Abstract：
Oocyte in vitro maturation (IVM) has been proposed as an alternative to conventional ovarian stimulation (COS) in subfertile women with polycystic ovary syndrome. To evaluate the effectiveness and safety of IVM compared with COS in women with predicted hyperresponse to gonadotropins, we searched the published literature for relevant studies comparing any IVM protocol with any COS protocol followed by in vitro fertilization or intracytoplasmic sperm injection. A systematic review was undertaken on 3 eligible prospective studies. Live birth rate was not significantly lower after IVM vs. COS (odds ratio [95% confidence interval] of 0.56 [0.32-1.01] overall, 0.83 [0.63-1.10] for human chorionic gonadotropin (hCG)-triggered IVM [hCG-IVM] and 0.45 [0.18-1.13] for non-hCG-triggered IVM [non-hCG-IVM]), irrespective of the stage of transferred embryos. Data from nonrandomized studies generally showed either significantly low or statistically comparable rates of live birth with IVM vs. COS. Most studies have not identified any significant difference between IVM and COS with respect to the rates of obstetric or perinatal complications, apart from a potentially higher rate of hypertensive disorders during pregnancy. The development of offspring from IVM and COS with in vitro fertilization or intracytoplasmic sperm injection appears to be similar. Additional research is needed to identify which patient populations will benefit most from IVM, to define the appropriate clinical protocol, and to develop the optimal culture system.
摘要：
已提出卵母细胞体外成熟（IVM）作为患有PCOS的低生育能力妇女的常规卵巢刺激（COS）的替代方法。评价对促性腺激素高反应的女性使用IVM和COS的有效性和安全性,本研究在已发表的文献中检索了相关研究,比较了任何IVM方案和任何COS方案后再进行IVF或ICSI.对三项符合条件的前瞻性研究进行了系统评价。与COS相比，IVM后的活产率没有显着降低（总体比值比[95％置信区间]为0.56[0.32-1.01]，对于hCG触发的IVM[hCG-IVM]为0.83[0.63-1.10]，对于非hCG触发的IVM[非hCG-IVM]为0.45[0.18-1.13]），无论移植胚胎的阶段如何。非随机研究的数据通常显示，与COS相比，IVM的活产率明显较低或具有统计学可比性。大多数研究没有发现IVM和COS在产科/围产期并发症发生率方面有任何显著差异。除了妊娠期高血压疾病的发病率可能更高。IVF/ICSI的IVM和COS后代的发育似乎相似。需要更多的研究来确定哪些患者群体将从IVM中受益最大，为了定义合适的临床方案，并发展最佳的文化体系。
