多囊卵巢综合征妇女体外成熟卵母细胞胚胎慢速冷冻复苏移植结局分析

目的评价未成熟卵母细胞体外成熟（IVM）后形成的卵裂期胚胎经慢速冷冻一解冻后的发育能力。方法将2006年1月至2010年12月北京大学第三医院因多囊卵巢综合征（PCOS）合并不孕症行卵裂期胚胎复苏移植的385例患者分为两组：复苏胚胎来源于体外成熟的卵母细胞组（IVM组，46例）和复苏胚胎来源于常规体内成熟的卵母细胞组（IVF组，339例）。采用慢冻速溶法解冻移植后比较两组患者的临床结局。结果IVM组复苏胚胎243枚，复苏后存活162枚，复苏率为66．67％；IVF组复苏胚胎1605枚，复苏后存活1082枚，复苏率为67．41％，两组比较，差异无统计学意义（P〉0．05）。IVM组患者的临床妊娠率和着床率分别为19．30％（11／57）和10．61％（14／132），明显低于IvF组临床妊娠率（45．45％，175／385）和着床率（26．14％，240／918；P均〈O．05）。结论体外成熟卵母细胞发育形成的卵裂期胚胎慢速冷冻后临床结局欠佳，可能与冻融前胚胎自身的发育潜力有关。

Development of frozen- thawed embryos derived from immature human oocytes following in- vitro maturation and fertilization in women with P03S

Objective To evaluate the development of frozen- thawed embryos derived from immature hu- man oocytes following in- vitro maturation and fertilization in women with PCOS. Methods 385 PCOS women un- derwent frozen- thawed embryo transfer cycles between Jan. 2006 to Dec. 2010 in Peking University Third Hospital. The frozen embryos derived from in vitro maturation of immature oocytes （IVM group） or mature oocytes of routine IVF cycles （IVF group）. All embryos were cryopreserved using slow- freeze protocol. The frozen embryos were thawed and transferred for assessment the survival, clinical pregnancy and implantation rates. Results 243 embryos were thawed and 162 embryos were survived in IVM group, The survival rate of IVM group （66.67%） was comparable to IVF group （67.41%, P〉0. 05）. However, the clinical pregnancy and implantation rates of embryos cryopreserved in IVM group were significantly lower than that in IVF group （19. 30% vs 45. 45%, 10. 61% vs 26.14%; P〈0. 05））. Conclusion Cleavage embryo slow- freeze programe may not be as efficient in IVM as in that in standard IVF. It implies the inferior development potential of IVM derived embryos before frozen.