施丽 公方强 莫毅 牛向丽

【摘要】 目的 比较人未成熟卵母细胞体外成熟（in vitro maturation，IVM）前后玻璃化冷冻对卵母细胞的影响。

方法 318枚人生发泡期（germinal vesicle，GV）卵母细胞来自100名不孕症患者，将患者随机分为A、B两组，每组50人。A组GV期卵母细胞玻璃化冷冻后解冻复苏行IVM;B组GV期卵母细胞行IVM后玻璃化冷冻再解冻复苏，比较两组卵母细胞的解冻复苏率、成熟率及24小时纺锤体出现率。

结果 两组卵母细胞行IVM培养24小时及48小时成熟率比较均有统计学意义（P<0.05），卵母细胞解冻复苏率、IVM培养24小时纺锤体形成率比较无统计学意义（P>0.05）。

结论 未成熟卵母细胞IVM后再行玻璃化冷冻保存效果更佳。

【关键词】 玻璃化冷冻;未成熟卵母细胞;体外成熟;成活率;成熟率

中图分类号：R321-33   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.07.004

【Abstract】 Objective To compare the effect of vitrification of human immature oocytes before and after in vitro maturation （IVM）.

Methods A total of 318 human germinal vesicle （GV） human oocytes were collected from 100 infertile patients， and the patients were randomly divided into group A and group B， with 50 cases in each group. The oocytes in the GV stage of the group A were vitrified and thawed before IVM， and the oocytes in the GV stage of the group B were vitrified and thawed after IVM. And then， the thawing recovery rate， maturation rate and 24-hour spindle formation rate of oocytes in the two groups were compared.

Results The maturation rates of oocytes cultured in IVM at 24 h and 48 h were statistically different between the group A and the group B （P < 0.05）， while there was no statistically significant difference in the thawing recovery rate of oocytes and the spindle formation rate after   24 h IVM culture between the two groups （P > 0.05）.

Conclusion Vitrification of immature oocytes after IVM is more effective.

【Key words】 vitrification; immature oocytes; IVM; survival rate; maturing rate

随着玻璃化冷冻技术在辅助生殖领域的应用，成熟人卵母细胞玻璃化冷冻的成功率显著增加[1～2]，玻璃化法已成为成熟卵母细胞冷冻保存的主要方法。国外学者研究证实未成熟卵母细胞体外成熟技术是有效的[3]，将未成熟卵母细胞的体外成熟和玻璃化冷冻相结合已成为癌症患者化疗前保存生育力的一种选择策略[4];同时，未成熟卵母细胞玻璃化冷冻保存的成功将为卵子库卵子的来源提供了新的途径。理论上，保存未成熟卵母细胞有两种可能的方法：未成熟卵母细胞体外培养成熟（in vitro maturation，IVM）后玻璃化冷冻保存和直接玻璃化冷冻未成熟卵母细胞[5]。学者们对于哪种方法冷冻保存未成熟卵母细胞后对卵母细胞的成熟及发育潜能影响较小尚存争议。本研究旨在探讨这两种方法对人卵母细胞存活率、成熟率及发育潜能的影响。……