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目的 应用卵母细胞体外成熟 (IVM)技术帮助卵泡成熟障碍的不孕症患者获得妊娠及分娩。方法 接受未成熟卵IVM技术治疗者 30例 35个周期 ,其中多囊卵巢综合征 14例 ,有卵巢过度刺激综合征病史 6例 ,体外受精和胚胎移植 (IVF ET)周期中卵巢反应不良患者 10例。设计卵巢刺激方案 ,采用含人成熟卵泡液的IVM培养液 ,建立未成熟卵母细胞的体外培养方法。结果 35个周期共取得未成熟卵母细胞 2 0 3个 ,平均每个周期 5 8个。培养后有 15 6个卵母细胞排出第一极体 ,IVM率 76 8% (15 6 2 0 3) ;在卵胞浆单精子显微注射 (ICSI) 12～ 18h后观察原核 ,正常受精率为 76 9%(12 0 15 6 ) ;共有移植周期 33个 ,获 8例临床妊娠 ,妊娠率 2 4 % (8 33) ;有 5例共 7个婴儿出生。结论 IVM对一些卵泡发育和成熟障碍 ,特别是顽固性多囊卵巢综合征患者 ,是一种有效的辅助生育措施。人成熟卵泡液含有理想的自然促卵母细胞成熟的成分。
Objective To apply oocyte maturation in vitro (IVM) technology to help women with infertility with obstructive follicles obtain pregnancy and childbirth. Methods Twenty-five patients underwent immature ovariectomy for 35 cycles, including 14 cases of polycystic ovary syndrome, 6 cases of history of ovarian hyperstimulation syndrome, 10 cases of ovarian dysfunction during in vitro fertilization and embryo transfer (IVF ET) example. Ovarian stimulation program was designed, IVM culture medium containing human mature follicular fluid was used to establish immature oocyte in vitro culture method. Results Twenty-three immature oocytes were obtained in 35 cycles, with an average of 58 in each cycle. After culturing, 15 6 oocytes were excreted in the first polar body with an IVM rate of 76.8% (15 6 2 0 3). Proto-nuclear and normal fertilization rates were observed after 12-18 h ICSI in the cytoplasm With a total of 76 9% (12 0 15 6). A total of 33 transplant cycles were performed, including 8 clinical pregnancies with a pregnancy rate of 24% (8 33). A total of 5 infants were born in 7 infants. Conclusions IVM is an effective ancillary fertility measure for some follicular development and maturation disorders, especially in patients with refractory polycystic ovary syndrome. Human mature follicular fluid contains the ideal natural ingredients for oocyte maturation.