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目的分析4例体外受精-胚胎移植(IVF-ET)患者共8个辅助助孕周期,全部73个卵母细胞均处于GV、Metaphase I期的可能原因。并与同期13例IVF-ET患者比较分析,比较组患者>50%卵母细胞处于GV、Metaphase I期。方法回顾分析本中心12年辅助助孕工作中出现的4例患者共8个周期所获卵母细胞均处于GV、MI的临床及实验室资料,并与同期13例超过50%卵母细胞处于GV、MI患者的临床、实验室资料进行比较。结果 4例患者73个卵母细胞均处于GV或MI期,经体外成熟培养,24,48,72 h仍无极体排出,停滞于GV、MI期。同期13例患者大部分卵母细胞不成熟,但体外培养后部分卵母细胞可进一步成熟,并可受精,获得妊娠。结论细胞和遗传机制引起卵母细胞成熟障碍,现有体外成熟培养方法尚无法促其成熟,目前赠卵是该类患者获得妊娠可供选择的助孕方法。但对于在控制性超促排卵中,出现大部分卵母细胞不成熟的患者可以通过延长促超排时间,增大hCG注射日卵泡直径,体外成熟培养等方法获得成熟的卵母细胞,获得妊娠。
OBJECTIVE: To analyze the possible reasons for a total of 8 assisted pregnancy cycles and all 73 oocytes in GV and Metaphase I stage in 4 cases of IVF-ET. Compared with 13 patients with IVF-ET in the same period, more than 50% of the oocytes in the group were in GV and Metaphase I stage. Methods Retrospective analysis of 12 cases of the center assisted in the work of pregnancy in 4 patients were a total of 8 cycles of oocytes were in GV, MI clinical and laboratory data, and with the same period in more than 50% of oocytes in the GV, MI patients with clinical, laboratory data were compared. Results All the 73 oocytes of 4 patients were in GV or MI stage. After maturation in vitro, no polar body was evacuated at 24, 48 and 72 h, and they were arrested in GV and MI phases. In the same period, most of the 13 patients had immature immature oocytes, but some oocytes could be further matured after in vitro culture and fertilized for pregnancy. Conclusion Cellular and genetic mechanisms cause oocyte maturation disorder, and the existing maturation culture methods in vitro are unable to promote its maturation. At present, the donation of eggs is the method of pregnancy-assisted pregnancy for these patients. However, in the control of superovulation, most patients with immature immature oocytes can get mature oocytes by prolonging the time for promoting superovulation, increasing the diameter of follicles on the day of hCG injection, and maturing in vitro to obtain the pregnancy .