Rienzi Laura, Ubaldi Filippo Mari, Iacobelli Marcello, Minasi Maria Giulia, Romano Stefania, Ferrero Susanna, Sapienza Fabio, Baroni Elena, Litwicka Katarzyna, Greco Ermanno
Reproductive Medicine, European Hospital, Rome, Italy.
Fertil Steril. 2008 Nov;90(5):1692-700. doi: 10.1016/j.fertnstert.2007.09.024. Epub 2008 Feb 4.
To evaluate the influence of specific oocyte morphologic features (morphotypes) on intracytoplasmic sperm injection (ICSI) outcome. The identification of oocyte quality markers is particularly important when a low number of oocytes can be used for IVF.
Retrospective analysis.
Medical center.
PATIENT(S): Five hundred sixteen consecutive ICSI cycles. Only couples affected by severe male factor infertility were excluded.
INTERVENTION(S): A total of 1,191 metaphase II (MII) oocytes (1-3 per patient) were randomly selected from the cohort of oocytes obtained from each patient and evaluated for morphologic appearance.
MAIN OUTCOME MEASURE(S): Fertilization, pronuclear morphology, embryo quality, pregnancy rate.
RESULT(S): There was a presence of vacuoles, abnormal I polar body, and large perivitelline space related to a lower fertilization rate. Pronuclear morphology was effected by the presence of a large perivitelline space, diffused cytoplasmic granularity, and/or centrally located granular area. The latter characteristic also negatively related to day 2 embryo quality. According to the odds ratios obtained for each oocyte morphotype to reach at least one outcome, an MII oocyte morphologic score (MOMS) was calculated. A significant relationship was found between MOMS and female age, female basal FSH, and clinical outcome.
CONCLUSION(S): Morphologic evaluation before ICSI helps to identify MII oocytes with higher developmental potential.
评估特定卵母细胞形态特征（形态类型）对卵胞浆内单精子注射（ICSI）结局的影响。当可用于体外受精（IVF）的卵母细胞数量较少时，鉴定卵母细胞质量标志物尤为重要。
回顾性分析。
医疗中心。
连续516个ICSI周期。仅排除受严重男性因素不育影响的夫妇。
从每位患者获取的卵母细胞队列中随机选取总共1191个中期II（MII）卵母细胞（每位患者1 - 3个），并评估其形态外观。
受精、原核形态、胚胎质量、妊娠率。
存在液泡、异常第一极体和较大的卵周间隙与较低的受精率相关。原核形态受较大卵周间隙、弥散的细胞质颗粒度和/或中央定位的颗粒区域的影响。后一特征也与第2天胚胎质量呈负相关。根据每种卵母细胞形态类型达到至少一项结局的优势比，计算出一个MII卵母细胞形态评分（MOMS）。发现MOMS与女性年龄、女性基础促卵泡激素（FSH）和临床结局之间存在显著关系。
ICSI前的形态学评估有助于识别具有较高发育潜力的MII卵母细胞。
