卵子體外成熟培養(IVM)重要概念

PCO打排卵針容易OHSS

PCO應採低劑量誘導排卵COH

IVM採卵壓力調低到100Hg

IVM培養液含75IU/ml hMG, 10iu/ml hCG

IVM培養液不含glucose

ET 當天可施打10000iu  HCG

http://humrep.oxfordjournals.org/content/17/1/134.full

Blastocyst development and pregnancies after IVF of mature oocytes retrieved from unstimulated patients with PCOS after in-vivo HCG priming: Case report

1. Weon-Young Son1,3, 
2. San-Hyun Yoon1,2, 
3. Suk-Won Lee1, 
4. Yong Ko2,
5. Hye-Gyun Yoon1 and 
6. Jin-Ho Lim1

+Author Affiliations

1. ¹Maria Infertility Hospital and
2. ²Department of Animal Science, Korea University, Seoul, Korea

• Received June 8, 2001.
• Accepted September 17, 2001.

 

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Abstract

A major side-effect of controlled ovarian stimulation (COS) in patients with polycystic ovarian syndrome (PCOS) is the risk of ovarian hyperstimulation syndrome (OHSS). In-vitro maturation (IVM) of immature oocytes represents a potential alternative for the fertility treatment of these patients. Two patients at high risk of OHSS were primed with 10 000 IU HCG 36 h before oocyte retrieval. After retrieval, oocyte maturity was evaluated. Oocytes considered to be mature at the time of collection were inseminated by IVF or ICSI, and the resulting embryos were cultured to blastocysts. Transfer of these blastocysts resulted in pregnancy in both patients. Immature oocytes were cultured in YS medium supplemented with 30% human follicular fluid, 1 IU/ml rFSH, 10 IU/ml HCG and 10 ng/ml epidermal growth factor (rhEGF). After in-vitro maturation of the oocytes, ICSI was performed. Two and five expanded blastocysts were obtained after 5 day culture and were cryopreserved. This report indicates that mature oocytes can be collected at the time of retrieval using only in-vivo HCG priming in women with PCOS, and clinical pregnancy can be established by transfer of blastocysts derived from the mature oocytes. This approach opens a potential for a new dimension in the management of patients with PCOS.