人脐带血清用于人未成熟卵母细胞体外成熟培养并获得妊娠的观察

目的:以人脐带血清作为卵母细胞体外成熟培养(IVM)培养液的主要成份开展IVM技术研究,旨在为IVM临床妊娠率的提高,IVM技术的进步探索一条新路。方法:47例、47个周期的PCOS患者接受了IVM技术的治疗。未成熟卵母细胞分别入IVM培养液Ⅰ(含人成熟卵泡液,卵泡液组)和IVM培养液Ⅱ(含脐带血清,脐带血清组)行体外成熟培养,分析人脐带血清对IVM结果影响。结果:脐带血组:15周期,160枚未成熟卵母细胞,体外成熟过程中,成熟率、优质胚率及临床妊娠率分别为93.75%(150/160)、50.00%(60/120)和40.00%(6/15),已分娩4例,另2例处于妊娠阶段;卵泡液组:32周期,未成熟卵母细胞349枚,成熟率、优质胚率分别为77.08%(269/349)和23.77%(53/223),胚胎移植31周期,获得7例临床妊娠,妊娠率为22.58%(7/31),目前已分娩4例,3例流产。成熟率和优质胚率方面,脐带血组高于卵泡液组。结论:人脐带血清作为IVM液的主要成份相对于人成熟卵泡液,将更加有助于未成熟卵母细胞的体外成熟培养、改善胚胎质量,并获得较好的妊娠结局。

Observation on pregnancy acquired by in vitro maturation of human immatured oocytes treated with human umbilical cord serum

Objective:To investigate in vitro maturation (IVM) technique by human umbilical cord serum as the main ingredient of IVM medium,so as to explore a new approach for the increase of clinical pregnancy rate and achievement of the technology.Methods:47 patients with polycystic ovary syndrome (PCOS) (47 cycles) underwent IVM,the immatured oocytes were placed intoⅠ medium (containing human mature follicle fluid,follicle fluid group) andⅡ medium (containing human umbilical cord serum,umbilical cord serum group) for IVM,the effect of human umbilical cord serum on results of IVM were analyzed.Results:Umbilical cord serum group:15 cycles,160 immatured oocytes,in the course of IVM,the rates of maturation,high quality embryo and clinical pregnancy were 93.75%(150/160),50.00% (60/120) and 40.00% (6/15),respectively,4 cases delivered,and 2 cases got pregnancy; follicle fluid group:32 cycles,349 immatured oocytes,the rates of maturation and high quality embryo were 77.08% (269/349) and 23.77% (53/223),respectively,embryo transplantation was conducted in 31 cycles,7 cases got pregnancy,the rate of pregnancy was 22.58% (7/31),4 cases delivered,and 3 cases had a miscarriage.The rates of maturation and high quality embryo in umbilical cord serum group were significantly higher than those in follicle fluid group.Conclusion:Compared to human mature follicular fluid,IVM medium containing human umbilical cord serum appears to be more effective to stimulate in vitro oocyte maturation,improve the quality of embryos and capable of achieving a promising clinical outcome.