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目的探讨无刺激周期未成熟卵母细胞体外培养在治疗多囊卵巢综合征(PCOS)不孕患者的应用价值。方法对70例PCOS患者,在人工周期或自然周期第10～12天行阴道B超监测,如双侧卵巢中无直径>8mm的卵泡,即肌内注射人绒毛膜促性腺激素10000IU,36h后经阴道穿刺取卵,将取出的未成熟卵母细胞进行体外成熟及体外受精胚胎移植。结果共进行体外成熟周期94个,移植周期75个。共获得卵母细胞1283个,获得成熟838个(65.3%,838/1283),其中受精553个(66.0%,553/838),获得胚胎402个(48.0%,402/838),获得优质胚胎199个(23.7%,199/838)。生发泡期卵母细胞的成熟率、受精率、获得胚胎率及优质胚胎率,分别为67.7%、66.4%、47.6%及24.1%;第1次减数分裂中期的卵母细胞,分别为69.7%、71.7%、52.2%及26.1%,生发泡期与第1次减数分裂中期比较,差异均无统计学意义(P>0.05)。无法评价的卵母细胞的成熟率、受精率、获得胚胎率及优质胚胎率,分别为44.8%、53.8%、46.2%及16.9%,与生发泡期及第1次减数分裂中期比较,差异均有统计学意义(P<0.05)。75个移植周期中,18例获得临床妊娠,妊娠率为24%(18/75)。结论无刺激周期未成熟卵母细胞体外成熟及体外受精胚胎移植可用于PCOS不孕患者的治疗,并能取得一定的妊娠成功率。
Objective To investigate the value of immature oocyte maturation in the treatment of infertility with polycystic ovary syndrome (PCOS) in vitro. Methods Seventy PCOS patients underwent vaginal ultrasound B on the 10th to 12th day of the artificial cycle or natural period. For example, there were no follicles> 8mm in diameter in both ovaries, that is, intramuscular injection of human chorionic gonadotropin 10,000IU, 36h later Ovulation by vaginal puncture, remove the immature oocytes in vitro maturation and in vitro fertilization embryo transfer. Results A total of 94 in vitro maturation cycles and 75 cycles were performed. A total of 1283 oocytes were obtained, of which 838 were mature (65.3%, 838/1283). Among them, 553 (66.0%, 553/838) were fertilized and 402 (48.0%, 402/838) 199 (23.7%, 199/838). The maturation rate, fertilization rate, embryo rate and high-quality embryo rate of primiparous stage oocytes were 67.7%, 66.4%, 47.6% and 24.1%, respectively. The number of oocytes in the first metaphase was 69.7 %, 71.7%, 52.2% and 26.1% respectively. There was no significant difference between the first stage of meningiogenesis and the first stage of meiosis (P> 0.05). The oocyte maturation rate, fertilization rate, embryo rate and high quality embryo rate were 44.8%, 53.8%, 46.2% and 16.9%, respectively. Compared with the metaphase of meningiogenesis and metaphase meiosis, the differences All were statistically significant (P <0.05). Of the 75 transplant cycles, 18 achieved clinical pregnancy with a pregnancy rate of 24% (18/75). Conclusion In vitro maturation and in vitro fertilization embryo transfer of non-stimulated cycle immature oocytes can be used for the treatment of PCOS infertility patients, and can achieve a certain pregnancy success rate.