卵丘颗粒细胞复合体在卵母细胞体外成熟和胚胎发育中的作用

The role of cumulus-granulosa cells complexes in the maturation of oocytes and embryo development in vitro

目的探讨卵丘颗粒细胞复合体在卵胞浆内单精子显微注射(ICSI)治疗周期中人类未成熟卵母细胞体外成熟和胚胎发育中的作用。方法收集156例不孕不育患者行ICSI治疗周期中获得的305枚未成熟卵[MⅠ期(A):186枚;GV期(B):119枚],随机分为加颗粒细胞组(A1组、B1组)和对照组(A2组、B2组),体外培养24-48h后比较不同时间段两组的成熟情况、受精后胚胎的发育情况以及培养液中雌二醇(E2)和孕酮(P)的分泌水平。结果加入颗粒细胞复合体共培养24-48h后,A1组24h成熟率和48h总成熟率高于A2组(P<0.05&P<0.05),B1组25-48h新增成熟率和48h总成熟率显著高于B2组(P<0.01&P<0.01),成熟后正常受精率、卵裂率、囊胚形成率组间比较均无统计学差异,但是A1组的优质胚胎率高于A2组(P<0.05);加颗粒细胞组的培养液中E2水平明显高于对照组(P<0.01)。结论与卵丘颗粒细胞复合体共培养可以提高ICSI治疗周期中所获未成熟卵的体外成熟率且MⅠ期来源的成熟卵母细胞可以获得更高的优质胚胎率。

Objective： To explore the clinical value of cumulus-granulosa cells complexes in the maturation of human oocytes and embryo development in vitro derived from intracytolasmic sperm injection （ICSI） cycles. Methods： A total of 305 immature human oocytes [M I phase （A） ： 186; GV phase （B） ： 119] were collected from ICSI treatment cycles. All of these immature oocytes were divided into different groups- granulosa ceils groups （A1, B1 ） and control groups （A2, B2） and cultured for 24 to 28 hours. The maturation and levels of estrogen （F~） and progesterone （P） in the culture medium were analyzed, as well as the frequency of embryo development underwent the ICSI procedure. Results： After the oocytes was co-cultured with cumulus- granulosa cells complexes for 24-48h, the maturation rate in 24h and total maturation rate in 48h of group A1 were higher than that of group A2 （P〈0.05＆P〈0.05） , the increased maturation rate of group B1 in 25-48h and total maturation rate in 48h were significantly higher than that of groups B2 （P〈0.01＆P〈0.01） , there was no statistically significant difference in the normal fertilization rate, cleavage rate and blastocyst formation rate after maturation, but the high-quality embryo rate of group A1 was higher than that of group A2 （P〈 0.05） ; The level of E2 in culture medium of granulose cell group was higher than that of control group （P〈0.01） . Conclusions： Co-culturing immature human oocytes with cumulus-granulosa cells prior to ICSI improves the maturation rate, and the rate of high-qualitv embryos can be increased for mature oocytes from M I stage.