未成熟卵母细胞体外培养在体外受精中对卵巢低反应性者的补救性应用

目的:探讨未成熟卵母细胞体外培养(IVM)在体外受精(IVF)中对卵巢低反应性者的补救性治疗效果。方法:30例行IVF时表现为卵巢低反应者(实验组)在B超引导下经阴道行卵泡穿刺术,取卵后对不同期未成熟卵母细胞行IVM,再行胞浆内单精子注射(ICSI)受精;对成熟卵母细胞则进行常规受精,胚胎形成后行移植术。取同期进行ICSI周期治疗的63例作为对照组。结果:应用IVM行IVF-ET补救治疗的30个周期中有29个周期获胚胎移植,临床妊娠9例(31%),胚胎种植率18.47%,但该组未成熟卵培养成熟后的受精率、卵裂率均低于对照组;总妊娠率及胚胎种植率比常规ICSI组低。结论:IVM技术联合IVF为卵巢低反应性者提供了一种有效的补救措施,明显减少了IVF周期的取消率,提高了妊娠机会。

The Effects of In Vitro Maturation in Rescue Treatment for Poor Ovarian Responders in In Vitro Fertilization

Objective: To examine the effects of in vitro maturation (IVM) in rescue treatment for poor ovarian responders in IVF. Methods: Ethical approval was signed by 30 cases who showed poor ovarian response to control ovarian hyperstimulation in IVF cycle. Transvaginal ultrasound-guided oocyte retrieval was carried, intracytoplasmic sperm injection (ICSI) was undergoing after IVM in the immaturate oocyte and conventional insemination was undergoing in MII oocyte, embryo were transferred following 2-3 d culture, 63 cases who underwent ICSI for control. Results: Total of 30 cycles were performed in rescue treatment group, among them, embryo transfer was carried in 29 cycles, 9 clinical pregnancies were confirmed, the pregnancy rate was 31% and the implantation rate was 18.47%. But a lower fertilization rate, cleavage rate, pregnancy rate and implantation rate respectively were observed in IVM ICSI group than that in control group. Conclusions: IVM ICSI offered a rescue treatment for poor ovarian responder, it reduced the cancel rate in IVF cycle and provide an opportunity for pregnancy.