国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (3): 181-184.

• 论著 •    下一篇

ICSI联合IVM技术在卵巢低反应高龄患者中的应用

宋文妍，田成成，金海霞，石森林，马馥荟   

  1. 450052 郑州大学第一附属医院生殖医学中心
  • 收稿日期:2018-12-11 修回日期:2019-03-01 出版日期:2019-05-15 发布日期:2019-05-16
  • 通讯作者: 宋文妍，E-mail：csxok@163.com E-mail:csxok@163.com
  • 基金资助:
    国家自然科学基金（81501331）；中华医学会临床医学科研专项基金（17020170686）

Application of ICSI Combined with IVM in Ageing Women with Poor Ovarian Response

SONG Wen-yan，TIAN Cheng-cheng，JIN Hai-xia，SHI Sen-lin，MA Fu-hui   

  1. Reproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052，China
  • Received:2018-12-11 Revised:2019-03-01 Published:2019-05-15 Online:2019-05-16
  • Contact: SONG Wen-yan，E-mail：csxok@163.com E-mail:csxok@163.com

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摘要： 目的：探讨胞浆内单精子注射（ICSI）联合未成熟卵母细胞体外成熟（IVM）技术在卵巢低反应高龄患者中的应用价值。方法：回顾性分析2016年1月—2018年9月于郑州大学第一附属医院生殖医学中心行ICSI助孕治疗81个周期，年龄≥35岁，获卵数≤3个，且卵母细胞均未成熟。按促排卵方案分为微刺激方案组（n=37）和拮抗剂方案组（n=44），统计2组患者基础情况、实验室结果及妊娠结局。结果：①2组患者年龄、不孕时间、基础内分泌、基础窦卵泡数及抗苗勒管激素（AMH）比较，差异均无统计学意义（P＞0.05）；②拮抗剂方案组Gn总量较微刺激方案组高，差异有统计学意义（P＜0.05）；③微刺激方案组与拮抗剂方案组体外培养成熟率、2PN率、卵裂率、可利用胚胎率及优胚率比较差异均无统计学意义（P＞0.05）；④微刺激方案组与拮抗剂方案组的胚胎存活率、种植率和临床妊娠率比较差异无统计学意义（P＞0.05）。结论：对于卵巢低反应的高龄患者行ICSI联合IVM培养有利于提高卵母细胞成熟率及胚胎利用率，增加妊娠机会，微刺激方案Gn用量少对卵巢低反应患者是经济有效的选择。

关键词: 精子注射, 细胞质内, 卵母细胞, 细胞培养技术, 卵巢功能早衰, 排卵诱导

Abstract: Objective：To investigate the application of intracytoplasmic sperm injection (ICSI) combined with immature oocyte in vitro maturation (IVM) in those ageing women with poor ovarian response(POR) who underwent different ovarian stimulation. Methods: A total of 81 cycles of ICSI were evaluated retrospectively from January 2016 to September 2018 at the First Affiliated Hospital of Zhengzhou University. The inclusion criteria were age ≥35 years, the number of oocytes≤3, and the oocytes immature. These cycles were grouped according to the protocols of ovulation stimulation: the micro-stimulation group (n=37) and the antagonist group (n=44). The basal levels of reproductive hormones and the pregnancy outcome were compared between the two gruops. Results: There were no significant differences in age, infertility years, basal levels of hormones (including AMH) and basal antral follicles between the two groups (P＞0.05). The amount of Gn in the antagonist group was significantly higher than that in the micro-stimulation group (P＜0.05). There were no significant differences in the in vitro culture maturation rate, 2PN rate, cleavage rate, embryonic rate and excellent embryo rate between the two groups (P＜0.05). Meanwhile, there were no significant differences in the implantation rate and the clinical pregnancy rate (P＞0.05). Conclusions: The ICSI combined with IVM in ageing women with POR is beneficial to improve the oocyte maturation rate and embryo utilization, and to increase the pregnancy chance. The micro-stimulation protocol is a cost-effective option for those women with POR.

Key words: Sperm injections, intracytoplasmic, Oocytes, Cell culture techniques, Ovarian failure, premature, Ovulation induction