空包卵Empty zona pellucida與病患卵子數量較少卵巢功能低下呈現正相關

臨床有時會遇到空包卵Empty zona pellucida (EZP)
本篇顯示EZP 與病患卵子數量較少, 卵巢功能低下, 卵子品質較差, 卵子受孕率較低, 高齡有正相關性

Gynecol Endocrinol. 2012 May;28(5):341-4. doi: 10.3109/09513590.2011.631632. Epub 2011 Dec 1.

Does empty zona pellucida indicate poor ovarian response on intra cytoplasmic sperm injection cycles?

Cinar O1, Demir B, Dilbaz S, Saltek S, Aydin S, Goktolga U.

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Abstract

The factors behind the empty zona pellucida (EZP) formation and its relationship with in vitro fertilization (IVF) outcomes were analyzed. A total of 104 patients who underwent IVF treatment and collected oocytes including EZP were enrolled in this study. EZP index (EZPI = the ratio of number of EZP to number of cumulus-oocyte complex (COC)) was used for the statistical analysis. Patients were grouped as Group 1 when EZPI ≤ 0.17 (n = 57) and Group 2 when EZPI > 0.17 (n = 47). Type-2 EZP, a variation or an advanced type of oocyte degeneration, is tested. Woman age, basal hormone levels, and total gonadotropin dose were significantly higher in Group 2 compared to Group 1. Total antral follicle count was significantly low in Group 2. Total number of mature oocytes, oocyte quality index, the number of fertilized oocytes, and the numbers of Grade 1 embryos were significantly low in Group 2. On the linear regression analysis, using gonadotropin releasing hormone antagonist protocol (B = 0.086, p = 0.030), the number of ≥17 mm follicle (B = 0.015, p = 0.047), peak serum level of estradiol (B = -3.625; p = 0.014), number of fertilized oocytes (B = -0.02, p = 0.0001) and the day-2 embryo score (B = -0,044, p = 0.001) significantly affected EZPI. An increment of the EZPI may be revealed decreased oocyte quality, and it is also related to the poor ovarian response.