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Analysis of related factors for low oocyte maturation rate in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection cycles
GAO Wen-yi, LIU Jing, LI Cai-xia, ZHANG Yan-ru, JIN Xin, DENG Yun, ZHU Jin
Chinese Journal of Practical Gynecology and Obstetrics ›› 2026, Vol. 42 ›› Issue (7) : 745-749.
PDF(1509 KB)
PDF(1509 KB)
Analysis of related factors for low oocyte maturation rate in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection cycles
Objective To investigate the impact of oocyte maturation rate on embryonic development and clinical outcomes in polycystic ovary syndrome （PCOS） patients undergoing intracytoplasmic sperm injection （ICSI） cycles，and to analyze its related factors. Methods A retrospective analysis was performed on the clinical data of 490 PCOS patients undergoing their first ICSI cycle in the 904th Hospital of the Joint Logistic Support Force of PLA from January 2020 to December 2025. Patients were divided into two groups according to the minimum performance （competence） levels for oocyte maturation rate recommended by the Vienna consensus：Group A （≥ 75%） and Group B （< 75%）. Baseline characteristics，embryonic development，and clinical outcomes were compared between the two groups. The receiver operating characteristic （ROC） curves were used to evaluate the predictive value of oocyte maturation rate for clinical outcomes and to determine the optimal cutoff value. Multivariate binary logistic regression analysis was used to identify independent influencing factors associated with low oocyte maturation rate. Results No statistically significant differences were observed in baseline characteristics between the two groups （P>0.05）. As the oocyte maturation rate decreased，the rates of normal fertilization，Day 3 high-quality embryos，blastocyst formation，clinical pregnancy，and live birth all declined （P<0.05）. ROC curve analysis revealed that the area under the curve （AUC） for oocyte maturation rate in predicting clinical pregnancy rate was 0.617 （95% CI 0.566-0.668，P<0.05），and for predicting live birth it was 0.621 （95% CI 0.571-0.670，P<0.05），with an optimal cutoff value of 86.82% for both. Multivariate logistic regression analysis showed that basal anti-Müllerian hormone （AMH） （OR=1.258，95% CI 1.010-1.566，P=0.04），testosterone （T） （OR=13.447，95% CI 2.411-74.980，P<0.01），and the number of retrieved oocytes （OR=1.104，95% CI 1.022-1.193，P=0.01） were independent risk factors for low oocyte maturation rate，while the interaction term between basal estradiol （E2） and T was a protective factor （OR=0.942，95% CI 0.899-0.988，P=0.01）. Conclusions In ICSI cycles of PCOS patients，a low oocyte maturation rate adversely affects embryo quality and clinical outcomes. Basal AMH，T，and the number of retrieved oocytes are independent risk factors for low oocyte maturation rate，while basal E2 may mitigate the negative impact of hyperandrogenism.
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The main features of polycystic ovary syndrome (PCOS) are abnormal follicular development and ovulatory dysfunction, which are caused by excessive apoptosis of ovarian granulosa cells. Acupuncture has been shown to improve follicular development abnormalities in patients with PCOS, but its mechanism is unknown. This study hypothesized that the mechanism of acupuncture on follicular development abnormalities in PCOS patients is the inhibition of granulosa cell apoptosis through LncMEG3-mediated regulation of miR-21-3p.A PCOS-like rat model was established using subcutaneous injection of dehydroepiandrosterone (DHEA). Acupuncture was performed on rats for 15 d (CV-4, RN-3, CV-6, SP-6 and EX-CA 1). Ovarian morphology was observed by HE staining, and sex hormone and AMH levels were detected by ELISA. Primary granulosa cells were isolated from each group of rats to assess the association of acupuncture treatment, LncMEG3, miR-21-3p, and granulosa cell apoptosis in rats with PCOS.LncMEG3 and miR-21-3p were highly expressed in the ovarian granulosa cells of rats with PCOS, and LncMEG3-mediated regulation of miR-21-3p was involved in the development of PCOS in rats. Silencing of MEG3 attenuated sex hormone dysregulation and ovarian histopathological changes in PCOS rats and promoted follicle cell development and maturation. In addition, silencing MEG3 increased the viability and number of granulosa cells. In addition, silencing MEG3 further inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats. Acupuncture improved polycystic ovarian morphology and sex hormone levels in PCOS rats. Acupuncture intervention increased the viability and number of granulosa cells. Acupuncture intervention inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats by targeting miR-21-3p via LncMEG3.These results suggest that acupuncture can downregulate LncMEG3, thereby targeting and regulating miR-21-3p to suppress early and late granulosa cell apoptosis and normalize their proliferation. These factors ultimately compensate for abnormal follicular development. These findings shed light on the clinical potential of acupuncture as a safe treatment for follicular developmental abnormalities in PCOS.© 2023. The Author(s).
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所有作者均声明不存在利益冲突
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