摘要
目的 探讨未刺激的未成熟卵体外培养成熟（IVN）治疗难治性多囊卵巢综合征（PCOS）不孕的疗效。方法 2004-08—2005-08温州医学院附属第一医院生殖中心对56例难治性PCOS不孕患者进行78个周期的IVN治疗。结果 9个周期取消，取消率为11．5％；69个移植周期共获卵1338个，平均每周期19．4个，培养48h后总成熟率为68．5％。正常受精率为70．2％，卵裂率为91．1％。移植日的子宫内膜厚度平均8．7ram，平均移植3．7个胚胎。1例异位妊娠，2例生化妊娠，28例获临床妊娠。每穿刺周期和移植周期的临床妊娠率分别为37．3％（28／75）和40．6％（28／69）。28例临床妊娠中，3例孕8～12周流产，1例孕22周因胎膜早破流产，15例已分娩，2例双胎和7例单胎在妊娠中。多胎妊娠率为39．3％（11／28）。结论 未经刺激的IVN技术用于治疗难治性PCOS不孕是一种有效的方法，具有简单、经济、最低损伤且可获得与常规体外受精-胚胎移植（IVF—ET）相近的临床妊娠率，但多胎妊娠的发生率仍较高。
Objective To evaluate the clinical application of in vitro maturation （IVM） of unstimulated immature oocyte in the treatment of infertility women with polycystic ovary syndrome. Methods Between August 2004 and August 2005 ,seventy eight cycles of IVM in 56 infertility women with obstinate polycystic ovary syndrome （PCOS） were carried out. Results Nine cycles were cancelled and cancellation rate was 11.5% ;a total of 1338 immature oocytes were obtained in 69 cycles with the average number of 19.4 per cycle, and 916 oocytes were developed at MII stage （68. 5% ）. A total of 643 oocytes were normally fertilized by ICSI （70. 2% ）, with a cleavage rate of 91.1%. Embryo transfer was performed in 69 cycles and the mean number of embryos transferred was 3.7 per cycle. The mean thickness of endometrial on the day of embryo transfer was 8. 7mm. One case was ectopic pregnancy, 2 cases were chemical pregnancy, and twenty-eight clinical pregnancies were obtained, giving a pregnancy rate of 36% （28/78） per puncture, and 40. 6% （28/ 69） per transfer. Among the 28 cases,3 were abortion during 8 ～ 12weeks and 1 was miscarriage because of premature rupture of membrane in 22 weeks. Twenty-four babies （9 twins and 6 singletons） have been bern and 2 twins and 7 single prenancies are ongoing, the muhipregnancy rate being 39. 3 % （ 11/28 ）. Conclusions Our results show that IVM of unstimulated immature oocytes isan effective method for the treatment of infertility women with obstinate PCOS,which may be offered as an alternative to conventional IVF, but the multipregnancy rate is still high.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2006年第10期759-761,共3页
Chinese Journal of Practical Gynecology and Obstetrics
基金
温州市科委资助项目(基金编号:WKW03023)
