卵母细胞滑面内质网聚集体与辅助生殖妊娠结局关系的研究进展

Smooth endoplasmic reticulum clusters in IVF and its impact on clinical outcomes

在人类辅助生殖中,经促排卵体外获得的卵母细胞中,有滑面内质网聚集体(smooth endoplasmic reticulum clusters,sERC)形成者占有一定比例。这些卵母细胞最终发展为非整倍体的比例较高,影响随后的胚胎发育和妊娠结局。近年来研究显示:卵母细胞胞质内sERC的形成与多种因素相关,主要是Ca2+浓度变化的影响。大多数学者认为卵母细胞sERC的形成会导致受精率、卵裂率和囊胚形成率降低及胚胎质量的下降,使得妊娠率显著降低;然而,也有多项报道已证实含sERC的卵母细胞可以正常受精并获得后代。因此对于那些临床助孕治疗中获得sERC+胚胎或者胚胎数目不足的患者,移植sERC+胚胎或sERC+/sERC-胚胎不失为胚胎移植的一个选择。

In the procedure of human assisted reproduction, the cytoplasm of the oocytes obtained from promoting ovulation may appear smooth endoplasmic reticulum clusters（s ERC） which assume a definite proportion of the numerous morphological abnormalities. These oocytes could develop into aneuploidy to a scale and affect the embryonic development and pregnancy outcomes consecutively. Whether the s ERC＋ embryos could be implanted in the process of assisted reproduction has not been determined. The review is focused on the discoveries about the prognosis of the s ERC＋ human oocytes overall the world during the past decades and found that a group of factors have an association with its formation mechanism especially the change of the concentration of Ca2＋. The majority of the studies suggested that it could lead to the reduction of the fertilization rate, cleavage rate and blastocyst formation rate as well as the reduction of embryonic development and embryo quality, which eventually making the pregnancy rate significantly reduce. Both domestic and foreign researchers, however, have confirmed that the oocytes containing s ERC can fertilize normally and develop into a healthy baby. In this review,for the couples who obtained s ERC＋ embryos, implanting s ERC＋ embryos or s ERC＋/s ERC- embryos may be a good option.