Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, SP, Brazil.
Reprod Sci. 2013 Apr;20(4):456-62. doi: 10.1177/1933719112459217. Epub 2012 Sep 18.
The objectives of this prospective study were to evaluate the nuclear maturation stage and the presence and location of meiotic spindles of in vivo matured oocytes from infertile women with and without endometriosis (male or tubal causes of infertility) undergoing stimulated cycles for intracytoplasmic sperm injection (ICSI). We also compared the ICSI outcomes among groups. We analyzed the meiotic spindles of oocytes from 36 patients with endometriosis I/II, 24 with endometriosis III/IV, and 60 without endometriosis (male or tubal causes of infertility). The oocytes were imaged using polarization microscopy. There were no differences in the number of oocytes in telophase I (mean [standard deviation]: 0.1 [0.5], 0.2 [0.4], and 0.2 [0.5], respectively, in the endometriosis I/II, endometriosis III/IV, and control groups), in metaphase II with visible spindles (4.2 [2.5], 3.1 [2.0], and 3.6 [2.2], respectively, in the endometriosis I/II, endometriosis III/IV, and control groups), and in spindle location among groups. We can conclude from this study that noninvasive analysis of spindles from in vivo matured oocytes of infertile patients with endometriosis did not demonstrate significant differences in terms of the nuclear maturation stage, the percentage of oocytes in metaphase II with visible spindles, and the spindle localization when compared to the control group. However, it is important to state that there are no studies evaluating the accuracy of polarization microscopy for the detection of meiotic anomalies in human oocytes, which would need to be better evaluated in future studies using an appropriate methodology.
本前瞻性研究的目的是评估患有子宫内膜异位症(男性或输卵管原因不孕)的不孕妇女体内成熟卵母细胞的核成熟阶段,以及有丝分裂纺锤体的存在和位置,这些妇女正在接受胞浆内单精子注射(ICSI)刺激周期。我们还比较了各组之间的 ICSI 结果。我们分析了 36 例子宫内膜异位症 I/II 期、24 例子宫内膜异位症 III/IV 期和 60 例无子宫内膜异位症(男性或输卵管原因不孕)患者的卵母细胞有丝分裂纺锤体。使用偏光显微镜对卵母细胞进行成像。在末期 I 期的卵母细胞数量(平均值[标准差]:子宫内膜异位症 I/II 组为 0.1[0.5],子宫内膜异位症 III/IV 组为 0.2[0.4],对照组为 0.2[0.5])、中期 II 期有可见纺锤体的卵母细胞(子宫内膜异位症 I/II 组为 4.2[2.5],子宫内膜异位症 III/IV 组为 3.1[2.0],对照组为 3.6[2.2])以及纺锤体位置方面,各组之间均无差异。从这项研究中可以得出结论,与对照组相比,对患有子宫内膜异位症的不孕患者体内成熟卵母细胞的纺锤体进行非侵入性分析,在核成熟阶段、中期 II 期有可见纺锤体的卵母细胞百分比以及纺锤体定位方面均未显示出显著差异。然而,重要的是要指出,目前尚无研究评估偏光显微镜检测人类卵母细胞有丝分裂异常的准确性,这需要在未来的研究中使用适当的方法学更好地评估。