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

Varování

Publikace nespadá pod Filozofickou fakultu, ale pod Lékařskou fakultu. Oficiální stránka publikace je na webu muni.cz.

Autoři	HOLUBCOVÁ Zuzana KYJOVSKÁ Drahomíra MARTONOVÁ Martina PÁRALOVÁ Darja KLENKOVÁ Tereza OTEVŘEL Pavel ŠTĚPÁNOVÁ Radka KLOUDOVÁ Soňa HAMPL Aleš
Rok publikování	2019
Druh	Článek v odborném periodiku
Časopis / Zdroj	Journal of Assisted Reproduction and Genetics
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://link.springer.com/article/10.1007%2Fs10815-018-1393-0
Doi	http://dx.doi.org/10.1007/s10815-018-1393-0
Klíčová slova	Timing of ICSI; Oocyte maturation; Polarized light microscopy; Meiotic spindle; Immature oocytes
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.