卵巢刺激周期中未成熟MI期卵子体外成熟后行卵质内单精子注射的受精及胚胎发育结局  

The fertilization and embryo development outcome of ICSI of MI stage oocytes matured in vitro from controlled ovarian stimulation cycles

作　　者：阮井玲 潘家坪 陈智勤 刘文强 滕晓明 RUAN Jingling;PAN Jiaping;CHEN Zhiqin;LIU Wenqiang;TENG Xiaoming(Reproductive Medicine Center,Shanghai First Maternity and Infant Hospital,School of Medicine,Tongji University,Shanghai 200092,China)

机构地区：[1]同济大学附属第一妇婴保健院生殖医学中心,上海200092

出　　处：《中国优生与遗传杂志》2021年第10期1383-1386,共4页Chinese Journal of Birth Health & Heredity

基　　金：雄原核因子促进体细胞克隆胚胎发育潜能的机制探索青年基金项目(31501196)。

摘　　要：目的对促排卵周期中第一次减数分裂中期未成熟卵子(MI卵子)经过常规体外成熟培养后获得的卵子(MI-MII卵子)与同胞MII卵子行卵质内单精子注射(ICSI)后的结局进行比较。方法回顾性分析了本中心2020年1月到2020年12月62个ICSI周期,共636枚卵子,其中509枚MII卵子在剥除卵丘细胞后即行ICSI;另外,收集45枚同周期内未成熟的MI卵子经4 h的体外成熟培养,39枚卵成熟到MII(86.67%)后行ICSI,对两组卵子行ICSI后的受精率、卵裂率及妊娠结局进行比较。结果MI-MII组的卵子ICSI后的退化率(10.26%)高于MII组(7.27%),但无显著差异(P>0.05);MI-MII组的2PN受精率(79.49%)高于MII组(67.78%)(P<0.01)。MI-MII组和MII组的异常受精率(5.13%,7.47%)差异显著(P<0.05);两组的延迟受精率差异不显著(P>0.05),但MI-MII组的延迟受精率较高(5.13%)。MI-MII组的卵裂率(84.85%)低于MII组(90.7%),但差异不显著(P>0.05);MI-MII组与MII组的有效胚胎率无显著差异(96.43%,86.43%)。MII组移植后临床累积妊娠25例(41.67%),其中2例流产(8%)。MI-MII组至今未获得妊娠。结论未成熟MI卵子经体外成熟后形成的MI-MII卵子,可以作为ICSI注射的卵子来源,能够受精、卵裂并且可以增加可移植胚胎的数量,提高卵子利用率。然而,与体内成熟的MII卵相比,来源于同胞未成熟MI经体外成熟的MI-MII卵子行ICSI后,胚胎发育潜力是降低的。Objective We compared the outcome of intracytoplasmic sperm injection(ICSI)of in vitro matured MII oocytes(MI-MII)and sibling in vivo matured MII oocytes from controlled ovarian stimulation cycles.Methods 62 ICSI cycles from our center were analyzed retrospectively from January 2020 to January 2021,636 oocytes were collected of in all.ICSI was performed on 509 mature MII oocytes at oocyte denudation.In addition,45 MI oocytes were collected in the same cycle,ICSI was performed on 39 oocytes which extruded the first polar body after cultured in vitro for 4 h(86.67%).Fertilization rate,cleavage rate and the pregnancy outcome of ICSI were compared among two groups.Results The degeneration rate of MI-MII oocytes(10.26%)was higher than that of MII oocytes(7.27%),but there was no significant difference(P>0.05).The 2PN fertilization rate of MI-MII oocytes(79.49%)was very significantly higher than that of MII oocytes(67.78%)(P<0.01).There was significant difference in abnormal fertilization rate between MI-MII group and MII group(5.13%,7.47%)(P<0.05).There was no significant difference in the delayed fertilization rate between the two groups(P>0.05),but the delayed fertilization rate was higher in the MI-MII group(5.13%).The cleavage rate of MI-MII group(84.85%)was lower than that of MII group(90.7%),but the difference was not significant(P>0.05).There was no significant difference in effective embryo rate between MI-MII group and MII group(96.43%,86.43%).In MII group,25 patients(41.67%)had cumulative pregnancy after transplantation,among which 2 patients(8%)had miscarriage.The MI-MII group has not yet achieved pregnancy.Conclusion The in vitro maturation MI-MII oocytes can be used as the sources of oocytes for sperm injection,which can be fertilized and can increase the number of embryos available for transfer.However,the developmental competence of embryos derived from the in vitro maturation MI-MII oocytes is reduced,compared with sibling in vivo matured oocytes.

关 键 词：MI卵子 体外成熟 ICSI 胚胎发育 

分 类 号：R714.8[医药卫生—妇产科学]