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目的:探讨三种不同来源的人未成熟卵母细胞体外成熟(IVM)的差异。方法:共获得未成熟卵母细胞1055枚,包括卵丘复合物(OCC)613枚和裸卵(DO)442枚。其中OCC分为自然周期组、孕晚期组和IVM组;DO分为自然周期组、孕晚期组和超促排卵组。所有未成熟卵母细胞在IVM培养体系体外培养成熟后,卵母细胞胞浆内单精子注射(ICSI)受精序贯培养,除IVM组行第2或第3天胚胎移植外,其余均培养至囊胚阶段。分别比较OCC和DO各组未成熟卵母细胞的成熟率、成熟卵母细胞的受精率、卵裂率;自然周期组和孕晚期组的囊胚形成率。结果:OCC:自然周期组、孕晚期组及IVM组的未成熟卵母细胞体外成熟率分别为79.5%、74.3%和82.2%,孕晚期组与IVM周期组相比具有统计学差异;3组成熟卵母细胞受精率、卵裂率及自然周期组和孕晚期组的囊胚形成率相比无统计学差异,IVM组的移植周期妊娠率为20%。DO:自然周期组、孕晚期组及超促排卵组未成熟卵母细胞体外成熟率超促排卵组最高(86.0%),明显高于自然周期组(74.5%)和孕晚期组(72.7%),(P<0.05和<0.01)。3组未成熟卵母细胞的成熟率、成熟卵母细胞的受精率、卵裂率、囊胚形成率相比未见统计学差异。结论:孕晚期来源的未成熟卵母细胞在体外同样具有发育潜能;孕晚期的卵母细胞可作为一种供卵来源。
Objective: To explore the differences of in vitro maturation (IVM) of human immature oocytes from three different sources. Methods: A total of 1055 immature oocytes were obtained, including 613 oocytes (OCC) and 442 oocytes (DO). Among them, OCC was divided into natural cycle group, third trimester group and IVM group. DO was divided into natural cycle group, third trimester group and super ovulation group. All immature oocytes were cultured in IVM culture system after in vitro maturation, and intracytoplasmic sperm injection (ICSI) fertilization was performed in sequential culture. Except IVM group, embryos were transplanted on day 2 or 3, Blastocyst stage. The maturation rate of immature oocytes, the fertilization rate and cleavage rate of mature oocytes were compared between OCC and DO groups, respectively. The blastocyst formation rate in the natural period group and the third trimester group were compared. Results: The in vitro maturation rates of OCC in immature oocytes of the natural cycle group, the third trimester group and the IVM group were 79.5%, 74.3% and 82.2%, respectively. There were significant differences between the third trimester and the third trimester group There was no significant difference in fertilization rate, cleavage rate, blastocyst formation rate between the natural period group and the third trimester group. The pregnancy rate in the IVM group was 20%. DO: The maturation rate of immature oocytes in the natural cycle group, the third trimester group and the super-ovulation group was the highest (86.0%) in vitro, which was significantly higher than that in the natural cycle group (74.5%) and the third trimester group (72.7% , (P <0.05 and <0.01). The maturation rate of immature oocytes in 3 groups, fertilization rate, cleavage rate and blastocyst formation rate of mature oocytes were not statistically different. CONCLUSION: The immature oocyte derived from the third trimester also has the same developmental potential in vitro. The third trimester oocyte can serve as a source of donor egg.