A quantitative assessment of follicle size on oocyte developmental competence
A quantitative assessment of follicle size on oocyte developmental competence
复制标题
DOI：
10.1016/j.fertnstert.2007.02.011
复制
发表时间：
2008-09-01
影响因子：
6.7
通讯作者：
Cedars, Marcelle I.
中科院分区：
文献类型：
--
作者：
Rosen, Mitchell P.;Shen, Shehua;Cedars, Marcelle I.
目的：定量评估卵泡大小对卵母细胞成熟、受精和胚胎质量的影响。设计：前瞻性研究。设定：学术医学中心。患者：接受卵巢刺激和体外受精（IVF）的夫妇。干预（S）：前瞻性监测共235个周期，从5组卵泡大小中收集2934个卵母细胞。重复测量多变量分析用于比较较小卵泡大小与领先卵泡。主要结果测量：卵母细胞成熟，受精和胚胎质量。结果：与领先卵泡组（> 18 mm）相比，16至18 mm卵泡中成熟卵母细胞的几率为37%，并且随着每个尺寸的增加而逐渐下降。来自16至18 mm大小的卵泡的卵母细胞的受精几率比铅组低28%，并且随着每个大小而降低。小卵泡组的多精受精率与常规授精相比增加（调整后的比值比= 2.37）。卵泡大小并没有预测胚胎细胞数，但从较小的卵泡胚胎有一个统计学上显着较高的碎片相比，铅group.Conclusions（S）：铅卵泡组是最有可能有一个成熟的卵母细胞，能够受精，最适合发展成一个高质量的胚胎。较小的卵泡能够产生可受精的中期II卵母细胞，但其受精率仅接近领先卵泡组的60%。
Objective: To quantitatively assess the impact of follicle size on oocyte maturation, fertilization, and embryo quality.Design: Prospective study. Setting: Academic medical center.Patient(s): Couples undergoing ovarian stimulation and in vitro fertilization (IVF).Intervention(S): A total of 235 cycles were monitored prospectively, and 2934 oocytes were collected from five groups of follicle size. Repeated measures multivariate analyses were used to compare the smaller follicle sizes with the lead follicle.Main Outcome Measure(s): Oocyte maturation, fertilization, and embryo quality.Result(s): Compared with the lead follicular group (> 18 mm), the odds of a mature oocyte from a 16 to 18 mm size follicle were 37% and declined progressively with each size. The odds of fertilization of oocytes from follicles 16 to 18 mm in size was 28% less than the lead group and decreased with each size. The rate of polyspermy with conventional insemination was increased for the smaller follicular groups (adjusted odds ratio = 2.37). Follicle size did not predict embryo cell number, but embryos from smaller follicles had a statistically significantly higher fragmentation compared with the lead group.Conclusion(s): The lead follicular group was most likely to have a mature oocyte that was capable of fertilization and best suited for development into a high-quality embryo. The smaller follicles were capable of producing metaphase II oocytes that could fertilize, but at rates approaching only 60% that of the lead follicular group.