체외수정시술 시 획득한 미성숙난자의 환자 연령에 따른 체외성숙률 및 수정률 비교

Effects of age on in vitro maturation and fertilization of immature oocytes from stimulated cycles in human IVF-ET program

  • 한상훈 (분당서울대학교병원 산부인과) ;
  • 이정렬 (서울대학교 의과대학 산부인과학교실) ;
  • 김현준 (분당서울대학교병원 산부인과) ;
  • 문정희 (분당서울대학교병원 산부인과) ;
  • 지병철 (분당서울대학교병원 산부인과) ;
  • 구승엽 (서울대학교 의과대학 산부인과학교실) ;
  • 서창석 (분당서울대학교병원 산부인과) ;
  • 김석현 (서울대학교 의과대학 산부인과학교실) ;
  • 최영민 (서울대학교 의과대학 산부인과학교실) ;
  • 김정구 (서울대학교 의과대학 산부인과학교실) ;
  • 문신용 (서울대학교 의과대학 산부인과학교실)
  • Han, Sang Hoon (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Lee, Jung Ryeol (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Kim, Hyun Jun (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Moon, Jung Hee (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Jee, Byung Chul (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Ku, Seung-Yup (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Suh, Chang Suk (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital) ;
  • Kim, Seok Hyun (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Choi, Young Min (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Kim, Jung-Gu (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Moon, Shin Yong (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University)
  • 발행 : 2005.12.30

초록

Objective: To investigate the effects of female age on in vitro maturation and fertilization of immature oocytes from controlled ovarian hyperstimulation (COH) in human IVF-ET program. Method: A total of 96 immature oocytes (GV & metaphase I) obtained from 40 cycles of IVF-ET (29 patients). The mean age of female patients was $31.8{\pm}3.1years$. Ovulation was triggered by urinary or recombinant hCG. Immature oocytes were cultured with YS medium containing 30% of patients' human follicular fluids, LH (1 IU/mL), FSH (1 IU/mL) and EGF (10 ng/mL), and then matured oocytes were fertilized by ICSI. In vitro maturation and fertilization of immature oocytes were analyzed according to age of female (< 34 or ${\geq}34years$). Results: The maturation rate was similar between two groups (68% vs 64%). The fertilization rate of in?vitro-matured oocytes was higher in patients < 34 years old, but there was no statistical significance (64% vs 50%, p=0.347). The fertilization rate of in-vitro-matured oocytes was significantly lower compared with those of in-vivo-matured oocytes in both age groups (64% vs 79%, p=0.035, 50% vs 86%, p=0.007). Conclusion: In older female group, fertilization rate of in-vitro-matured oocytes seems to be decreased. Further investigations should be warranted to increase fertilization potential of in-vitro-matured oocytes.

키워드

참고문헌

  1. Mandelbaum J, Junca AM, Belaisch-Allart J, SalatBaroux J, Plachot M, Antoine JM, et al. Oocyte maturation and intracytoplasmic sperm injection. Contracept Fertil Sex 1996; 24: 534-8
  2. De Vos A, Van de Velde H, Joris H, Van Steirteghem A. In-vitro matured metaphase-I oocytes have a lower fertilization rate but similar embryo quality as mature metaphase-Il oocytes after intracytoplasmic sperm injection. Hum Reprod 1999; 14: 1859-63 https://doi.org/10.1093/humrep/14.7.1859
  3. Coetzee K, Windt ML Fertilization and pregnancy using metaphase I oocytes in an intracytoplasmic sperm injection program. J Assist Reprod Genet 1996; 13: 768-71 https://doi.org/10.1007/BF02066495
  4. Edirisinghe WR, Junk SM, Matson PL, Yovich JL Birth from cryopreserved embryos following in-vitro maturation of oocytes and intracytoplasmic sperm injection. Hum Reprod 1997; 12: 1056-8 https://doi.org/10.1093/humrep/12.5.1056
  5. Child TJ, Phillips SJ, Abdul-Jalil AK, Gulekli B, Tan SL A comparison of in vitro maturation and in vitro fertilization for women with polycystic ovaries. Obstet Gynecol 2002; 100: 665-70 https://doi.org/10.1016/S0029-7844(02)02193-2
  6. Yoon HG, Yoon SH, Son WY, Kim JG, Im KS, Lim JH. Alternative embryo transfer on day 3 or day 5 for reducing the risk of multiple gestations. J Assist Reprod Genet 2001; 18: 262-7 https://doi.org/10.1023/A:1016651016502
  7. Jee BC, Ku SY, Suh CS, Choi YM, Kim JG, Moon SY, et al. Cumulative ongoing pregnancy rate in intracytoplasmic sperm injection cycles. J Obstet Gynaecol Res 2004; 30: 372-6 https://doi.org/10.1111/j.1447-0756.2004.00219.x
  8. De Vos A, Van de Velde H, Joris H, Van Steirteghem A. In-vitro matured metaphase-I oocytes have a lower fertilization rate but similar embryo quality as mature metaphase-Il oocytes after intracytoplasmic sperm injection. Hum Reprod 1999; 14: 1859-63 https://doi.org/10.1093/humrep/14.7.1859
  9. Combelles CM, Cekleniak NA, Racowsky C, Albertini DF. Assessment of nuclear and cytoplasmic maturation in in-vitro matured human oocytes, Hum Reprod 2002; 17: 1006-16 https://doi.org/10.1093/humrep/17.4.1006
  10. De Vos A, Van Steirteghem A. Zona hardening, zona drilling and assisted hatching: new achievements in assisted reproduction. Cells Tissues Organs 2000; 166: 220-7 https://doi.org/10.1159/000016734
  11. Sauer MV. The impact of age on reproductive potential: lessons learned from oocyte donation. Maturitas 1998; 30: 221-5 https://doi.org/10.1016/S0378-5122(98)00077-2
  12. Armstrong DT. Effects of maternal age on oocyte developmental competence. Theriogenology 2001; 55: 1303-22 https://doi.org/10.1016/S0093-691X(01)00484-8
  13. Sutton ML, Cetica PD, Beconi MT, Kind KL, Gilchrist RB, Thompson JG. Influence of oocytesecreted factors and culture duration on the metabolic activity of bovine cumulus cell complexes. Reproduction 2003; 126: 27-34 https://doi.org/10.1530/rep.0.1260027
  14. Sutton ML, Gilchrist RB, Thompson JG. Effects of in-vivo and in-vitro environments on the metabolism of the cumulus-oocyte complex and its influence on oocyte developmental capacity. Hum Reprod Update 2003; 9: 35-48 https://doi.org/10.1093/humupd/dmg009
  15. Barnes FL, Crombie A, Gardner DK, Kausche A, Lacharn-Kaplan O, Suikkari AM, et al. Blastocyst development and birth after in-vitro maturation of human primary oocytes, intracytoplasmic sperm injection and assisted hatching. Hum Reprod 1995; 10: 3243-7 https://doi.org/10.1093/oxfordjournals.humrep.a135896
  16. Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril 1994; 62: 353-62 https://doi.org/10.1016/S0015-0282(16)56891-5