与同期卵母细胞大部分不成熟患者比较分析

Analyze oocyte maturation arrest of four patients and patients at the same period most of the oocytes aren't mature

目的分析4例体外受精-胚胎移植(IVF-ET)患者共8个辅助助孕周期,全部73个卵母细胞均处于GV、Metaphase I期的可能原因。并与同期13例IVF-ET患者比较分析,比较组患者>50%卵母细胞处于GV、Metaphase I期。方法回顾分析本中心12年辅助助孕工作中出现的4例患者共8个周期所获卵母细胞均处于GV、MI的临床及实验室资料,并与同期13例超过50%卵母细胞处于GV、MI患者的临床、实验室资料进行比较。结果 4例患者73个卵母细胞均处于GV或MI期,经体外成熟培养,24,48,72 h仍无极体排出,停滞于GV、MI期。同期13例患者大部分卵母细胞不成熟,但体外培养后部分卵母细胞可进一步成熟,并可受精,获得妊娠。结论细胞和遗传机制引起卵母细胞成熟障碍,现有体外成熟培养方法尚无法促其成熟,目前赠卵是该类患者获得妊娠可供选择的助孕方法。但对于在控制性超促排卵中,出现大部分卵母细胞不成熟的患者可以通过延长促超排时间,增大hCG注射日卵泡直径,体外成熟培养等方法获得成熟的卵母细胞,获得妊娠。

Objective： To analyze four patients of IVF - ET, altogether eight cycles. Why all of the eighty - two oocytes are both in GV, MI？ And analyze thirteen patients which do the IVF - ET at the same time, this group of patients have more than fifty percent oocytes in GV, MI. Methods ： To review four patients, altogether eight cycles, in our centre of ten years＇ works. The clinic and lab informations of the patients. And the clinic and lab informations of thirteen patients who have more than fifty percent oocytes in GV, MI. Results ： Four patients, eighty - two oocytes, are both in GV, MI, after vitro mature cultivate for 24, 48, 72 hours, still haven＇t polar body discharged, still in GV, MI. That thirteen patients, although most of the oocytes aren＇t mature, after vitro mature cultivate, parts of the oocytes can mature, fertilize, and at last get pregnancy. Conclusion： Cell and genetic mechanism cause oocyte maturation arrest, available vitro mature cultivate can＇t promote it to maturation. Giving oocyte is the only method to help them to pregnant. But for patients in COH, most of whose oocytes aren＇ t mature, we can enlarge the diameter of the follicles and vitro mature cultivate, and get pregnancy.