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目的:通过对案例的对比研究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复苏后的发育能力。方法:以该院2009年1月~2013年12月因多囊卵巢综合征(PCOS)合并不孕症行卵裂期胚胎复苏移植的462例患者为研究对象,分为两组,复苏胚胎来源于体外成熟的卵母细胞组为IVM组,共55例,复苏胚胎来源于常规体内成熟的卵母细胞组为IVF组,共407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292枚,复苏后存活194枚,复苏率为66.44%;IVF组复苏胚胎1 926枚,复苏后存活1 298枚,复苏率为67.39%,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19.12%(13/68)和10.90%(17/130),明显低于IVF组临床妊娠率(45.45%,210/462)和着床率(26.50%,288/1 087,P均<0.05)。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。
OBJECTIVE: To evaluate the developmental ability of cleaved embryos formed after in vitro maturation (IVM) of immature oocytes by slow freezing and thawing after comparing the cases. Methods: A total of 462 patients with PCOS complicated with infertility and embryo resuscitation from January 2009 to December 2013 were divided into two groups. The source of resuscitation embryo In vitro maturation of oocytes in IVM group, a total of 55 cases, the embryos from the conventional in vivo maturation of the oocyte group IVF group, a total of 407 cases. The clinical outcomes of the two groups were compared after thawing with slow freezing thawing. Results: There were 292 embryos resuscitated in IVM group, 194 survived after resuscitation, the recovery rate was 66.44%, 1 926 embryos rescued in IVF group and 1 298 survived after resuscitation, the recovery rate was 67.39%. There was no significant difference between the two groups Significance (P> 0.05). The clinical pregnancy rate and implantation rate in IVM group were 19.12% (13/68) and 10.90% (17/130) respectively, which were significantly lower than those in IVF group (45.45%, 210/462) and implantation rate 26.50%, 288/1 087, P <0.05). Conclusion: The development of in vitro mature oocyte embryos cleaved poorly after clinical outcome, may be related to the development potential of embryos before freezing and thawing.