In-vitro matured metaphase-I oocytes have a lower fertilization rate but similar embryo quality as mature metaphase-II oocytes after intracytoplasmic sperm injection
In-vitro matured metaphase-I oocytes have a lower fertilization rate but similar embryo quality as mature metaphase-II oocytes after intracytoplasmic sperm injection
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DOI：
10.1093/humrep/14.7.1859
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发表时间：
1999-07-01
影响因子：
6.1
通讯作者：
Van Steirteghem, A
中科院分区：
文献类型：
--
作者：
De Vos, A;Van de Velde, H;Van Steirteghem, A
在胞浆内单精子注射（ICSI）前脱落的卵母细胞中，约有4%处于中期i期（MI）。通常，这些卵母细胞在体外培养数小时后实现减数分裂，并在卵母细胞回收当天可用于ICSI。在896个ICSI周期中，使用人绝经期促性腺激素（HMG）和人绒毛膜促性腺激素（HCG）对卵巢进行控制刺激后，在体外培养后4小时内注射1210个MI- MII成熟卵母细胞，8803个MII卵母细胞在脱光后立即或晚一点注射。体外成熟卵母细胞受精率显著低于MII成熟卵母细胞（分别为52.7%和70.8%,P < 0.001）。体外成熟卵母细胞组获得优质胚胎的比例为47.4%，而MII卵母细胞组获得优质胚胎的比例为53.2% （P < 0.05）。体外成熟卵母细胞和成熟卵母细胞获得的优质胚胎（5.7%和7.0%，NS）和优质胚胎（17.6%和15.3%，NS）的比例相同。体外成熟卵母细胞衍生的胚胎只有在质量较好或没有足够的成熟卵母细胞衍生的胚胎时才能移植。15例移植仅涉及来自体外成熟卵母细胞的胚胎：11例单胚胎移植和4例2个胚胎移植，导致1例单胎妊娠和健康婴儿的出生。由此可见，在MII卵母细胞较少的周期中，注射体外成熟的MII卵母细胞以增加可用于移植的胚胎数量可能是值得的。
About 4% of all the oocytes denuded prior to intracytoplasmic sperm injection (ICSI) are in metaphase-I (MI), Frequently, these oocytes achieve meiosis after a few hours of in-vitro culture and are available for ICSI on the day of oocyte retrieval. In this retrospective study, the aim was to evaluate the fertilization rate and the developmental capacity of these in-vitro matured MI oocytes, After controlled ovarian stimulation using human menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG) in 896 ICSI cycles, 1210 MI-to-MII-matured oocytes were injected similar to 4 h after in-vitro culture and 8803 MII oocytes were injected immediately, or later, after denudation. The fertilization rate of in-vitro matured oocytes was significantly lower than that of mature MII oocytes (52.7 and 70.8% respectively, P < 0.001). Embryo quality was only slightly different as regards the numbers of good quality embryos: 47.4% good quality embryos were obtained in the in-vitro matured oocyte group, whereas 53.2% good quality embryos were obtained in the MII oocyte group (P < 0.05). The same proportions of excellent (5.7 and 7.0%, NS) and fair quality (17.6 and 15.3%, NS) embryos were obtained for in-vitro matured and mature oocytes respectively. Embryos derived from in-vitro matured oocytes were transferred only if they were of better quality or if there were not enough mature oocyte derived embryos available. Fifteen transfers involved only embryos derived from in-vitro matured oocytes: 11 single embryo transfers and four transfers of two embryos, resulting in one singleton pregnancy and the birth of a healthy baby. It may be concluded that in cycles with few MII oocytes it might be worthwhile to inject in-vitro matured MI oocytes in order to increase the number of embryos available for transfer.