生殖医学杂志2012，Vol.21Issue(4)：334-337,4.DOI:10.3969/j.issn.1004-3845.2012.04.007
微刺激结合未成熟卵母细胞体外成熟培养治疗多囊卵巢综合征不孕
Treatment of infertile women suffered from polycystic ovarian syndrome by mini-stimulation combined with in vitro maturation
柏海燕 1薛侠 1师娟子 1张四林 1赵皖秋 1周寒鹰1
作者信息
- 1. 陕西省妇幼保健院生殖医学中心,西安710003
- 折叠
摘要
Abstract
Objective: To investigate the effect of in vitro maturation(IVM) , fertilization and embryo transfer of immature oocytes derived from mild stimulated cycles on treatment of infertility women with polycystic ovarian syndrome (PCOS).
Methods: A total of 31 infertility women with PCOS underwent IVM cycles which were primed with human menotrophin (HMG) from January 2010 to August 2011. All patients were pre-treated with metformin and oral conceptive for 3 months. The sexual hormone assay and transvaginal ultrasound scan were performed until lead-follicle reach to 14 mm in diameter and endometrial thickness≥7 mm, then a single injection of 10,000 IU of human chorionic gonadotropin (hCG) to prime follicles 36 hours before oocyte retrieval. The retrieved oocytes were cultured in IVM culture solution to maturation, then the mature oocytes were inseminated by intracytoplasmic sperm injection (ICSI) and the embryo transfers were performed 2 or 3 days later. The results were compared with those of infertile women with PCOS treatment by conventional IVF.
Results: Oocyte retrieval was performed in 29 cycles (two cycles were cancelled due to follicle dominance). The time of stimulation was from 6 to 11 days. The dosage of HMG was from 6 to 26 ampoules. And the duration of in vitro maturation range was 8 to 31 hours. Embryo transfer was performed in 24 cycles. The oocyte pickup rates, oocyte maturity, fertilization, cycle cancellation due to severe ovarian hyperstimulation syndrome (OHSS), implantation, pregnancy and miscarriage rates were 88.2% (262/297) 86.6% (227/262), 68.7% (156/227), 6.9% (2/29), 29.2% (14/48), 50% (12/24) and 8. 3% (1/12), respectively. At the same period, infertility patients with PCOS underwent 144 conventional IVF cycles and 65 cycles were cancelled to avoid severe OHSS (45. 1%). The rates of implantation, pregnancy and miscarriage were 26. 3% (42/160), 45. 6% (36/79) and 41. 7% (15/36), respectively. There was no significant difference in implantation and pregnancy rates between two groups, while the rates of sever OHSS and miscarriage were much lower in IVM cycles than those in conventional IVF group.
Conclusions: Our results showed that infertile patients with PCOS who were pretreated with oral-contraceptive and metformin and used in vitro matured oocytes from mini-stimulated ovaries could obtain similar pregnancy rate and better pregnancy outcomes than the patients treated by conventional IVF. It might be offered as one of replacement treatment for traditional IVF in women with PCOS.关键词
微刺激/体外成熟/体外受精-胚胎移植/多囊卵巢综合征Key words
Mini-stimulation/ In vitro maturation/ In vitro fertilization-embryo transfer/ 0Polycystic ovarian syndrome引用本文复制引用
柏海燕,薛侠,师娟子,张四林,赵皖秋,周寒鹰..微刺激结合未成熟卵母细胞体外成熟培养治疗多囊卵巢综合征不孕[J].生殖医学杂志,2012,21(4):334-337,4.
