本文關(guān)鍵詞：未成熟人卵母細胞的體外成熟培養(yǎng)、受精及胚胎移植研究　出處：《重慶醫(yī)科大學(xué)》2005年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 卵母細胞 體外成熟(IVM) 控制性超排卵(COH) 體外受精-胚胎移植(IVF-ET) 卵胞漿內(nèi)單精子顯微注射(ICSI)

【摘要】：在體外受精與胚胎移植助孕技術(shù)(IVF-ET)中需要獲得多個優(yōu)質(zhì)卵母細胞和胚胎,才能得到較高的妊娠率,因此需要進行常規(guī)地控制性超排卵(COH)。在藥物誘發(fā)超排卵時,由于卵巢中卵泡不同步發(fā)育,所采集的卵母細胞約有 15%未達到成熟,過去常因為不能使用而被丟棄。如果能提高未成熟卵的體外成熟和發(fā)育能力并加以利用,將增加每個助孕周期的胚胎數(shù)量,增加可移植胚胎和冷凍胚胎的數(shù)量,增加累積妊娠率,提高助孕成功率。 目的: 研究控制性超排卵周期中獲得的未成熟卵體外成熟培養(yǎng)(in vitromaturation,IVM)的方法,及未成熟卵的卵丘細胞和培養(yǎng)成熟時間對其成熟、受精及發(fā)育能力的影響,建立有效的人卵體外成熟培養(yǎng)系統(tǒng),探討 IVM 在人類輔助生殖技術(shù)(ART)中的應(yīng)用及意義。 方法: 1、選取接受控制性超排卵周期助孕治療的不孕夫婦為研究對象。 2、將采集的卵母細胞分為體內(nèi)成熟卵(MII 期)和未成熟卵兩組。未成熟卵又分為帶卵丘細胞(卵冠丘復(fù)合體,OCCC)和不帶卵丘細胞(裸卵,DO)組(均包括 MI 期和 GV 期),分別進行體外成熟培養(yǎng) 24或 48h。 重慶醫(yī)科大學(xué)碩士研究生學(xué)位論文 4 3、體外成熟卵采用卵胞漿內(nèi)單精子顯微注射(ICSI)授精。體內(nèi) 成熟卵按預(yù)定的助孕方案采用 IVF、ICSI 或 IVF+ICSI 受精。 4、取卵第三天優(yōu)先選擇體內(nèi)成熟卵產(chǎn)生的胚胎進行移植(ET), 其次選擇體外成熟卵產(chǎn)生的胚胎移植,剩余胚胎冷凍保存。 5、比較卵丘細胞和體外成熟時間對未成熟卵體外成熟、受精和胚 胎發(fā)育的影響;比較體內(nèi)成熟卵和體外成熟卵的受精、卵裂和優(yōu)質(zhì)胚 胎形成情況;比較 IVM 技術(shù)的使用是否提高了助孕結(jié)局。 結(jié)果: 1、70.5%的未成熟卵在 IVM 24h 后成熟,11.2%在 IVM 48h 后成熟, 體外成熟率達 81.7%。 2、未成熟卵中,OCCC 與 DO 組的體外成熟率、受精率、卵裂率和 優(yōu)質(zhì)胚胎形成率均無明顯差異(P0.05);GV 期與 MI 期卵的體外成熟 率、受精率、卵裂率和優(yōu)質(zhì)胚胎形成率均無明顯差異(P0.05), GV 期 DO 卵 24h 成熟率高于 OCCC 卵,差異顯著(P0.05);培養(yǎng) 24h 與 48h 成熟的不成熟卵相比較,受精率、卵裂率無明顯差異(P0.05),24h 成熟卵優(yōu)質(zhì)胚胎形成率更高(28.3%比 12.5%),但差異無統(tǒng)計學(xué)意義 (P0.05)。 3、體內(nèi)成熟卵與體外成熟卵相比較,正常受精率、異常受精率和 卵裂率均無明顯差異,體內(nèi)成熟卵優(yōu)質(zhì)胚胎形成率更高,差異顯著 (P0.005)。 4、比較 2004 年 14 例與 2003 年 17 例體內(nèi)成熟卵產(chǎn)生可移植胚胎 數(shù)量2 個的患者,IVM 技術(shù)的使用增加了可移植胚胎、冷凍胚胎數(shù)量, 減少了周期取消率,提高了助孕成功率。 結(jié)論: 1、超排卵周期中獲得的未成熟卵具有在體外完成成熟和進一步發(fā) 育成早期胚胎的能力。
[Abstract]:In the technology of in vitro fertilization and embryo transfer (IVF-ET) will need to get a number of high-quality oocytes and embryos, in order to get a higher pregnancy rate, so we need to carry out routine controlled ovarian hyperstimulation (COH). The drug induced ovulation, because ovarian follicles do not develop synchronously. The collected oocytes about 15% cells did not reach maturity, often because you can not use the discarded. If we can improve the in vitro oocyte maturation and development and utilization, will increase the number of embryos per pregnancy cycle, increase the number of embryos and frozen embryos, increase the cumulative pregnancy rate, improve pregnancy rate.
Objective:
In vitro maturation of oocytes of superovulation in the cycle (in vitromaturation IVM) method, and immature oocyte cumulus cells and culture time on the mature mature, fertilization and developmental competence, to establish a culture system in vitro maturation of human oocytes effectively, IVM in human assisted reproductive technology (ART application) and their significance.
Method:
1, the study object is to select the infertile couples who receive the controlled cycle of ovarian hyperstimulation.
2, the collected oocytes were divided into oocytes matured in vivo (MII) and immature oocytes of two groups. The immature eggs are divided into with cumulus cells (OCCC, OCCC) and without (naked oocytes, cumulus cells (DO) group were including MI and GV), respectively, 24 in vitro maturation or 48h.
Master's degree thesis of Medical University Of Chongqing
Four
3, in vitro mature eggs are inseminated by intracytoplasmic sperm injection (ICSI).
Mature eggs are fertilized by IVF, ICSI, or IVF+ICSI according to the predetermined scheme.
4, for third days, oocytes were preferred to select embryos from the mature eggs of the body to be transplanted (ET).
Secondly, the embryo transfer produced by the mature egg in vitro was selected, and the remaining embryos were frozen and preserved.
5, comparison of cumulus cells and in vitro maturation time of oocytes in vitro maturation, fertilization and embryo
The effects of fetal development; comparison of fertilization, cleavage, and quality embryos of mature and in vitro mature eggs
The formation of the fetus; the comparison of the use of IVM technology to improve the outcome of the pregnancy.
Result:
Immature eggs of 1,70.5% mature after IVM 24h, and 11.2% mature after IVM 48h.
In vitro maturation rate is up to 81.7%.
2, in the immature eggs, in vitro maturation rate, fertilization rate, cleavage rate and the rate of OCCC and DO
There was no significant difference in the formation rate of high quality embryos (P0.05), and in vitro maturation of GV and MI eggs
There was no significant difference in rate, fertilization rate, cleavage rate and high quality embryo formation rate (P0.05), GV
The 24h maturation rate of DO eggs was higher than that of OCCC eggs (P0.05), and 24h and 48h were cultured.
There was no significant difference in fertilization rate and cleavage rate between mature and immature eggs (P0.05), 24h
The rate of high quality embryos in mature eggs was higher (28.3% than 12.5%), but the difference was not statistically significant.
(P0.05).
3, the normal fertilization rate, the abnormal fertilization rate and the rate of fertilization were compared with the mature ova in vitro.
There was no obvious difference in cleavage rate. The rate of high quality embryos in mature eggs in vivo was higher, and the difference was significant.
(P0.005).
4, compared with 14 cases in 2004 and 17 cases of mature eggs in 2003 to produce transplantable embryos
In 2 patients, the use of IVM technology increased the number of transplanted embryos, the number of frozen embryos,
It reduces the cycle cancellation rate and improves the success rate of pregnancy.
Conclusion:
1, immature eggs obtained in the superovulation cycle are mature and further developed in vitro.
The ability to develop early embryos.

【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2005
【分類號】：R321

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