自然周期IVF/IVM技术取卵时有无成熟卵母细胞获得对临床结局的影响  

Clinical outcomes for natural cycle IVF /IVM treatment based on the mature or immature oocytes retrieved at time of collection

作　　者：李建华[1] 郭军红[1] 徐野[1] 

机构地区：[1]北京军区总医院生殖医学中心,北京100700

出　　处：《中国优生与遗传杂志》2013年第8期116-119,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨取卵时卵母细胞成熟度对自然周期IVF/IVM临床结局的影响。方法实施自然周期IVF/IVM技术的患者首先根据取卵时是否获得成熟卵母细胞分为两组:A组:取卵时有成熟卵母细胞获得;B组:取卵时获得卵母细胞全部未成熟。然后根据取卵时优势卵泡(dominant follicle,DF)和小卵泡(small follicle,SF)中是否有成熟卵母细胞,将A组分为3类:A1:DF和SF取卵时都有成熟卵母细胞获得;A2:取卵时只有DF中获得成熟卵母细胞;A3:取卵时DF中未成熟,SF中有成熟卵母细胞。比较各组体外成熟率、受精率和卵裂率以及临床妊娠率、着床率、分娩活胎率和流产率等。结果 A组和B组之间的体外成熟率、受精率和卵裂率无显著差异,两组的临床妊娠率分别为35.2%(152/432)和28.1%(27/96),也无显著差异。但是,B组活胎率(48.1%)相对于A组(72.4%)显著下降,流产率(51.9%VS27.6%)显著上升。在有成熟卵母细胞获得的三组中,临床妊娠率(A1:38.2%,A2:33.6%,和A3:30.9%)、着床率(分别为16.4%,15.5%和14.1%)以及活胎率和流产率都无显著差异。结论自然周期IVF/IVM技术治疗中,虽然取卵时有无成熟卵母细胞对产生的临床妊娠率未产生显著影响,但是取卵时有成熟卵母细胞组的活胎率显著高于未成熟卵母细胞组。Objective： To compare the clinical outcomes of natural cycle in vitro fertilization（IVF） combined with in vitro maturation（IVM） treatment（natural cycle IVF / IVM） based on the mature or immature oocytes retrieved.Methods： Infertile women were divided into two groups：（A） with mature oocytes retrieved at the time of oocyte collection and（B） with only immature oocytes at the time retrieval.Group A was further divided into three subgroups：（A1） mature oocytes retrieved from both the dominant and small follicles,（A2） mature oocytes retrieved from the dominant follicle only,and（A3） mature oocytes retrieved from the small follicles only.The rates for IVM of immature oocyte,fertilization and cleavage as well as clinical pregnancy and implantation were compared.Results： There were no significant differences seen in the rates for IVM,fertilization and cleavage between Group A and B.The clinical pregnancy rates were 35.2%（152 /432） and 28.1%（27 /96） for groups A and B,respectively,with no significant differences observed.However,the live birth rate in Group B（48.1%） was significant decreased compared with Group A（72.4%） and the miscarriage rate was significantly higher in Group B（51.9%） than Group A（27.6%）.Meanwhile,there were no differences in pregnancy rates among the three subgroups of Group A（A1： 38.2%,A2： 33.6%,and A3： 30.9%） as well as the implantation rates among the groups（16.4%,15.5% and 14.1%,respectively）.Conclusions： In natural cycle IVF / IVM treatment,the clinical pregnancy rates are not different based on the mature oocytes retrieved at the time of collection,while the live birth rate is higher（P 0.05） when the mature oocytes are obtained at the time of retrieval.

关 键 词：IVF 体外成熟 自然周期 不孕症 临床妊娠率 

分 类 号：R714.8[医药卫生—妇产科学]