人未成熟卵母细胞体外培养成熟、受精及胚胎移植  

In vitro maturation,fertilization and embryo transfer of human immature oocyte

作　　者：刘嘉茵[1] 钱云[1] 冒韵东[1] 丁卫[1] 杨乃明[1] 

机构地区：[1]南京医科大学第一附属医院妇产科,210029

出　　处：《中华妇产科杂志》2003年第4期230-232,i002,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　应用卵母细胞体外成熟 (IVM)技术帮助卵泡成熟障碍的不孕症患者获得妊娠及分娩。方法　接受未成熟卵IVM技术治疗者 30例 35个周期 ,其中多囊卵巢综合征 14例 ,有卵巢过度刺激综合征病史 6例 ,体外受精和胚胎移植 (IVF ET)周期中卵巢反应不良患者 10例。设计卵巢刺激方案 ,采用含人成熟卵泡液的IVM培养液 ,建立未成熟卵母细胞的体外培养方法。结果　 35个周期共取得未成熟卵母细胞 2 0 3个 ,平均每个周期 5 8个。培养后有 15 6个卵母细胞排出第一极体 ,IVM率 76 8% (15 6 2 0 3) ;在卵胞浆单精子显微注射 (ICSI) 12～ 18h后观察原核 ,正常受精率为 76 9%(12 0 15 6 ) ;共有移植周期 33个 ,获 8例临床妊娠 ,妊娠率 2 4 % (8 33) ;有 5例共 7个婴儿出生。结论　IVM对一些卵泡发育和成熟障碍 ,特别是顽固性多囊卵巢综合征患者 ,是一种有效的辅助生育措施。人成熟卵泡液含有理想的自然促卵母细胞成熟的成分。Objective To try a new method for treating infertile women by in vitro maturation technique. Methods To set up in vitro maturation(IVM) program, including stimulating regimen, oocyte retrieval technique, and culture system of the immature oocytes with the medium consisted of essential supplements and human mature follicular fluid. IVM was performed in 30 infertile patients (35 cycles) ,(1)with polycystic ovary syndrome (POCS) (14/30),(2)overy hupestimulation syndrome(OHSS) in the previous stimulating cycles (6/30), and (3)retardation of the oocyte growth in conventional IVF cycles (10/30). Results Totally 203 oocytes were obtained, with a mean of 5.8 oocytes each cycle. First polar bodies were observed in 156 oocytes, maturation rate was 76.8%. There were 120 oocytes getting into pronucleus stage, normal fertilization rate was 76.9%. Embryo transfer was performed in 33 cycles. Eight pregnancies were established, pregnancy rate was 24%. Five patients have delivered 7 healthy babies. Conclusions The result of our study indicated that IVM is one of the new assisted reproductive technologies for the infertile women with PCOS, poor response to stimulation and the history of OHSS. Human mature follicular fluid would be an ideal component in the maturation medium for oocyte maturation in vitro and provides a much simplified and practical method for clinical use.

关 键 词：人未成熟卵母细胞 体外培养 受精 胚胎移植 卵泡成熟障碍 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]