Alessandro Bartolacci, Andrea Busnelli, Luca Pagliardini, Sofia de Girolamo, Lucia De Santis, Stefania Esposito, Alessandra Alteri, Paolo Emanuele Levi Setti, Enrico Papaleo
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引用次数: 0
摘要
目的：评估经体外成熟（IVM）抢救后成熟的卵母细胞的发育能力：方法：使用相关关键词和医学主题词对 PubMed、EmBASE 和 SCOPUS 进行系统检索，寻找经同行评审的原始论文。研究质量采用纽卡斯尔-渥太华量表进行评估。应用随机效应模型计算了带有 95% 置信区间的比值比。主要结果为受精率和胚泡形成率。次要结果包括异常受精率、卵裂率、整倍体率、临床妊娠率和活产率：结果：24 项研究被纳入荟萃分析。与同胞体内成熟卵母细胞相比，抢救性体外受精后成熟的卵母细胞的受精率、卵裂率、胚泡形成率和临床妊娠率明显降低。优倍性囊胚移植中的优倍性和活产率没有发现明显差异。在反应差的患者中，体外成熟 GV 的受精率降低，而体外成熟 MI 的受精率则没有降低。与结论相比，隔夜成熟的 MI 的裂解率更低：我们的研究结果表明，体外人工授精后成熟的卵母细胞的发育能力受到了影响。然而，对于反应不佳者，拯救性 IVM 可最大限度地提高治疗效率。值得注意的是，我们的数据表明，体外人工授精应在 6 个孵育小时内成熟：临床试验注册号：CRD42023467232。
Assessing the developmental competence of oocytes matured following rescue in vitro maturation: a systematic review and meta-analysis.
Purpose: To assess the developmental competence of oocytes matured following rescue in vitro maturation (IVM).
Methods: PubMed, EmBASE, and SCOPUS were systematically searched for peer-reviewed original papers using relevant keywords and Medical Subject Heading terms. Study quality was assessed using the Newcastle-Ottawa Scale. Odds ratios with a 95% confidence interval were calculated by applying a random effects model. The primary outcomes were fertilization and blastulation rates. Secondary outcomes included abnormal fertilization, cleavage, euploidy, clinical pregnancy, and live-birth rates.
Result: Twenty-four studies were included in the meta-analysis. The oocytes matured following rescue IVM showed significantly reduced fertilization, cleavage, blastulation, and clinical pregnancy rates compared to sibling in vivo-matured oocytes. No significant differences were found for the euploidy and live-birth rates in euploid blastocyst transfer. In poor responders, a reduced fertilization rate was observed using in vitro-matured GV but not with in vitro-matured MI. A reduced cleavage rate in MI matured overnight compared to < 6 incubation hours was found.
Conclusion: Our results showed compromised developmental competence in oocytes matured following rescue IVM. However, in poor responders, rescue IVM could maximize the efficiency of the treatment. Notably, our data suggests using in vitro MI matured within 6 incubation hours.
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