ICSI位置應位於第一極體另一側

去除卵丘細胞之體外卵子其紡錘體58%位於靠近第一極體30度內
未去除卵丘細胞之體外卵子其紡錘體37%位於靠近第一極體30度內
其差異可能由於去除卵丘細胞造成
ICSI位置應位於第一極體>90度(Zone 4)

http://humrep.oxfordjournals.org/content/15/6/1372.full

Figure 2.

MII risk zones. A schematic illustration of how we propose that the spermatozoon should be injected into the oocyte. The closer to the first PB (top), the greater the risk of MII-spindle damage (indicated by the red colour). Illustration by H.Samuelsson.

The position of the metaphase II spindle cannot be predicted by the location of the first polar body in the human oocyte

1. Th. Hardarson1, 
2. K. Lundin and 
3. L. Hamberger

+Author Affiliations

1. Department of Obstetrics and Gynaecology, Göteborg University, SU/Sahlgrenska, 413 45 Gothenburg, Sweden

• Received October 18, 1999.
• Accepted February 28, 2000.

 

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Abstract

When performing intracytoplasmic sperm injection (ICSI) on human oocytes, the injection is traditionally made at the 3 o'clock position, with the first polar body (PB) at the 12 or 6 o'clock position. This has been based on the assumption that the second meiotic metaphase II (MII) spindle lies in close proximity to the first PB. The objective of this study was to document the actual spatial relationship between the first PB and the MII spindle both in in-vivo matured (fresh) human MII oocytes and in oocytes matured in vitro. We found that the MII spindle was, on average, not located directly adjacent to the PB. The in-vivo group (n = 54) showed a mean deviation of the MII spindle from the position of the PB of 41.7° and the in-vitro group 26.6° (n = 43). The difference between the angle of the two groups was statistically significant (P = 0.005), indicating that the lateral displacement of the first PB is only partly due to the denuding procedure during ICSI, because the in-vitro matured oocytes were denuded before extrusion of the first PB. The majority of the MII spindles in both groups were found in the same hemisphere as the first PB, suggesting that care should be taken to avoid damaging the MII spindle by inserting the ICSI needle in the other half of the oocyte.

Table I.

Position of the MII spindle in relation to the first PB

Zonea	Degreesb	n	In-vitro matured MII		n	In-vivo matured MII
			% total	Cumulative %		% total	Cumulative %
aNote that zones 1–3 represent the animal pole and zone 4 the vegetal pole (see Figure 2).
bAssuming that the first polar body is positioned at zero degrees.
1	0–29.9	25	58	58	20	37	37
2	30–59.9	15	35	93	17	32	69
3	60–89.9	3	7	100	13	24	93
4	>90	0	0	100	4	7	100
Total		43	100		54	100