多囊性卵巢病患打破卵針後38小時取卵可取得較高比例之成熟卵子

多囊性卵巢(PCO)病患，打完破卵針後38小時取卵比35小時取卵可取得較高比例之成熟卵子
對不成熟卵子之體外培養(IVM)38小時取卵可達較高之培養率，
較多可用胚胎以供植入，可能可達到較高之懷孕率極著床率

http://humrep.oxfordjournals.org/content/23/9/2010.long

A 38 h interval between hCG priming and oocyte retrieval increases in vivo and in vitro oocyte maturation rate in programmed IVM cycles†

1. Weon-Young Son1, 
2. Jin-Tae Chung, 
3. Ri-Cheng Chian, 
4. Belen Herrero,
5. Ezgi Demirtas, 
6. Shai Elizur, 
7. Yariv Gidoni, 
8. Camille Sylvestre, 
9. Nicola Dean and
10. Seang Lin Tan

+Author Affiliations

1. McGill Reproductive Center, Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, QC, Canada H3A 1A1

1. 1Correspondence address. Fax: +1-514-843-1496; E-mail: weon-young.son@muhc.mcgill.ca

• Received December 20, 2007.
• Revision received April 23, 2008.
• Accepted May 7, 2008.

 

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Abstract

BACKGROUND Our aim was to evaluate whether extending the interval between human chorionic gonadotrophin (hCG) priming and immature oocyte retrieval increases the oocyte maturation rate following in vitro maturation (IVM).

METHODS This study was performed retrospectively. IVM was performed on 113 polycystic ovary syndrome patients (n = 120 cycles). Oocyte collection was performed either 35 h (Group 1; n = 76) or 38 h (Group 2; n = 44) after 10 000 IU of hCG priming. Following oocyte retrieval, oocyte maturity was assessed and the remaining immature oocytes were cultured in IVM medium up to Day 2.

RESULTS The number of in vivo matured oocytes collected was significantly higher in Group 2 (13.6%, 114/840 versus 7.3%, 96/1312 in Group 1) (P < 0.01); the oocyte maturation rate after Day 1 was significantly higher (P < 0.01) in Group 2 (46.3 versus 36.0% in Group 1); and clinical pregnancy (40.9 versus 25%) and implantation rates (15.6 versus 9.6%) were better in Group 2 than those in Group 1.

CONCLUSIONS The results suggest that extending the period of hCG priming time from 35 to 38 h for immature oocyte retrieval promotes oocyte maturationin vivo and increases the IVM rate of immature oocytes. Therefore, oocyte retrieval after 38 h of hCG priming may improve subsequent pregnancy outcome in cycles programmed for IVM treatment.

Table II.

Maturation, fertilization, development and pregnancy rates in Groups 1 and 2.

Variables	Group 1 (hCG + 35 h)	Group 2 (hCG + 38 h)	P value
No. of cycles	76	44
No. of cycles with in vivo matured oocytes (%)	38 (50)	36 (81.8)	P < 0.01
No. of oocytes collected (mean ± SD)	1312 (17.3 ± 9.0)	840 (19.1 ± 9.5)	NS
No. of oocytes matured on collection day (%)	96 (7.3)	114 (13.6)	P < 0.01
Mean ± SD (range)	1.3 ± 2.1 (0–12)	2.6 ± 2.8 (0–12)	P < 0.01
No. of oocytes cultured in vitro	1216	726
No. of oocytes matured in vitro on Day 1(%)	438 (36.0)	336 (46.3)	P < 0.01
No. of oocytes matured in vitro on Day 2(%)	320 (26.3)	159 (21.9)	NS
No. of MII oocytes matured in vitro (%)	758 (62.3)	495 (68.2)	P < 0.05
No. of total MII oocytes (%)	854 (65.1)	609 (72.5)	P < 0.01
No. of normal fertilized oocytes (%)	623 (73.0)	447 (73.4)	NS
No. of embryos cleaved (%)	560 (89.9)	413 (92.4)	NS
Mean no. of embryos available for ET	7.4 ± 5.7	9.4 ± 5.9	P < 0.01
No. of transferred embryos (mean ± SD)	280 (3.7 ± 1.0)	160 (3.6 ± 0.9)	NS
No. of clinical pregnancies (%)	19 (25.0)	18 (40.9)	P = 0.1
No. of implantations (%)	27 (9.6)	25 (15.6)	P = 0.07

• Group 1: IVM cycles where oocytes were collected 35 h after 10 000IU hCG; Group 2: IVM cycles where oocytes were collected 38 h after 10 000 IU hCG. NS, non significant.