Immature oocyte

未成熟卵母细胞
  • 文章类型: Journal Article
    与其他哺乳动物相比,犬卵母细胞的体外成熟(IVM)率由于其独特的生殖特征而仍然很低。本研究旨在探讨犬未成熟卵母细胞IVM期间补充激素对核成熟的影响,并随后评估其在犬体细胞核移植(SCNT)中的潜在应用。收集未成熟的卵母细胞并在补充有激素(促卵泡激素[FSH]和孕酮[P4])或无激素(对照)的IVM培养基中培养24小时。激素处理组卵母细胞成熟率(94.92±3.15%)明显高于对照组(61.01±4.23%)。体外和体内成熟的卵母细胞都接受了NT来评估它们的效用,体外成熟组的融合率高于体内成熟组,体内和体外成熟组之间不显著(73.28%和82.35%,分别)。因此,将来自体外成熟组的14个融合胚胎转移到两个替代品中,一个代孕者成功怀孕并分娩四只小狗。而在体内成熟组,85个融合胚胎被转移到8个代孕母亲身上,导致三个代理人怀孕并分娩一个,四,还有两只小狗.两组妊娠率无显著性差异(50%和37.50%),但后代数量差异显著(28.57%和8.23%)。总之,我们通过使用体外成熟的卵母细胞成功生产克隆的小狗,实现了一个非凡的里程碑,强调从体外回收的卵母细胞中克隆犬的可行性。重要的是要注意,这项研究仅关注排卵后的未成熟卵母细胞,并且仅在发情期。针对发情周期其他阶段的进一步研究可能会提高犬的克隆效率。
    The in vitro maturation (IVM) rate of canine oocytes remains low compared to other mammals due to their unique reproductive characteristics. This study aimed to explore the effect of hormone supplementation during the IVM of canine immature oocytes on nuclear maturation and subsequently assess its potential application in canine somatic cell nuclear transfer (SCNT). Immature oocytes were collected and cultured in an IVM medium supplemented with hormones (follicle-stimulating hormone [FSH] and progesterone [P4]) or without hormones (control) for 24 hours. The maturation rates of oocytes in the hormone-treated group (94.92 ± 3.15%) were significantly higher than those in the control group (61.01 ± 4.23%). Both in vitro and in vivo matured oocytes underwent NT to evaluate their utility, and the fusion rates were higher in the in vitro matured group than those in the vivo matured group, not significant between in vivo and in vitro matured group (73.28% and 82.35%, respectively). As a result, 14 fused embryos from the in vitro matured group were transferred into two surrogates, with one surrogate achieving a successful pregnancy and delivering four puppies. Whereas in the in vivo matured group, 85 fused embryos were transferred to 8 surrogate mothers, leading to three surrogates becoming pregnant and delivering one, four, and two puppies. The pregnancy rates were not significant between both groups (50% and 37.50%), but the number of offspring exhibited a significant difference (28.57% and 8.23%). In conclusion, we achieved a remarkable milestone by successfully producing cloned puppies using in vitro matured oocytes, underscoring the feasibility of canine cloning from in vitro recovered oocytes. It is important to note that this study focused only on immature oocytes after ovulation and only during the estrus stage. Further research targeting other stages of the estrous cycle could potentially enhance canine cloning efficiency.
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  • 文章类型: Journal Article
    背景:尽管生育力保存技术最近取得了进展,在卵巢肿瘤妇女中实现妊娠仍然具有挑战性。这里,我们报道一例OTO-IVM(卵巢组织卵母细胞体外成熟)导致分娩成功.
    方法:患者,一名33岁的女性,有左卵巢交界性肿瘤(BOT)的病史,三年前接受了左输卵管卵巢切除术,在不孕症治疗期间出现右卵巢增大,表明BOT的复发。因为患者不同意根治性手术和正常的保留部分手术,我们最终执行了OTO-IVM。首先进行了右输卵管卵巢切除术。不仅从可见的卵泡中立即吸出八个未成熟的卵母细胞,而且来自整个皮层的隐形毛囊,切除的卵巢。此外,IVM程序产生了六个成熟卵母细胞,并进行了胞浆内精子注射(ICSI)。因此,获得三个胚胎并冷冻保存。手术三个月后,开始激素替代疗法,一个冻融的胚胎被转移,导致成功怀孕。尽管由于产妇肠梗阻在36周时进行了剖宫产,婴儿分娩时没有出现并发症。
    结论:本报告表明,这种治疗方法是一种有效的方法,可以保护BOT患者的生育能力。尤其是,提示了从整个卵巢皮质收集卵母细胞的重要性。
    BACKGROUND: Despite the recent progress of fertility preservation technique, achievement of pregnancy in women with ovarian tumor is still challenging. Here, we report a case of OTO-IVM (ovarian tissue oocyte in-vitro maturation) resulting in a successful delivery.
    METHODS: The patient, a 33-year-old woman with a history of left borderline ovarian tumor (BOT) who underwent left salpingo-oophorectomy three years ago, presented with an enlarged right ovary during infertility treatment, indicating the recurrence of BOT. Because the patient disagreed with curative surgery and normal part-preservation surgery, we eventually performed OTO-IVM. A right salpingo-oophorectomy was first performed. Eight immature oocytes were immediately aspirated not only from visible follicles, but also from entire cortex for invisible follicles, of the removed ovary. In addition, IVM procedure generated six mature oocytes, and were subjected to intracytoplasmic sperm injection (ICSI). Accordingly, three embryos were obtained and cryopreserved. Three months after surgery, hormone replacement therapy was initiated, and a frozen-thawed embryo was transferred, resulting in a successful pregnancy. Although a cesarean section was performed at 36 weeks due to maternal ileus, the baby was delivered without complications.
    CONCLUSIONS: This report indicates this treatment to be an effective approach for fertility preservation in BOT patients, especially, the importance of collecting oocytes from the entire ovarian cortex was suggested.
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  • 文章类型: Journal Article
    卵母细胞冷冻保存是雌性种质体外基因库的重要技术。虽然缓慢冷冻是不可行的,猪卵母细胞在高玻璃化条件下存活。生发囊泡阶段的冷冻保存似乎比中期II阶段的冷冻保存更有利。几个因素被认为影响玻璃化的成功和未成熟的猪卵母细胞的后续利用,如装置,冷冻保护剂的应用方案,变暖,和变暖后的文化。虽然活的仔猪可以从玻璃化的未成熟卵母细胞中获得,与非玻璃化的对应物相比,它们发育到胚泡阶段的能力仍然降低,这表明还有进一步改进的空间。玻璃化卵母细胞遭受各种类型的损伤和改变,这可能降低其发育能力。其中一些可以在随后的培养过程中恢复到一定程度,如细胞骨架和线粒体的损伤。其他如过早的核进展,DNA损伤和表观遗传改变将需要进一步的研究来澄清和解决。迄今为止,卵母细胞玻璃化在猪中的实际应用仅限于一些本地品种的基因库。
    Cryopreservation of oocytes is an important technology for the in vitro gene banking of female germplasm. Although slow freezing is not feasible, porcine oocytes survive vitrification at high rates. Cryopreservation at the germinal vesicle stage appears to be more advantageous than that at the metaphase-II stage. Several factors are considered to affect the success of vitrification and subsequent utilization of immature porcine oocytes such as the device, the protocols for cryoprotectant application, warming, and the post-warming culture. Although live piglets could be obtained from vitrified immature oocytes, their competence to develop to the blastocyst stage is still reduced compared to their non-vitrified counterparts, indicating that there is room for further improvement. Vitrified oocytes suffer various types of damage and alteration which may reduce their developmental ability. Some of these can recover to some extent during subsequent culture, such as the damage of the cytoskeleton and mitochondria. Others such as premature nuclear progression, DNA damage and epigenetic alterations will require further research to be clarified and addressed. To date, the practical application of oocyte vitrification in pigs has been confined to the gene banking of a few native breeds.
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  • 文章类型: Journal Article
    在生发囊泡(GV)阶段,猪未成熟卵母细胞的玻璃化会降低随后的胚胎产量,并且在胚胎发育过程中可能会发生分子水平的变化。因此,本研究使用猪孤雌生殖胚胎作为模型,使用Smart-seq2RNA-seq技术研究GV卵母细胞玻璃化对4细胞和胚泡阶段所得胚胎转录谱的影响。我们从玻璃化GV卵母细胞的4细胞胚胎和胚泡中鉴定出743(420上调和323下调)和994(554上调和440下调)差异表达基因(DEG),分别。4细胞胚胎中DEGs的功能富集分析表明,GV卵母细胞的玻璃化影响与转录调节相关的调节机制,凋亡过程,代谢和关键通路,如MAPK信号通路。此外,玻璃化GV卵母细胞产生的胚泡中的DEGs富含关键的生物学功能,包括细胞粘附,细胞迁移,AMPK信号通路,GnRH信号通路等。此外,转录组学分析和实时定量PCR结果一致。总之,本研究表明,猪GV卵母细胞的玻璃化可以在随后的胚胎发育阶段改变基因表达模式,可能会影响他们的发展能力。
    Vitrification of porcine immature oocytes at the germinal vesicle (GV) stage reduces subsequent embryo yield and changes at the molecular level may occur during embryonic development. Therefore, the present study used porcine parthenogenetic embryos as a model to investigate the effect of GV oocyte vitrification on the transcriptional profiles of the resultant embryos at the 4-cell and blastocyst stages using the Smart-seq2 RNA-seq technique. We identified 743 (420 up-regulated and 323 down-regulated) and 994 (554 up-regulated and 440 down-regulated) differentially expressed genes (DEGs) from 4-cell embryos and blastocysts derived from vitrified GV oocytes, respectively. Functional enrichment analysis of DEGs in 4-cell embryos showed that vitrification of GV oocytes influenced regulatory mechanisms related to transcription regulation, apoptotic process, metabolism and key pathways such as the MAPK signaling pathway. Moreover, DEGs in blastocysts produced from vitrified GV oocytes were enriched in critical biological functions including cell adhesion, cell migration, AMPK signaling pathway, GnRH signaling pathway and so on. In addition, the transcriptomic analysis and quantitative real-time PCR results were consistent. In summary, the present study revealed that the vitrification of porcine GV oocytes could alter gene expression patterns during subsequent embryonic developmental stages, potentially affecting their developmental competence.
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  • 文章类型: Journal Article
    目的是使用延时监测(TLM)系统研究胚胎形态动力学,并评估卵胞浆内单精子注射(ICSI)结合透明带(ZP)结合精子选择和常规方法的临床结果。研究了来自50个ICSI周期的371个中期II(MII)卵母细胞。将同胞卵母细胞随机分为对照组(n=199)和ZP结合组(n=172)。在ICSI后第3天,在TLM系统中培养并监测所有得到的受精卵。施肥率,早期胚胎发育,并对临床结局进行评价.受精率差异不显著,延时定性和定量措施,原核褪色时间(PNF)t2,t3,t4,t5,t6和t7(分裂到2,3,4,5,6和7细胞的时间),分别。然而,t8(裂解8个细胞的时间)和cc3(第三个细胞周期的持续时间)显示对照组和ZP结合组之间存在显着差异(p<0.05)。两组的A级胚胎率(根据Basile算法)之间存在显着差异(p<0.05),化学妊娠,临床妊娠,并观察到植入。使用生物材料选择精子,比如ZP,改善胚胎质量和妊娠结局,尽管不影响早期胚胎发育和形态动力学参数,直到t8。这项前瞻性随机同胞卵母细胞试验于2020年10月至2022年1月注册(IRCT20200705048021N1)。
    The objective was to investigate the embryo morphokinitics using a time-lapse monitoring (TLM) system and assessment of clinical outcomes following intracytoplasmic sperm injection (ICSI) with zona pellucida (ZP)-bound sperm selection and conventional methods. A total of 371 metaphase II (MII) oocytes from 50 ICSI cycles were studied. Sibling oocytes were randomly divided into control (n = 199) and ZP-bound group (n = 172). All resulting zygotes were cultured and monitored in the TLM system up to Day 3 after ICSI. Fertilization rate, early embryo development, and clinical outcomes were evaluated. No significant differences were found in fertilization rate, time-lapse qualitative and quantitative measures, pronuclear fading time (PNF) t2, t3, t4, t5, t6, and t7 (times of cleavage to 2, 3, 4, 5, 6, and 7 cells), respectively. However, the t8 (time of cleavage to eight cells) and cc3 (duration of third cell cycle) revealed a significant difference between control and ZP-bound groups (p < .05). A significant difference between the two groups (p < .05) in the rates of Grade A embryos (according to Basile algorithm), chemical pregnancy, clinical pregnancy, and implantation was observed. Sperm selection using biological materials, such as ZP, improved both embryo quality and pregnancy outcomes, despite not affecting the early embryo development and morphokinetic parameters up to t8. This prospective randomized sibling oocyte trial was registered in October 2020 to January 2022 (IRCT20200705048021N1).
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  • 文章类型: Journal Article
    在体外受精(IVF)之前接受控制性卵巢过度刺激的妇女使用各种方案进行治疗,以诱导多个卵泡生长。在IVF周期中,所有卵母细胞完全不能成熟是罕见的;然而,它是原发性女性不孕的已知原因。最近,在有卵母细胞成熟缺陷的女性中已经发现了一些基因的致病变异;然而,潜在的遗传原因在很大程度上仍然未知。这项研究包括一个土耳其家庭,包括三个姐妹,在多次卵巢刺激后,在生发囊泡阶段反复出现卵母细胞成熟停滞。外显子组测序显示纯合错义变体(c.1037C>T,p.Ala346Val)在所有三个受影响的姐妹中的EPAB基因(也称为PABPC1L)中,在未受影响的家庭成员中不存在或杂合子。通过转染HEK293T细胞进行证实变体的致病性的功能实验,并证明突变的PABPC1L/EPAB蛋白的蛋白水解的不稳定性和增加的速率。确定的变体,位于保守的第四个RNA识别基序(RRM4)中,计算机3D建模表明PABPC1L/EPAB致病变体的物理性质发生了变化。我们的发现证实了PABPC1L/EPAB是人类卵母细胞成熟过程的重要遗传因素,并对患者及其家庭成员的遗传咨询具有直接意义。
    Women undergoing controlled ovarian hyperstimulation prior to in vitro fertilization (IVF) are treated using various protocols to induce multiple follicular growths. Complete failure of all oocytes to mature during IVF cycles is rare; however, it is a known cause of primary female infertility. Recently, pathogenic variations in a few genes have been identified in women with oocyte maturation defects; however, the underlying genetic causes remain largely unknown.This study included a Turkish family comprising three sisters with recurring oocyte maturation arrest at the germinal vesicle stage after multiple ovarian stimulations. Exome sequencing revealed a homozygous missense variant (c.1037C>T, p.Ala346Val) in the EPAB gene (also known as PABPC1L) in all three affected sisters, which was either absent or heterozygous in the unaffected family members. Functional experiments confirming the pathogenicity of the variant were performed by transfecting HEK293T cells and demonstrated the instability and increased rate of proteolysis of the mutated PABPC1L/EPAB protein. The identified variant, located in the well-conserved fourth RNA recognition motif (RRM4), in silico 3D modelling suggested changes in the physical properties of the pathogenic variant of PABPC1L/EPAB. Our findings validate PABPC1L/EPAB as an essential genetic contributor to the oocyte maturation process in humans and have direct implications for the genetic counselling of patients and their family members.
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  • 文章类型: Journal Article
    哺乳动物早期胚胎的生长发育主要发生在输卵管,它不仅为胚胎生长和发育提供营养,还提供合适的机械条件。辅助生殖技术中建立的胚胎培养系统主要模拟卵母细胞和胚胎在体内生长发育的环境。然而,目前的体外胚胎培养主要是静态的,不能完全模拟胚胎在体内生长和发育的机械环境。因此,为了更准确地模拟输卵管中胚胎的机械环境,我们开发了一种动态培养装置,以研究机械刺激对未成熟卵母细胞体外成熟及其孤雌生殖发育潜力的影响。未成熟小鼠卵母细胞通过静态培养和振动(3Hz,6赫兹)倾斜15~16小时。培养期后观察卵母细胞的成熟。通过孤雌生殖激活成熟卵母细胞,并分析胚胎压实率和孤雌生殖囊胚形成率。结果表明,使用3Hz振动和倾斜可以显着提高未成熟小鼠卵母细胞的孤雌生殖发育潜能。
    The growth and development of early mammalian embryos mainly take place in the fallopian tube, which not only provides nutrients for embryonic growth and development but also offers suitable mechanical conditions. The embryo culture system established in assisted reproductive technology mainly simulates the environment in which oocytes and embryos grow and develop in vivo. However, current in vitro embryo culture is mainly static and cannot completely mimic the mechanical environment in which embryos grow and develop in vivo. Therefore, to more accurately simulate the mechanical environment of embryos in the fallopian tube, we have developed a dynamic culture device to investigate the effects of mechanical stimulation on the in vitro maturation of immature oocytes and their parthenogenetic developmental potential. Immature mice oocytes were subjected to in vitro maturation by static culture and vibration (3 Hz, 6 Hz) with tilting for 15∼16 hours. The maturation of oocytes was observed after the culture period. The mature oocytes were activated by parthenogenesis and the rate of embryo compaction and formation of parthenogenetic blastocysts was analyzed. The results showed that using 3 Hz vibration and tilting can significantly improve the parthenogenetic development potential of immature mice oocytes.
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  • 文章类型: Journal Article
    背景:严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染对辅助生殖技术(ART)的影响越来越受到关注。据报道,SARS-CoV-2核糖核酸(RNA)无法在卵泡液和颗粒细胞中检测到。然而,SARS-CoV-2RNA在未成熟卵母细胞和胚泡中的检出率尚不清楚。此外,在Omicron流行期间,SARS-CoV-2感染对ART胚胎结局的影响有限.
    方法:进行了一项前瞻性研究,以探讨SARS-CoV-2RNA检测阳性的患者的生物标本中病毒RNA的检出率以及SARS-CoV-2感染对胚胎结局的影响。2022年12月13日至2022年12月30日,共有211例患者在广州医科大学附属第三医院接受了经阴道取卵术。在经阴道取卵前,61名个体在24小时内检测出SARS-CoV-2RNA呈阳性。在取卵过程中保留了卵泡液。在脱颗粒后收集颗粒细胞(仅卵胞浆内单精子注射)。在ICSI结束时收集未成熟卵母细胞。在第6天(D6)收集不可用的胚泡。使用天龙SARS-CoV-2RT-PCR-试剂盒检测所有样品中的SARS-CoV-2RNA。COVID-19和非COVID-19组在以下方面进行了对比:受精率,2PN率,第3天(D3)可用胚胎率,D3优质胚胎率,囊胚形成率,优质囊胚形成率。
    结果:除未成熟卵母细胞样本SARS-CoV-2病毒RNA阳性外,其余样本均为阴性,检出率为6.67%。无论是体外受精(IVF)还是卵胞浆内单精子注射(ICSI),受精率,2PN,D3可用胚胎,D3优质胚胎,囊胚形成,COVID-19组和非COVID-19组之间的优质胚泡形成无明显阴性差异。我们的发现通过对来自同一患者的SRAS-Cov-2感染前周期的胚胎学结果的概述得到了验证。
    结论:除未成熟卵母细胞外,没有卵泡液,颗粒细胞,或胚泡样品含有病毒RNA。此外,SARS-CoV-2感染对ART的胚胎结局没有不利影响。
    BACKGROUND: The influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on assisted reproductive technology (ART) has received increasing attention. It has been reported that the SARS-CoV-2 RiboNucleic Acid (RNA) cannot be detected in follicular fluid and granulosa cells. However, the detection rate of SARS-CoV-2 RNA in immature oocytes and blastocysts has still unknown. Moreover, the effect of SARS-CoV-2 infection on embryological outcomes in ART during the Omicron epidemic is limited.
    METHODS: A prospective study was performed to explore the detection rate of viral RNA in biological specimens from patients who tested positive for SARS-CoV-2 RNA and the effects of SARS-CoV-2 infection on embryological outcomes. A total of 211 patients underwent transvaginal oocyte retrieval at the Third Affiliated Hospital of Guangzhou Medical University between December 13, 2022 and December 30, 2022. Prior to transvaginal oocyte retrieval, 61 individuals tested positive for SARS-CoV-2 RNA within 24 h. Follicular fluid was preserved during oocyte retrieval. Granular cells were collected after degranulation (Intracytoplasmic sperm injection only). Immature oocytes were collected at the end of the ICSI. Unavailable blastocysts were collected on day 6 (D6). The TIANLONG SARS-CoV-2 RT-PCR-Kit was used to detect SARS-CoV-2 RNA in all samples. The COVID-19 and Non COVID-19 groups were contrasted in the following areas: fertilization rate, 2PN rate, Day 3 (D3) available embryos rate, D3 good-quality embryos rate, blastocyst formation rate, good-quality blastocyst formation rate.
    RESULTS: All samples were negative except for an immature oocytes sample that was positive for SARS-CoV-2 viral RNA with a detection rate of 6.67%. Whether in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), the rate of fertilization, 2PN, D3 available embryos, D3 good-quality embryos, blastocyst formation, good-quality blastocyst formation was not significantly negative different between the COVID-19 and the Non COVID-19 groups. Our findings were validated by an overview of the embryological outcome from the cycles before SARS- Cov-2 infection from the same patient.
    CONCLUSIONS: Except for immature oocytes, none of the follicular fluid, granulosa cells, or blastocysts samples contained viral RNA. In addition, SARS-CoV-2 infection had no detrimental effects on the embryological outcomes of ART.
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  • 文章类型: Journal Article
    目的:尽管最近在儿科患者中进行的体外成熟(IVM)研究已经证明了卵母细胞的成功回收和成熟,这些研究仅包括少数初潮患者.在本研究中,我们研究了接受卵巢组织冷冻保存(OTC)的儿科患者的卵母细胞取出和成熟的潜在用途.
    方法:我们回顾性检查了2015年10月至2022年12月在我们机构接受OTC的儿科患者的临床记录。关于年龄的数据,原发疾病,月经史,术前化疗,抗苗勒管激素(AMH)水平,从卵巢组织离体收集的卵母细胞数量,并检查了来自IVM的成熟卵母细胞的数量。
    结果:纳入60名儿科患者(1-17岁)的数据进行分析。从36例患者中取出卵母细胞;其中18例患者的卵母细胞可以冷冻保存。初潮前患者的IVM发生率明显低于初潮后患者。未化疗组从IVM回收的成熟卵母细胞数量高于化疗组。在AMH水平和IVM结果之间观察到显著正相关。
    结论:接受OTC的儿科患者的卵母细胞提取和成熟在未接受化疗的患者中特别有用。在接受化疗的患者中,AMH水平可能有助于预测IVM结局.在儿科患者体内激活卵母细胞成熟过程以及更好地了解卵母细胞成熟的主要调节因子对于提高IVM程序的实用性是必要的。
    OBJECTIVE: Although recent in vitro maturation (IVM) studies in pediatric patients have demonstrated successful retrieval and maturation of oocytes, the studies included only a small number of premenarchal patients. In the present study, we examined the potential use of oocyte retrieval and maturation for pediatric patients who undergo ovarian tissue cryopreservation (OTC).
    METHODS: We retrospectively examined the clinical records of pediatric patients who underwent OTC at our institution between October 2015 and December 2022. Data on the age, primary disease, menstrual history, pre-procedure chemotherapy, anti-Müllerian hormone (AMH) level, number of oocytes collected ex vivo from ovarian tissue, and number of mature oocytes from IVM were examined.
    RESULTS: Data of 60 pediatric patients (aged 1 to 17 years) were included for analysis. Oocytes were retrieved from 36 patients; the oocytes of 18 of these patients could be cryopreserved. The IVM rate was significantly lower in the premenarchal patients than in the postmenarchal patients. The number of mature oocytes retrieved from IVM was higher in the no-chemotherapy group than in the chemotherapy group. A significant positive correlation was observed between the AMH level and the IVM outcomes.
    CONCLUSIONS: Oocyte retrieval and maturation in pediatric patients undergoing OTC is particularly useful in those not receiving chemotherapy. In patients receiving chemotherapy, the AMH level may be useful for predicting the IVM outcome. Activation of the oocyte maturation process in vivo in pediatric patients and better understanding of the major regulators of oocyte maturation are necessary to improve the utility of the IVM procedure.
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  • 文章类型: Journal Article
    为了确保在肿瘤生育保护(FP)计划中对患者进行护理,专家必须提供最适合患者临床条件的技术。对于需要紧急肿瘤治疗的女性,体外卵母细胞成熟(IVM)和卵巢组织冷冻保存(OTC)是可能的生育力保存治疗。IVM包括从小的窦卵泡中取出未成熟的卵母细胞,没有或很少有促性腺激素刺激卵巢。因此,IVM已成为保留生育能力的相关选择,特别是对于卵巢刺激不可行或禁忌的病例。未成熟卵母细胞的现有数据,经阴道取回(OPU-IVM)或从“离体”卵巢组织提取(OTO-IVM),在技术一致性方面仍然有限,功效,和安全。本回顾性队列研究包括89名使用IVM方法进行生育力保存的妇女和26名同时进行卵巢刺激(OS)的妇女。总的来说,从IVM患者收集533个未成熟卵母细胞,在培养24h和48h时,OTO-IVM的成熟率为57%和70%,OPU-IVM的成熟率为73%和82%,分别。观察到的高成熟率可能是由于使用患者血清在其先天状态,即,没有热灭活。这允许7.6±5.7和4.6±4.9卵母细胞在OTO-IVM和OPU-IVM中玻璃化,分别,与OS患者的6.8±4.6相比。关于OS患者,其中两个在完全缓解后,在温暖的卵母细胞授精后进行了胚胎移植,导致一名患者一次活产。在终止肿瘤治疗后对两名OTO-IVM患者进行随访时,总共11个温暖的卵母细胞导致单个胚胎的转移,但是没有怀孕。从OPU-IVM,三个患者在卵母细胞玻璃化4.25年后转移了六个胚胎,导致一个健康男孩的活产。目前的活产病例是迄今为止报道的第一批病例之一,并支持以下观点:当需要保存卵母细胞但禁止卵巢刺激时,IVM可能是癌症患者的相关且安全的FP选择。
    To ensure patient care in an oncological fertility preservation (FP) programme, specialists must provide technology that best suits the patients\' clinical conditions. In vitro oocyte maturation (IVM) and ovarian tissue cryopreservation (OTC) are possible fertility preservation treatments for women in need of urgent oncological treatment. IVM consists of the retrieval of immature oocytes from small antral follicles, with no or minimal ovarian stimulation by gonadotropins. Therefore, IVM has become a pertinent option for fertility preservation, especially for cases whereby ovarian stimulation is unfeasible or contra-indicated. Existing data on immature oocytes, retrieved transvaginally (OPU-IVM) or extracted from ovarian tissue \'ex vivo\' (OTO-IVM), are still limited on technical consistency, efficacy, and safety. The present retrospective cohort study includes 89 women undergoing fertility preservation using IVM methodologies and 26 women undergoing ovarian stimulation (OS) in concomitant period. In total, 533 immature oocytes were collected from IVM patients, achieving a maturation rate of 57% and 70% in OTO-IVM and 73% and 82% in OPU-IVM at 24 h and 48 h in culture, respectively. The observed high maturation rates might be due to the use of patients\' serum in its innate status, i.e., without heat-inactivation. This permitted 7.6 ± 5.7 and 4.6 ± 4.9 oocytes to be vitrified in OTO-IVM and OPU-IVM, respectively, compared to 6.8 ± 4.6 from OS patients. Regarding OS patients, two of them underwent embryo transfer following the insemination of warmed oocytes after complete remission, resulting in a single live birth from one patient. Upon follow-up of two OTO-IVM patients after the termination of their oncological treatment, a total of 11 warmed oocytes lead to a transfer of a single embryo, but pregnancy was not achieved. From OPU-IVM, six embryos were transferred in three patients 4.25 years after oocyte vitrification, leading to the live birth of a healthy boy. The present case of live birth is among the first cases reported so far and supports the notion that IVM might be a relevant and safe FP option for cancer patients when oocyte preservation is required but ovarian stimulation is contra-indicated.
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