【摘要】 目的:探讨未成熟卵母细胞体外成熟在多囊卵巢综合症的应用。方法:自然或小剂量FSH刺激至卵泡直径达到10mm注射hCG,36h后经阴道穿刺获取未成熟卵母细胞,体外培养24～48h,成熟卵母细胞进行ICSI。结果:11例PCOS患者共获卵141个,平均12.8个,培养24～48h后共96个达到MⅡ期,成熟率68%,ICSI后受精共59个,自然受精6个,ICSI受精率68%,自然受精率67%,46个发生卵裂(其中6个为自然受精),ICSI卵裂率68%,优质胚胎(Ⅰ～Ⅲ级)37个,自然受精6个均为优质胚胎。移植后14天,2例血hCG阳性,移植后28天探及子宫内单个孕囊并见原始心管搏动。IVM失败后4例原克罗米芬抵抗者,3例诱导排卵成功,其中1例妊娠,另1例经HMG两个周期妊娠。结论:①IVM是PCOS不孕治疗的新选择;②体外成熟卵母细胞可以自然受精;③经阴道卵巢穿刺可以作为PCOS手术治疗的一种方式。更多还原

【Abstract】 Objective:To investigate immature oocyte maturation,fertilization and pregnancy in women with polycystic ovarian syndrome.Methods:Oocytes whose diameter was 10 mm were injected hCG,oocytes were obtained by transvaginal ovarian centesis after 36 hours.Immature oocyte matured in vitro for 24～48 hours and fertilized by ICSI.Results:141 oocytes were obtained from 11 women with polycystic ovarian syndrome,12.8 on average.The overall oocyte maturation rate was 68% and fertilization rates by ICSI and nature were 68% and 67%.The egg cleavage rate was high by nature fertilization(68%).After the failure of IVM,ovulation induction was succeed in four clomiphene resisted cases and pregnancy was established in two cases.Conclusion:①Oocyte maturation in vitro is a promising alternative for the treatment of polycystic ovarian syndrome;②Maturated oocyte can be natured fertilized;③Transvaginal ovarian centesis may be a substitute operation for PCOS.更多还原