卵子細胞質與ZP與ICSI懷孕率無關
http://humrep.oxfordjournals.org/content/15/2/427.full
Prognostic value of first polar body morphology on fertilization rate and embryo quality in intracytoplasmic sperm injection
+Author Affiliations
- Received March 15, 1999.
- Accepted November 4, 1999.
Abstract
The association between oocyte morphology and subsequent fertilization rate and embryo quality in intracytoplasmic sperm injection (ICSI) is subject to considerable controversy. This retrospective study was carried out to investigate a possible prognostic value of first polar body morphology with regard to fertilization rate and embryo quality. A total of 70 consecutive ICSI cases was included in this study. The results showed that classification based on first polar body morphology revealed a significant correlation with fertilization rate (P < 0.025) and embryo quality (P < 0.001). Cytoplasmic criteria showed no correlation in this respect. Present data indicate that ICSI of oocytes with intact well-shaped first polar bodies yields higher fertilization rates and higher quality embryos.
Table II. Fertilization rate and embryo quality according to morphological anomalies of the cytoplasm and first polar body morphology of metaphase II oocytes
| ICSI results | Embryo quality <25% fragments | |||||
|---|---|---|---|---|---|---|
| n | Deg | 0/1PN | 3PN | 2PN | ||
| Values in parentheses are percentages. | ||||||
| *Only the most frequent anomalies were separately recorded (see text), which accounts for the difference in the total number recorded (307) and the total number of oocytes showing any anomaly (320 above). | ||||||
| Percentages with different superscripts in a column differ significantly: a,b,cP < 0.025, d,e,fP < 0.001 (χ2-test). | ||||||
| ICSI = intracytoplasmic sperm injection; Deg = degeneration of oocyte; PN = pronucleus. | ||||||
| No anomaly | 300 | 19 | 27 | 5 | 249 (83.0) | 164 (65.9) |
| One anomaly | 156 | 12 | 12 | 7 | 125 (80.1) | 82 (65.6) |
| At least two anomalies | 82 | 8 | 9 | 3 | 62 (75.6) | 39 (62.9) |
| Morphological anomaly* | ||||||
| Dark incorporations | 152 | 12 | 16 | 7 | 117 (77.0) | 75 (64.1) |
| Dark cytoplasm/zona pellucida | 54 | 5 | 8 | 1 | 40 (74.1) | 25 (62.5) |
| Refractile body | 84 | 7 | 17 | 2 | 58 (69.1) | 38 (65.5) |
| Irregular shape | 17 | 3 | 1 | 1 | 12 (70.6) | 6 (50.0) |
| First polar body | ||||||
| grade 1 | 174 | 7 | 7 | 5 | 155 (89.1)a | 138 (89.0)d |
| grade 2 | 187 | 13 | 14 | 0 | 160 (85.6)b | 90 (56.3)e |
| grade 3 | 159 | 15 | 23 | 9 | 112 (70.4)c | 53 (47.3)f |
| grade 4 | 18 | 4 | 4 | 1 | 9 (50.0) | 4 (22.2) |
Figure 1.
Oocyte grading based on first polar body morphology. (a) Grade 1, ovoid first polar body with smooth surface; (b) grade 2, ovoid first polar body with rough surface; (c) grade 3, fragmented first polar body; (d) huge first polar body. Magnification does not represent actual working situation. Scale bar = 20 μm.
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