懷孕率約20%左右
仍比傳統誘導排卵知試管懷孕率30-40%為低
IVM 培養液含
0.075 IU/ml FSH
0.1 IU/ml hCG
http://humrep.oxfordjournals.org/content/23/9/2010.full
Favourable pregnancy results with insemination of in vitro matured oocytes from unstimulated patients
+Author Affiliations
- 1To whom correspondence should be addressed at: The Family Federation of Finland, Infertility Clinic, PO Box 849, 00101 Helsinki, Finland. Email: viveca.soderstrom-anttila@vaestoliitto.fi
- Received September 14, 2004.
- Revision received December 20, 2004.
- Accepted January 10, 2005.
Abstract
BACKGROUND: The purpose has been to develop an in vitro oocyte maturation (IVM) method for a wide range of patients. METHODS: A total of 239 cycles with immature oocyte retrieval (IOC) were carried out without hormonal priming. Patients with regular cycles and normal or polycystic ovaries (PCO) and anovulatory cycles with PCOS were included. Insemination or intracytoplasmic sperm injection (ICSI) according to sperm quality was alternatively used in fertilization of the matured oocytes. RESULTS: A total of 971 immature oocytes (mean 8.0±5.2) were collected in 122 IVM-IVF cycles and 851 oocytes (mean 7.3±4.4) in 117 IVM-ICSI cycles. The oocyte maturation and fertilization rate was 62.6% and 37.7% after insemination, and 53.9% and 69.3% after ICSI, respectively. The mean number of embryos transferred was 1.6. Clinical pregnancy rate per IOC was 23.8% in IVM-IVF and 17.1% in IVM-ICSI (ns). Implantation rate was higher in IVM-IVF (24.2%) than in IVM-ICSI (14.8%) (P<0.05). CONCLUSIONS: Insemination of IVM oocytes functions well, resulting in comparable pregnancy rates per IOC between IVM-IVF and IVM-ICSI. Good pregnancy results can be achieved both in patients with regular cycles and with PCO(S) by transferring only one or two embryos at a time.
Table II.
Comparison of outcomes between IVM-IVF and IVM-ICSI in all patients without hormonal priming (summary of groups 1–3)
| IVM-IVF | IVM-ICSI | Significance | |
|---|---|---|---|
| No. of immature oocyte collection cycles (IOC) | 122 | 117 | |
| No. of follicles cd 3–4 | 17.5±7.4 | 14.7 ± 6.7 | P<0.01 |
| Cycle day of IOC | 9.4±3.1 | 9.3 ± 2.7 | NS |
| Endometrium at day of IOC (mm) | 5.6±1.3 | 5.4 ± 1.4 | NS |
| No. of oocytes collected | |||
| Total | 971 | 851 | |
| Mean | 8.0±5.2 | 7.3±4.4 | NS |
| No. of oocytes matured (%) | 608 (62.6) | 459 (53.9) | |
| No. of matured oocytes fertilized (%) | 229 (37.7) | 318 (69.3) | |
| No. of fertilized oocytes cleaved (%) | |||
| Total | 193 | 259 | P<0.01 |
| Mean | 1.6±1.5 | 2.2±1.6 | |
| No. of embryo transfer (ET) cycles (%) | 84 (68.9) | 100 (85.5) | P<0.01 |
| No. of cycles with more than two embryos to choose for transfer (%) | 24 (19.7) | 42 (35.9) | P<0.01 |
| No. of embryos transferred | |||
| Total | 128 | 159 | |
| Mean | 1.5±0.5 | 1.6±0.5 | NS |
| Clinical pregnancy rate per ET (%) | 34.5 (29/84) | 20.0 (20/100) | P<0.05 |
| Clinical pregnancy rate per IOC (%) | 23.8 (29/122) | 17.1 (20/117) | NS |
| No. of implantations (%) | 31 (24.2) | 22 (14.8) | P<0.05 |
| No. of deliveries/ongoing pregnancies (% per IOC) | 20 (16.4) | 16 (13.7) | NS |
| No. of miscarriages (%) | 9 (31) | 4 (20.0) | NS |
| No. of cycles with cryopreservation of excess good quality embryos (%) | 13 (10.6) | 19 (16.2) | NS |
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