卵泡大小和从它们中获取的卵母细胞的质量之间是否存在关联,这是根据达到胚泡阶段的能力来判断的,
尽管卵泡大小是卵母细胞成熟的有价值的预测指标,也是受精卵母细胞成为优质胚泡的能力的重要预测指标,每个优质囊胚的倍性与从中取出卵母细胞的卵泡的大小无关.
尚不清楚较大卵泡中的卵母细胞是否是队列中最好的卵母细胞。尽管已经有研究检查了卵泡大小与胚胎质量的关系,没有研究将胚胎中整倍体的发生率与卵泡大小相关。
这项研究的目的是检查卵泡的大小和这些卵泡的卵母细胞(以及由这些卵母细胞产生的胚胎),以确定卵泡的大小与卵母细胞的质量之间是否存在关联,如达到胚泡阶段的能力所判断的,囊胚等级和囊胚倍性。卵母细胞的卵泡大小被评估为直径(mm)和Z值(表示为它们相对于该供体的卵泡队列的平均值和标准偏差的大小)。使用累积直方图进行比较,滚动平均值和接受者操作者特征(ROC)曲线及其AUC。
本研究纳入了22个卵母细胞供体(年龄:24.5±3.5岁),其受体将使用ICSI进行授精。一次吸出卵泡,以确定吸出的卵母细胞来自测量的相同卵泡。在胚胎学记录中记录卵泡测量值(大小)。卵母细胞在胚胎学实验室的整个时间内分别培养,以便卵泡大小可以与每个卵母细胞独特地相关。根据从中取出卵母细胞的卵泡的大小分析卵母细胞和胚胎。
三百十七个卵母细胞(96.1%)具有相关的卵泡大小。在卵泡大小的卵母细胞中,255(80.4%)有极体(MII),和60(18.9%)未成熟:31(9.8%)具有可见的生发囊泡(GV期),29(9.1%)既没有极体也没有可见的生发囊泡(MI)。使用mm(ROC的AUC=0.87;P<0.0001)或Z值(ROC的AUC=0.86;P<0.0001),MII卵母细胞的发生率与较大的卵泡大小显着相关。在MII卵母细胞中,228个具有两个原核(2PN)的卵母细胞的出现与卵泡大小无关。在2个PN中,使用mm(ROC'sAUC=0.59;P=0.01)或Z值(ROC'sAUC=0.57;P=0.01),接受滋养外胚层活检(TEBx)的94个优质囊胚的发育与较大卵泡存在显著关联.使用卵泡直径作为特征来区分最终会变成胚泡的受精卵母细胞与不会变成胚泡的受精卵母细胞导致胚泡形成的富集从20%至40%。在94个优质胚泡中,通过下一代测序(NGS)确定51为整倍体。尽管卵母细胞成熟度和囊胚形成的发生率与卵泡大小有关,活检胚泡中整倍体的发生率没有.通过两种不同的方法(mm或Z值)测量的卵泡主要得出相同的结论。
本研究调查了当相似地处理供体时卵泡大小与卵母细胞/胚胎质量测量值之间的关系。因此,这项研究没有调查当卵泡队列大小不同或铅卵泡大小不同时,触发和回收卵母细胞的效果.尽管在卵泡大小和整倍体囊胚之间没有发现关联,胚泡倍性并不完全依赖于卵母细胞倍性(例如来自有丝分裂错误或来自受精精子的非整倍体),这使得很难推断卵泡直径与卵母细胞倍性之间的关系.
证实卵泡直径是卵母细胞成熟的预测指标。然而,一旦知道卵母细胞成熟,从中取出卵母细胞的卵泡直径并不具有指导意义.从任何观察到的卵泡直径通过成熟卵母细胞的受精和发育产生的胚胎同样可能成为整倍体胚泡。
这项研究由ReproART:格鲁吉亚美国生殖医学中心资助。没有任何作者声明任何实际的利益冲突。D.H.M.从ReproART获得赔偿,生物遗传学公司和纽约精子和胚胎银行以及费林制药公司和格拉纳塔生物公司的酬金和旅费。S.M.获得了CooperGenomics的赔偿,以及FerringPharmaceuticals的酬金和差旅费。L.C.是LTDOvamedi的创始人,代表佐治亚州库珀基因组学的组织,并获得了欧洲人类生殖和胚胎学学会的差旅费。
不适用。
Is there is an association between follicle size and the quality of oocytes retrieved from them as judged by ability to achieve the blastocyst stage, blastocyst grades and blastocyst ploidy?
Although follicle size is a valuable predictor of oocyte maturity and is a significant predictor of the ability of a fertilized oocyte to become a quality blastocyst, the ploidy of each quality blastocyst is not related to the size of the follicle from which its oocyte was retrieved.
It is unclear whether the oocytes within larger follicles are the best oocytes of the cohort. Although there have been studies examining follicle size in relation to embryo quality, there has been no study relating the incidence of euploidy in embryos to follicle size.
The purpose of this study was to examine follicle sizes and the oocytes from those follicles (and the embryos that result from those oocytes) to see if there is an association between follicle size and the quality of oocytes as judged by ability to achieve the blastocyst stage, blastocyst grades and blastocyst ploidy. Follicle sizes for oocytes were assessed both as diameters (mm) and as Z values (expressed as their size relative to the mean and standard deviation of that donor\'s follicular cohort). Comparisons were made using cumulative histograms, rolling averages and receiver operator characteristic (ROC) curves and its AUC.
Twenty-two oocyte donors (ages: 24.5 ± 3.5 years) whose recipients would use ICSI for insemination were enrolled in this study. Follicles were aspirated one-at-a-time to be certain that the aspirated oocyte was from the same follicle measured. The follicle measurement (size) was noted in the embryology records. Oocytes were cultured individually throughout their time in the embryology laboratory so that follicle sizes could be uniquely associated with each oocyte. Oocytes and embryos were analyzed according to the size of the follicle from which the oocyte was retrieved.
Three hundred seventeen oocytes (96.1%) had an associated follicle size. Of the oocytes with follicle sizes, 255 (80.4%) had a polar body (MII), and 60 (18.9%) were immature: 31 (9.8%) with a visible germinal vesicle (GV stage) and 29 (9.1%) with neither a polar body nor a visible germinal vesicle (MI). The incidence of MII oocytes was significantly associated with larger follicle size using either mm (ROC\'s AUC = 0.87; P < 0.0001) or Z values (ROC\'s AUC = 0.86; P < 0.0001). Among MII oocytes there was no association with follicle size for the appearance of 228 oocytes with two pronuclei (2 PN). Among 2 PN\'s, the development of 94 quality blastocysts that underwent trophectoderm biopsy (TE Bx) exhibited a significant association with larger follicles using either mm (ROC\'s AUC = 0.59; P = 0.01) or Z values (ROC\'s AUC = 0.57; P = 0.01). The use of follicle diameter as a feature to distinguish between fertilized oocytes that would ultimately become blastocysts versus those that would not become blastocysts resulted in an enrichment for blastocyst formation from 20 to 40%. Of the 94 quality blastocysts, 51 were determined by next generation sequencing (NGS) to be euploid.Although oocyte maturity and the incidence of blastocyst formation were associated with follicle size, the incidence of euploidy among biopsied blastocysts was not. Follicles measured by two different methods (mm or Z values) led to predominantly the same conclusions.
This study investigated the relationship between follicle size and measures of oocyte/embryo quality when donors were treated similarly. Therefore, this study does not investigate the effects of triggering and retrieving oocytes when the follicle cohorts are of different sizes or lead follicles are of different sizes. Although no association was found between follicle size and euploid blastocysts, the fact that blastocyst ploidy is not entirely dependent upon oocyte ploidy (e.g. aneuploidies derived from mitotic errors or from the fertilizing sperm) makes it difficult to infer the relationship between follicle diameter and oocyte ploidy.
It is confirmed that follicle diameter is predictive of oocyte maturity. However, once oocyte maturity is known, the diameter of the follicle from which the oocyte was retrieved is not instructive. Embryos generated through fertilization and development of the mature oocytes from any observed follicle diameter were equally likely to become euploid blastocysts.
This study was funded by ReproART: Georgian American Center for Reproductive Medicine. None of the authors declare any actual conflicts of interest. D.H.M. received compensation from ReproART, Biogenetics Corporation and the Sperm and Embryo Bank of New York and honoraria and travel funding from Ferring Pharmaceuticals and from Granata Bio. S.M. received compensation from Cooper Genomics and an honorarium and travel funding from Ferring Pharmaceuticals. L.C. is the founder of LTD Ovamedi, the organization that represents Cooper Genomics in Georgia, and received travel funding from the European Society for Human Reproduction and Embryology.
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