补充褪黑素的人卵母细胞体外培养成熟技术在COH周期中的应用  

Application of melatonin-supplemented in vitro maturation technology for human oocytes during COH cycle

作　　者：任宇 韩星星 张琦琦 刘璐[7] 许孝凤[1,4,5,6] 章志国 邹慧娟[1,2,3,4] Ren Yu;Han Xingxing;Zhang Qiqi;Liu Lu;Xu Xiaofeng;Zhang Zhiguo;Zou Huijuan(Dept of Obstetrics and Gynecology,The First Affiliated Hospital of Anhui Medical University,Hefei 230032;NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract,Hefei 230032;Key Laboratory of Population Health Across Life Cycle,Ministry of Education of the People′s Republic of China,Hefei 230032;Engineering Research Center of Biopreservation and Artifical Organs,Ministry of Education,Hefei 230032;Anhui Province Key Laboratory of Reproductive Health and Genetics,Hefei 230032;Anhui Provincial Institute of Translational Medicine,Hefei 230032;Dept of Obstetrics and Gynecology,Feidong County People′s Hospital,East of the First Affiliated Hospital of Anhui Medical University,Hefei 231600)

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥230032 [2]国家卫生健康委配子及生殖道异常研究重点实验室,合肥230032 [3]出生人口健康教育部重点实验室,合肥230032 [4]生命资源保存与人工器官教育部工程研究中心,合肥230032 [5]生殖健康与遗传安徽省重点实验室,合肥230032 [6]安徽省转化医学研究院,合肥230032 [7]安徽医科大学第一附属医院东城院区肥东县人民医院妇产科,合肥231600

出　　处：《安徽医科大学学报》2024年第6期983-988,共6页Acta Universitatis Medicinalis Anhui

基　　金：国家重点研发计划资助项目(编号:2022YFC2703000);国家自然科学基金(编号:32000642、82071724);安徽省卫健委重点项目(编号:AHWJ2023A10019);安徽省重点研发与开发计划项目(编号:202204295107020041);安徽医科大学校科研基金(编号:2023xkj158)。

摘　　要：目的比较同一控制性超促排卵(COH)治疗周期中,体内成熟与改良技术体外培养成熟(IVM)的卵母细胞的早期胚胎发育能力及临床结局,探讨补充褪黑素的IVM技术在临床中的应用。方法收集159例患者在COH周期中的920个成熟卵母细胞进行常规体外受精(IVF/ICSI)处理,同时收集同周期中1283个未成熟卵母细胞,在添加褪黑素的改良IVM培养基中培养成熟后行ICSI处理。通过回顾性分析,比较常规助孕技术与改良IVM技术这两种方式,对辅助生殖治疗的助孕结局和妊娠结局的影响。结果与从COH周期中收集到的行常规IVF/ICSI处理的成熟卵母细胞相比,经改良IVM技术促成熟的卵母细胞的优质囊胚形成率较低。但经胚胎移植后,两种方式获得的成熟卵母细胞的临床结局包括临床妊娠率、足月产率、婴儿体长、新生儿Apgar评分,差异均无统计学意义。结论IVM可以提高从COH周期中回收的未成熟卵母细胞的卵子利用率,改善辅助生殖技术助孕患者的妊娠结局。Objective To compare the early embryonic developmental potential and clinical outcomes of oocytes matured in vivo and those matured by modified in vitro maturation(LVM)technology during the same controlled ovarian hyperstimulation(COH)cycle,and to explore the clinical application of melatonin-supplemented IVM technology.Methods 159 patients were recruited into the study.920 mature oocytes were collected during their COH cycles processed for conventional IVF/ICSI protocols,while 1283 immature oocytes from the same cycles were matured in a melatonin-supplemented IVM medium before ICSI was performed.A retrospective analysis was conducted to compare the impact of conventional assisted reproductive technology and improved IVM technology on the outcomes of assisted reproductive therapy and pregnancy outcomes.Results Compared with mature oocytes collected from COH cycles treated with conventional IVF/ICSI,oocytes promoted by improved melatonin-supplemented IVM technology had a lower rate of high-quality blastocyst formation.However,after embryo transfer,there was no significant difference in the clinical outcomes of mature oocytes obtained through two methods,including clinical pregnancy rate,full-term birth rate,neonatal length,and neonatal Apgar score.Conclusion The application of melatonin-supplemented IVM significantly increases the utilization of immature oocytes collected from COH cycles,improving the pregnancy outcomes of patients assisted by assisted reproductive technology.

关 键 词：卵母细胞 体外培养成熟技术 体外受精 控制性超促排卵 妊娠结局 

分 类 号：R715.5[医药卫生—妇产科学]