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目的:探讨未成熟卵母细胞体外成熟(IVM)技术联合玻璃化冷冻保存黄体期卵母细胞对某些女性肿瘤患者的生育能力的保存情况。方法:采集因妇科肿瘤等行卵巢切除手术过程中穿刺获取的256枚未成熟卵母细胞,按取卵时患者的月经周期分为卵泡期组(143枚)与黄体期组(113枚),每组再随即分为新鲜对照组及玻璃化冷冻组。分别进行IVM后行新鲜卵胞质内单精子注射(ICSI)授精和玻璃化冻融卵ICSI授精,比较各组间IVM后MII卵率、受精率、卵裂率、优质胚胎率。结果:①卵泡期与黄体期卵母细胞的IVM率差异无统计学意义;而组间复苏存活率(68.0%vs 48.1%)有统计学差异(P<0.05);卵泡期与黄体期卵母细胞新鲜组间受精率、卵裂率、优质胚胎率无统计学差异,冷冻组间差异亦无统计学意义。②与新鲜组相比,玻璃化冷冻使卵泡期与黄体期卵母细胞的受精率均降低(P<0.01)。结论:黄体期未成熟卵母细胞可以体外成熟并有继续发育为优质胚胎的能力;玻璃化冷冻使卵母细胞受精率、卵裂率下降。IVM和冻融后体外授精是某些女性肿瘤患者保存生育能力的一种有临床应用前景的方式。
Objective: To investigate the preservation of fertility in some female patients with oocysts by vitrifying cryopreserved luteal phase oocytes in vitro maturation (IVM) by immature oocytes. Methods: A total of 256 immature oocytes obtained during the ovariectomy operation were collected and divided into follicular phase group (n = 143) and luteal phase group (n = 113) according to their menstrual cycle. Each group was then divided into fresh control group and vitrification group. After IVM, fresh cytoplasmic sperm injection (ICSI) and ICSI insemination of vitrification were performed respectively. The MII egg rate, fertilization rate, cleavage rate and quality embryo rate after IVM were compared between groups. Results: ① There was no significant difference in IVM rate between follicular phase and luteal phase oocytes; while the survival rate between groups was statistically significant (68.0% vs 48.1%) (P <0.05); follicular phase and luteal phase oocytes There was no significant difference in fertilization rate, cleavage rate and high quality embryo among fresh cells, but there was no significant difference between frozen groups. Compared with fresh group, vitrification reduced the fertilization rate of follicular phase and luteal phase oocytes (P <0.01). Conclusion: The immature oocytes of luteal phase can mature in vitro and have the ability to continue to develop into high quality embryos. Vitrification can reduce the rate of oocyte fertilization and cleavage. In vitro fertilization after IVM and freeze-thaw cycles is a promising method for preserving fertility in some female cancer patients.