Egg maturity assessment prior to ICSI prevents premature fertilization of late-maturing oocytes

Autor: Aleš Hampl, Zuzana Holubcová, Martina Martonová, Tereza Klenková, Pavel Otevřel, Darja Páralová, Soňa Kloudová, Drahomíra Kyjovská, Radka Štěpánová
Rok vydání: 2019
Předmět:
0301 basic medicine
medicine.medical_treatment
Embryonic Development
Fertilization in Vitro
Biology
Intracytoplasmic sperm injection
Andrology
03 medical and health sciences
Polar body
Oogenesis
0302 clinical medicine
Human fertilization
Pregnancy
Meiotic spindle
Oocyte maturation
Genetics
medicine
Humans
Sperm Injections
Intracytoplasmic
Blastocyst
Metaphase
reproductive and urinary physiology
Genetics (clinical)
030219 obstetrics & reproductive medicine
urogenital system
Timing of ICSI
Embryogenesis
Obstetrics and Gynecology
Embryo
General Medicine
Oocyte
Embryo Biology
030104 developmental biology
medicine.anatomical_structure
Reproductive Medicine
Polarized light microscopy
embryonic structures
Immature oocytes
Oocytes
Female
Maturity assessment
Microscopy
Polarization
Developmental Biology
Zdroj: Journal of Assisted Reproduction and Genetics
ISSN: 1573-7330
1058-0468
Popis: Propose The presence of metaphase II (MII) spindle together with the polar body (PB) indicates completion of oocyte maturation. This study was designed to explore if spindle imaging can be used to optimize timing of intracytoplasmic sperm injection (ICSI). Methods The study involved 916 oocytes from 234 conventionally stimulated ICSI cycles with an unexpectedly poor ovarian response. All PB-displaying oocytes were subjected to polarized light microscopy (PLM) prior to ICSI. When MII spindle was absent in the majority of oocytes, ICSI was postponed and performed after additional spindle imaging. Fertilization, embryo development, and clinical outcome were evaluated with respect to the observed spindle pattern. Results The visible spindle was absent in 32.64% of PB-displaying oocytes. The late-maturing oocytes extruding PB in vitro were less likely to exhibit a spindle signal than in vivo matured MII oocytes (38.86% vs. 89.84%). When fertilization was postponed, 59.39% of initially spindle-negative oocytes developed detectable MII spindle. Spindled eggs had significantly higher developmental potential, and the presence of the spindle has been identified as an independent measure for predicting the formation of the blastocyst. Embryos derived from spindle-positive oocytes also showed a higher chance to implant and develop to term. Notably, 11 children were conceived by finely timed fertilization of late-maturing oocytes which are normally discarded. Conclusions The study confirms the prognostic value of spindle imaging and demonstrates that immature oocytes can be clinically utilized and give rise to live births when the timing of ICSI is adjusted to their developmental stage. Electronic supplementary material The online version of this article (10.1007/s10815-018-1393-0) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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