培养液中添加不同促性腺激素对卵母细胞体外成熟的影响

目的:比较卵母细胞体外成熟培养液中添加不同促性腺激素对未成熟卵母细胞体外成熟结局的影响。方法:将行卵母细胞体外成熟(IVM)的35例患者共42个新鲜取卵周期,随机分成A组:22个取卵周期将重组人促卵泡激素(果纳芬,rFSH)和重组人绒毛膜促性腺激素(艾泽,hCG)按1∶1的比例混合添加,终浓度为75 mIU/ml;B组:20个取卵周期添加终浓度为75 mIU/ml的尿源性促性腺激素(hMG),进行未成熟卵母细胞体外成熟培养。35例患者中新鲜取卵周期未移植或移植后未孕者行解冻胚胎移植。比较组间患者的卵母细胞成熟率、受精率、卵裂率、优质胚胎率、累计临床妊娠率及胚胎着床率。结果:取卵均于月经周期第12日或最大卵泡发育至10￣12 mm时进行,故所获卵均为未成熟卵。A组获卵181枚,经培养后成熟84枚,行卵胞浆内单精子注射(ICSI)84枚,受精60枚,卵裂55枚,优质胚胎20枚;新鲜胚胎移植9例,获1例临床妊娠,解冻胚胎移植5例,获1例临床妊娠,累计临床妊娠率为14.29%,胚胎着床率为7.14%。B组获卵176枚,经培养后成熟120枚,行ICSI 120枚,受精97枚,卵裂90枚,优质胚胎41枚,新鲜胚胎移植6例,获4例临床妊娠,解冻胚胎移植9例,获3例临床妊娠,累计临床妊娠率为46.67%,胚胎着床率为33.33%。结论:卵母细胞体外成熟培养液中添加尿源性促性腺激素可获得较添加重组人促卵泡激素和重组人绒毛膜促性腺激素高的卵母细胞成熟率、临床妊娠率及胚胎着床率。

Influence of Adding Different Gonadotropins into Culture Medium of In Vitro Maturation of Immature Oocytes

Objective： To compare the results of adding different gonadotropins into culture medium for in vitro maturation of immature oocytes.Methods： Thirty-five patients,42 cycles were randomly divided into two groups,rFSH and rhCG were added into culture medium of IVM in group A with the proportion of 1∶1,the final concentration was 75 mIU/ml,and 75 mIU/ml hMG was added in group B.The rates of maturation,infertility,cleavage,good embryo,cumulative clinical pregnancy and implantation were compared.Results： There were 181 immature oocytes in group A,84 oocytes matured after cultured,these oocytes were all done ICSI,then 60 fertilized oocytes,55 cleaved embryos,20 good embryos were obtained;there were 1 clinical pregnancy in 9 embryo transfer of oocyte retrieval cycles,and 1 clinical pregnancy in 5 thawed cycles.So cumulative clinical pregnancy rate was 14.29%,implantation rate was 7.14%.There were 176 immature oocytes in group B,120 oocytes matured after cultured,these oocytes were all done ICSI,then 97 fertilized oocytes,90 cleaved embryos,41 good embryos were obtained;there were 4 clinical pregnancies in 6 embryo transfer of fresh cycles,3 clinical pregnancies in 9 thawed cycles.So cumulative clinical pregnancy rate was 46.67%,implantation rate was 33.33%.Conclusion： The rate of maturation,clinical pregnancy and implantation of adding hMG into IVM culture medium were higher than adding rFSH and rhCG.