拯救或不拯救未成熟的卵子细胞:前景和挑战
Giovanni Coticchio1, Danilo Cimadomo2, Michel De Vos3
1IVIRMA Global Research Alliance, IVIRMA Italia, Rome, Italy.
Fertility and sterility
|March 9, 2025
概括
试管成熟 (IVM) 帮助不成熟的卵细胞成熟. 救援IVM (r-IVM) 由于缺乏累积细胞支持而面临挑战,限制了其临床使用,但可能会使特定的患者群体受益.
科学领域:
- 生殖生物学 生殖生物学
- 辅助生殖技术 辅助生殖技术
- 卵细胞成熟的过程
背景情况:
- 未成熟卵细胞的体外成熟 (IVM) 是辅助生殖的一个关键领域.
- 卵细胞的成熟依赖于生殖细胞和体细胞之间的复杂相互作用.
- 经典IVM使用完好无损的积卵子封闭卵细胞,为PCOS等疾病提供了更温和的方法.
研究的目的:
- 评估救援IVM (r-IVM) 的疗效和临床适用性.
- 了解成熟卵子在体外没有累积支持的挑战.
- 探索r-IVM对具有低卵细胞成熟率的特定患者群体的潜在益处.
主要方法:
- 救援IVM (r-IVM) 涉及在标准卵巢刺激周期中获取的未成熟卵细胞的体外成熟.
- 卵细胞在移除累积细胞后进行培养,缺乏关键的体细胞支持.
- 对于在生殖囊泡或I阶段转化阶段被捕的卵细胞,需要不同的管理策略.
主要成果:
- 有效的r-IVM具有挑战性,因为缺乏由累积细胞衍生的代谢和调节支持.
- 不成熟的卵细胞表现出不同的发育和染色体能力,这取决于它们的停止阶段.
- 总体而言,r-IVM的临床疗效受到低最佳卵细胞成熟和发育潜力的限制.
结论:
- 救援IVM具有有限的临床实用性,需要仔细考虑成本效益和适当的患者选择.
- 在具有高成熟卵细胞产量的周期中,r-IVM可能无关紧要.
- 预后不佳的特定病例 (成熟度,产量或质量低) 可能受益于从r-IVM卵细胞中获得的胚胎,突出显示需要在体外模仿累积细胞支持.
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