IVM取卵時機為最大濾泡1-1.4cm

IVM 培養液中含有serum (非HSA)
hCG可加速IVM速度
IVM取卵時機為最大濾泡1-1.4cm

http://humupd.oxfordjournals.org/content/16/6/675.full

Laboratory and embryological aspects of hCG-primed in vitro maturation cycles for patients with polycystic ovaries

 

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Abstract

BACKGROUND In this review, recent advances in the laboratory as well as embryological aspects of hCG priming in vitro maturation (IVM) cycles are described.

METHODS This report is based on publications from literature searches and the authors' experience.

RESULTS In IVM cycles, priming with hCG permits the recovery of a certain number of oocytes with an expanding/dispersed cumulus pattern which facilitates its identification within follicular fluid as compared with non-primed IVM cycles. The immature oocytes with dispersed cumulus cells (CC) at collection have high IVM rates and embryo development potentials. Moreover, a few in vivo matured oocytes with dispersed CC can be obtained, and these have produced good quality embryos. hCG can be given to patients when a dominant follicle reaches 10–12 mm to avoid negative effects on the sibling immature oocytes. ICSI should be performed at least 1 h after the first polar body extrusion. Embryo transfer time depends on quantity and quality of the embryos produced after IVM. Compared with slow freezing, vitrification is a more efficient method for freezing the embryos produced from IVM.

CONCLUSIONS The data from the meta-analyses suggests that the effect on clinical outcome of gonadotrophin priming of IVM still needs to be studied. In order to improve the IVM programs, it is essential to define not only the clinical aspects but also the laboratory and embryological aspects.

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Figure 7

COC morphology of oocytes with dispersed CC collected from different size of follicles. (A) M-II-stage oocyte with clumped corona radiata retrieved from <8 mm follicle. (B) GV-stage oocyte with clumped corona radiata retrieved from <8 mm follicle. (C) M-II-stage oocyte with little expanded corona radiata retrieved from 9 to 11 mm follicle. (D) GV-stage oocyte with little expanded corona radiata from 9 to 11 mm follicle. (E) M-II-stage oocyte with expanded corona radiata retrieved from ≥12 mm follicle. (F) GV-stage oocyte with expanded corona radiata from ≥12 mm follicle (original magnification ×200). PB, first polar body; GV, Germinal vesicle; M-II, Metaphase II. Reprinted from an article in Reproductive BioMedicine Online by Son et al. (2008a), with permission from Reproductive Healthcare Ltd.