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.