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目的探讨取卵时卵母细胞成熟度对自然周期IVF/IVM临床结局的影响。方法实施自然周期IVF/IVM技术的患者首先根据取卵时是否获得成熟卵母细胞分为两组:A组:取卵时有成熟卵母细胞获得;B组:取卵时获得卵母细胞全部未成熟。然后根据取卵时优势卵泡(dominant follicle,DF)和小卵泡(small follicle,SF)中是否有成熟卵母细胞,将A组分为3类:A1:DF和SF取卵时都有成熟卵母细胞获得;A2:取卵时只有DF中获得成熟卵母细胞;A3:取卵时DF中未成熟,SF中有成熟卵母细胞。比较各组体外成熟率、受精率和卵裂率以及临床妊娠率、着床率、分娩活胎率和流产率等。结果 A组和B组之间的体外成熟率、受精率和卵裂率无显著差异,两组的临床妊娠率分别为35.2%(152/432)和28.1%(27/96),也无显著差异。但是,B组活胎率(48.1%)相对于A组(72.4%)显著下降,流产率(51.9%VS27.6%)显著上升。在有成熟卵母细胞获得的三组中,临床妊娠率(A1:38.2%,A2:33.6%,和A3:30.9%)、着床率(分别为16.4%,15.5%和14.1%)以及活胎率和流产率都无显著差异。结论自然周期IVF/IVM技术治疗中,虽然取卵时有无成熟卵母细胞对产生的临床妊娠率未产生显著影响,但是取卵时有成熟卵母细胞组的活胎率显著高于未成熟卵母细胞组。
Objective To investigate the effect of oocyte maturation on natural cycle IVF / IVM clinical outcome when oocyte retrieval. Methods Patients with natural cycle IVF / IVM technique were divided into two groups based on whether oocytes were obtained during oocyte retrieval: group A: mature oocytes at the time of oocyte retrieval; group B: all oocytes at oocyte retrieval time Immature. Then, according to whether there are mature oocytes in the dominant follicles (DF) and small follicles (SF) at the time of oocyte retrieval, the A groups are divided into three categories: A1: mature eggs Obtained from blast cells; A2: mature oocytes were obtained from only DF in egg retrieval; A3: immature DF in egg retrieval and mature oocytes in SF. The maturation rate, fertilization rate, cleavage rate, clinical pregnancy rate, implantation rate, live birth rate and miscarriage rate in each group were compared. Results There was no significant difference in in vitro maturation rate, fertilization rate and cleavage rate between group A and group B. The clinical pregnancy rates were 35.2% (152/432) and 28.1% (27/96) respectively, with no significant difference between the two groups difference. However, the live birth rate in group B (48.1%) was significantly lower than that in group A (72.4%), and abortion rate (51.9% VS 27.6%) was significantly increased. Clinical pregnancy rates (A1: 38.2%, A2: 33.6%, and A3: 30.9%), implantation rates (16.4%, 15.5%, and 14.1%, respectively) and survival in the three groups with mature oocytes There was no significant difference in fetal and abortion rates. Conclusion In the natural cycle IVF / IVM technique, although the number of mature oocytes during ovulation did not have a significant effect on the clinical pregnancy rate, the percentage of live fetuses in mature oocyte group was significantly higher than that of immature Oocyte group.