卵細胞質異常內容物施行ICSI後胚胎著床率與懷孕率較低

卵細胞質異常內容物施行ICSI後胚胎著床率與懷孕率較低


http://humrep.oxfordjournals.org/content/16/10/2118.abstract?ijkey=44d3f25b203e44f1e9318db9c83f16f362d376a7&keytype2=tf_ipsecsha

Tracking of oocyte dysmorphisms for ICSI patients may prove relevant to the outcome in subsequent patient cycles

1. James S. Meriano,
2. Jennifer Alexis,
3. Shirin Visram-Zaver,
4. Micheal Cruz and
5. Robert F. Casper1

+ Author Affiliations

1. Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Toronto Centre for Advanced Reproductive Technology, University of Toronto, Toronto, Ontario, Canada

• Received February 12, 2001.
• Accepted June 14, 2001.

 

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Abstract

BACKGROUND: We determined whether oocyte dysmorphisms, especially repetition of specific dysmorphisms from cycle to cycle, had a prognostic impact on intracytoplasmic sperm injection (ICSI) outcome. METHODS: ICSI patients (n = 67) were grouped as follows: group 1 >50% phenotypically dysmorphic oocytes per cohort (cytoplasmic and extra-cytoplasmic dysmorphisms) with no repetition of a specific dysmorphism from cycle one to cycle two (36 cycles and 274 oocytes); group 2 >50% dysmorphic oocytes per cohort and repetition of the same dysmorphism from cycle one to cycle two (32 cycles and 313 oocytes); group 3 (control) <30% dysmorphic oocytes (33 cycles and 378 oocytes). RESULTS: In group 2 (repetitive), 47% of oocytes were observed to have organelle clustering versus 20.5% in group 1 and 17.3% in group 3 (P < 0.001). There was no difference between the groups in fertilization rates, cleavage rates or embryo quality. Embryos derived from normal oocytes were transferred in each group (57, 33 and 72% respectively). The clinical pregnancy and implantation rates in group 2 (3.1 and 1.7% respectively) were lower (P < 0.01, P = 0.005) than both group 1 (28 and 15% respectively) and group 3 (45.5 and 26.5% respectively). CONCLUSIONS: The low implantation rate in group 2, even though 33% of transferred embryos were derived from morphologically normal oocytes, suggests that repetitive organelle clustering may be associated with an underlying adverse factor affecting the entire follicular cohort.

Figure 1.

Normal and dysmorphic oocytes (A, B) Normal appearing oocytes with no visually outstanding features in cytoplasm or otherwise. (C–F) Varying degrees of organelle clusters (*) (central granularity) observed from mild to very severe (G, N). Aggregation (arrows) of smooth endoplasmic reticulum as a flat, clear disc in the middle of the cytoplasm of the oocyte. (H) A dark `horse shoe shaped' (large arrow) cytoplasmic inclusion. (I, J, K) Varying degrees (mild to severe) of fluid filled vacuoles within the cytoplasm. (L) Organelle cluster with fragmented polar body (arrow) and increased perivitelline debris (*) and space. (K–M) Combination of cytoplasmic dysmorphisms and extra-cytoplasmic phenotypes.