Oocyte maturity

卵母细胞成熟度
  • 文章类型: Journal Article
    目的:探讨体外受精周期卵母细胞成熟度低与囊胚整倍体的关系。
    方法:在2021年1月至2022年11月期间,我们中心共进行了563个胚胎植入前遗传学检测(PGT)周期(不包括染色体结构重排的PGT周期)(平均卵母细胞成熟率:86.4%±14.6%)。其中,93个PGT周期分为低卵母细胞成熟率组(A组,<平均值-1个标准偏差[SD]),并将186个PGT周期分为平均卵母细胞成熟度组(B组,平均值±1标准差)。B组与A组2:1匹配,囊胚倍性,比较两组患者的临床结局。
    结果:卵母细胞成熟度(中期II[MII卵母细胞]),MII卵母细胞率,A组2个原核(2PN)率明显低于B组(5.2±3.0vs.8.9±5.0,P=0.000;61.6%vs.93.0%,P=0.000;78.7%vs.84.8%,分别为P=0.002)。在A组中,因非整倍体而接受PGT的236个囊胚中有106个(44.9%)是整倍体,与B组(336/729,46.1%,P=0.753)。然而,A组仅在55个周期内获得整倍体囊胚(55/93,59.1%),低于B组(145/186,78.0%,P=0.001)。B组临床妊娠率(73.9%)高于A组(58.0%)(P=0.040)。
    结论:我们的结果表明,低卵母细胞成熟度与胚泡整倍体无关,但与用于移植的整倍体胚泡的周期较少有关。较低的2PN率,降低临床妊娠率。
    OBJECTIVE: To investigate the association between a low oocyte maturity ratio from in vitro fertilization cycle and blastocyst euploidy.
    METHODS: A total of 563 preimplantation genetic testing (PGT) cycles (PGT cycles with chromosomal structural rearrangements were excluded) were performed between January 2021 and November 2022 at our center (average oocyte maturity rate: 86.4% ± 14.6%). Among them, 93 PGT cycles were classified into the low oocyte maturity rate group (group A, < mean - 1 standard deviation [SD]), and 186 PGT cycles were grouped into the average oocyte maturity rate group (group B, mean ± 1 SD). Group B was 2:1 matched with group A. Embryological, blastocyst ploidy, and clinical outcomes were compared between the two groups.
    RESULTS: The oocyte maturity (metaphase II [MII oocytes]), MII oocyte rate, and two pronuclei (2PN) rates were significantly lower in group A than in group B (5.2 ± 3.0 vs. 8.9 ± 5.0, P = 0.000; 61.6% vs. 93.0%, P = 0.000; 78.7% vs. 84.8%, P = 0.002, respectively). In group A, 106 of 236 blastocysts (44.9%) that underwent PGT for aneuploidy were euploid, which was not significantly different from the rate in group B (336/729, 46.1%, P = 0.753). However, euploid blastocysts were obtained only in 55 cycles in group A (55/93, 59.1%), which was lower than the rate in group B (145/186, 78.0%, P = 0.001). The clinical pregnancy rate in group B (73.9%) was higher than that in group A (58.0%) (P = 0.040).
    CONCLUSIONS: Our results suggest that a low oocyte maturity ratio is not associated with blastocyst euploidy but is associated with fewer cycles with euploid blastocysts for transfer, lower 2PN rates, and lower clinical pregnancy rates.
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  • 文章类型: Journal Article
    目的评估体外受精-胚胎移植(IVF-ET)过程中,在正常卵巢储备患者中,周围触发女性生殖激素(FRHs)在预测卵母细胞成熟中的功效。
    使用医院数据库提取2020年1月至2021年9月的IVF-ET病例数据。女性生殖荷尔蒙的水平,包括雌二醇(E2),黄体生成素(LH),孕酮(P),和卵泡刺激素(FSH),最初是在基线时评估的,触发的那天,触发后的第二天,和取卵日。E2、LH、P,时间点1(触发日期和基线)和时间点2(触发日期之后和触发日期之后)之间的FSH分别定义为E2_RoV1/2、LH_RoV1/2、P_RoV1/2和FSH_RoV1/2。进行单变量和多变量回归来筛选周围触发FRHs以预测卵母细胞成熟。
    共有118名患者参加了我们的研究。单变量分析显示E2_RoV1与GnRH激动剂组的MII卵母细胞比率之间存在显著关联(p<0.05),但在GnRH拮抗剂方案组中没有。相反,P_RoV2作为两个方案组中MII卵母细胞率的潜在预测因子(p<0.05)。多变量分析证实P_RoV2在预测两组卵母细胞成熟率中的意义(p<0.05)。而E2_RoV1在两组中的相关性均不显著。然而,在GnRH激动剂方案组中的高P_RoV2亚组内,没有观察到相关性是显著的。GnRH激动剂方案组的C指数为0.83(95%CI[0.73-0.92]),GnRH拮抗剂方案组为0.77(95%CI[0.63-0.90])。ROC曲线分析进一步支持了模型的令人满意的性能,GnRH激动剂方案组的曲线下面积(AUC)值为0.79,GnRH拮抗剂方案组为0.81。
    P_RoV2对GnRH激动剂和GnRH拮抗剂方案组的卵母细胞成熟均显示出显著的预测价值,这增强了对评估卵母细胞成熟的理解,并为正常卵巢储备患者在IVF-ET期间控制性超促排卵的个体化治疗方案提供了信息。
    UNASSIGNED: To evaluate the efficacy of peri-trigger female reproductive hormones (FRHs) in the prediction of oocyte maturation in normal ovarian reserve patients during the in vitro fertilization-embryo transfer (IVF-ET) procedure.
    UNASSIGNED: A hospital database was used to extract data on IVF-ET cases from January 2020 to September 2021. The levels of female reproductive hormones, including estradiol (E2), luteinizing hormone (LH), progesterone (P), and follicle-stimulating hormone (FSH), were initially evaluated at baseline, the day of the trigger, the day after the trigger, and the day of oocyte retrieval. The relative change in E2, LH, P, FSH between time point 1 (the day of trigger and baseline) and time point 2 (the day after the trigger and day on the trigger) was defined as E2_RoV1/2, LH_RoV1/2, P_RoV1/2, and FSH_RoV1/2, respectively. Univariable and multivariable regression were performed to screen the peri-trigger FRHs for the prediction of oocyte maturation.
    UNASSIGNED: A total of 118 patients were enrolled in our study. Univariable analysis revealed significant associations between E2_RoV1 and the rate of MII oocytes in the GnRH-agonist protocol group (p < 0.05), but not in the GnRH-antagonist protocol group. Conversely, P_RoV2 emerged as a potential predictor for the rate of MII oocytes in both protocol groups (p < 0.05). Multivariable analysis confirmed the significance of P_RoV2 in predicting oocyte maturation rate in both groups (p < 0.05), while the association of E2_RoV1 was not significant in either group. However, within the subgroup of high P_RoV2 in the GnRH-agonist protocol group, association was not observed to be significant. The C-index was 0.83 (95% CI [0.73-0.92]) for the GnRH-agonist protocol group and 0.77 (95% CI [0.63-0.90]) for the GnRH-antagonist protocol group. The ROC curve analysis further supported the satisfactory performance of the models, with area under the curve (AUC) values of 0.79 for the GnRH-agonist protocol group and 0.81 for the GnRH-antagonist protocol group.
    UNASSIGNED: P_RoV2 showed significant predictive value for oocyte maturation in both GnRH-agonist and GnRH-antagonist protocol groups, which enhances the understanding of evaluating oocyte maturation and inform individualized treatment protocols in controlled ovarian hyperstimulation during IVF-ET for normal ovarian reserve patients.
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  • 文章类型: Journal Article
    UNASSIGNED: The aim is to study the effect of follicle-stimulating hormone (FSH) administration on the day of human chorionic gonadotropin (hCG) trigger on the assisted reproductive technique (ART) outcomes in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.
    UNASSIGNED: Retrospective cohort study was conducted in the ART center of our hospital.
    UNASSIGNED: Two hundred and ninety IVF/ICSI cycles performed between September 2012 and August 2017 were included in the study. Patients who received 375 IU of FSH on the day of hCG trigger (149 cycles) were compared with those who did not receive FSH on the day of trigger (141 cycles).
    UNASSIGNED: Chi-square test and Student\'s t-test were used.
    UNASSIGNED: The FSH co-administered group had a significantly higher number of oocytes retrieved, mature oocytes, and fertilization rate compared to those who did not receive FSH on the day of trigger (p < 0.001). The total number of embryos, the number of grade 1 embryos and the number of embryos available for cryopreservation were also significantly higher in the FSH administered group (p < 0.001). Implantation rate, clinical pregnancy rate, and live birth rate were not significantly different between the two groups.
    UNASSIGNED: This study has shown that FSH administration on the day of the trigger may be considered in IVF cycles receiving hCG trigger to improve the oocyte recovery and maturity if the patient is not at increased risk of ovarian hyperstimulation and serum estradiol on the day of the trigger is <4500 pg/ml. However, there is only an increase in the total number of oocytes retrieved and the number of mature oocytes but no significant change in the implantation, clinical pregnancy, and live birth rates.
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  • 文章类型: Journal Article
    The aim of this study was to investigate whether the automatic measurement of follicular volume by three-dimensional (3D) ultrasound can predict the number of mature oocytes retrieved. A prospective cohort study including 47 women undergoing in vitro fertilization was conducted in a private fertility center. Follicular growth was monitored both manually and automatically using 3D scanning with SonoAVC on the day of human chorionic gonadotropin (hCG) administration. Regression analysis showed that under a standard protocol for hCG administration, the count of mature oocytes is well predicted by a multivariate model including the counts of follicles in the volume classes 2.00 to 5.00 cm3, 1.50 to 1.99 cm3, 1.00 to 1.49 cm3, and 0.60 to 0.99 cm3 In conclusion, this study shows that follicular volume as measured by SonoAVC on the day of hCG administration can be useful to predict oocyte maturity. Specifically, larger follicles and smaller size follicles (class 0.60-0.99 cm3) contribute to the mature oocyte count. This finding warrants the design of clinical trials to establish new criteria for hCG administration based on follicular volume.
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