19 KB78 KB18 KB192920262009Čižek-Sajko, MojcaKovač, VilmaVlaisavljević, Veljkoštevilka:1letnik:78str. I-75-I-78ISSN:1318-0347COBISSID:3484991URN:URN:NBN:SI:doc-0E96NGVVslSlovensko zdravniško društvoZdravniški vestnikin vitro maturacijajajčne celicePolycystic Ovary SyndromeReproductive Techniques, AssistedSindrom policističnih ovarijevTehnike asistirane reprodukcijeumetna oploditevzorenjeZorenje jajčnih celic in vitro (IVM) pri bolnicah s PCOS| In vitro maturation of oocytes (IVM) in PCOS patients|Background. In vitro maturation (IVM) is a relatively new method of assisted reproduction. The basis of this method is maturation of immature oocytes in conditions in vitro. The main advantage of this method over the conventional IVF/ICSi technique is that patients don't need medications for controlled ovarian hyperstimulation and that ovarian hyperstimulation syndrome (OHSS) is avoided. The avoidance of OHSS is very important for patients with polycystic ovarian syndrome (PCOS), which have increased risk for OHSS. The IVM method is suitable for the patients with PCOS who require treatment with assisted reproductive technology (ART). There are numerous factors which influence the maturation of human oocytes in vitro such as the nature of the patients, endogenous endocrine background, treatment with gonadotrophins and ovarian steroids, cumulus cell and granulose cell function. In spite the fact that pregnancy rates have been improved in IVM patients last years, the implantation rates stay low (10-11 %). Reports on children born after IVM showed no increased risk for congenital maiformations, however permanent follow-up of this children is needed. Conclusions. IVM is a promising method of ART and offers good results for PCOS patients. Further investigations are needed to improve the success of IVM methodIzhodišča. In vitro maturacija (IVM) je sorazmerno nov postopek oploditve z biomedicinsko pomočjo (OBMP), katerega osnova je zorenje nezrelih jajčnih celic v pogojih in vitro. Glavna prednost IVM v primerjavi z ustaljenima postopkoma IVP in ICSI je ta, da bolnice ne potrebujejo zdravil za kontrolirano ovarijsko hiperstimulacijo (KOH). S tem se v celoti izognemo tveganju za razvoj sindroma ovarijske hiperstimulacije (OHSS), kar je pomembno zlasti za bolnice s sindromom policističnih jajčnikov (PCOS), pri katerih je ta nevarnost večja. Postopek IVM je torej primeren zlasti za bolnice s PCOS, ki v okviru zdravljenja neplodnosti potrebujejo postopke OBMP. Na procese zorenja jajčnih celic in vitro vplivajo dejavniki, kot so: izbira bolnic, endogeno hormonsko okolje, zdravljenje z gonadotropini in ovarijskimi steroidi, funkcija celic granuloze ter kumulusa. Čeprav se je stopnja zanositve v zadnjih letih izboljšala, pa deleži ugnezditve ostajajo nizki (10-11 %). Poročila o otrocih, spočetih po IVM kažejo, da metoda ne zvišuje tveganja za prirojene malformacije, kljub temu je potrebno še naprej slediti rojstvom in razvoju teh otrok. Zaključki. IVM je obetavna metoda OBM, s katero lahko dosežemo dobre rezultate zlasti pri bolnicah s PCOS. Potrebne so nadaljnje raziskave, da bi uspešnost IVM izboljšaliTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo