体外受精-胚胎移植周期未成熟卵体外成熟培养的临床价值

Clinical value of immature human oocytes matured in vitro derived from IVF-ET cycles

目的探讨体外受精-胚胎移植(IVF-ET)周期未成熟卵体外成熟培养(IVM)的临床价值。方法对106例不孕患者IVF/ICSI-ET治疗周期中357枚未成熟卵(MⅠ期,217枚;GV期,140枚)进行24h和48h体外培养,比较不同发育阶段未成熟卵的体外成熟率、受精率、卵裂率、优质胚胎率及囊胚形成率。结果 MⅠ期卵24h和48h总成熟率均显著高于GV期卵(分别为59.91%vs.24.29%和72.35%vs.42.86%)(P<0.05);体外成熟MⅡ卵平均每取卵周期可利用胚胎数只有(0.50±0.84)枚,且受精率、卵裂率和优胚率、可利用胚胎数均显著低于同一促排卵周期体内成熟MⅡ卵(P<0.05)。结论 IVF-ET周期中所获未成熟卵经IVM能发育成熟,并具备一定的受精和胚胎发育潜能,但相关指标明显低于体内成熟卵,临床应用价值有限。

Objective： To explore the clinical value of immature human oocytes cultured in vitro derived from IVF-ET cycles.Methods： A total of 357 immature human oocytes（217 MⅠand 140 GV）were collected from 106 conventional IVF/ICSI cycles and performed in vitro culture for 24 or 48 hours in the study.The maturation rate,normal fertilization rate,cleavage rate,good quality embryo rate and blastulation rate were compared between MⅠ and GV oocytes.Results： The maturation rates of M Ⅰoocytes in 24 or 48 hours（59.91% and 72.35%）were significantly higher than those of GV oocytes（24.29% and 42.86%,P0.05）.There were only（0.50±0.84）available embryos per oocyte retrieval cycle in IMV-MⅡ oocytes.The normal fertilization rate,cleavage rate,good quality embryo rate and available embryos derived from oocytes matured in vitro were significantly lower than the oocytes matured in vivo in same IVF-ET cycle（P0.05）.Conclusions：Immature human oocytes derived from conventional IVF-ET cycles could be matured through in vitro culture and have some potential of fertilization and development.However,the fertilization rate and available embryos were significantly lower than the oocytes matured in vivo.The clinical application value is limited.