Shin Seung Bi, Cho Jae Won, Lee Sun-Hee, Yang Kwang Moon, Lim Chun Kyu, Lee Hyoung-Song
Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
Clin Exp Reprod Med. 2013 Mar;40(1):7-11. doi: 10.5653/cerm.2013.40.1.7. Epub 2013 Mar 31.
We evaluated the fertilization potential of immature oocytes obtained from controlled ovarian hyperstimulation cycles of patients undergoing ICSI.
We retrospectively analyzed 463 ICSI cycles containing at least one immature oocyte at oocyte denudation. ICSI was performed on mature oocytes at oocyte denudation (metaphase-II [MII] oocytes) and the oocytes that extruded the first polar body between oocyte denudation and ICSI (MI-MII oocytes). Fertilization and early embryonic development were compared between MII and MI-MII oocytes. To investigate the pregnancy potential of MI-MII oocytes, the pregnancy outcome was analyzed in 24 ICSI cycles containing only immature oocytes at retrieval.
The fertilization rate of MI-MII oocytes (37.0%) was significantly lower than that of MII oocytes (72.3%). The rates of delayed embryos and damaged embryos did not significantly differ. Eighty-one immature oocytes were retrieved in 24 cycles that retrieved only immature oocytes and 61 (75.3%) of them were in the MI stage. ICSI was performed on 36 oocytes (59.0%) that extruded the first polar body before ICSI and nine MI-MII oocytes (25.0%) were fertilized. Embryo transfers were performed in five cycles. Pregnancy was observed in one cycle, but it ended in biochemical pregnancy.
In ICSI cycles, oocytes that extruded the first polar body between denudation and ICSI can be used as a source of oocytes for sperm injection. However, their fertilization and pregnancy potential are lower than that of mature oocytes. Therefore, ovarian stimulation should be performed carefully for mature oocytes obtained at retrieval, especially in cycles with a small number of retrieved oocytes.
我们评估了从接受卵胞浆内单精子注射（ICSI）患者的控制性卵巢过度刺激周期中获得的未成熟卵母细胞的受精潜力。
我们回顾性分析了463个ICSI周期，这些周期在卵母细胞剥除时至少含有一个未成熟卵母细胞。在卵母细胞剥除时对成熟卵母细胞（中期II [MII] 卵母细胞）以及在卵母细胞剥除和ICSI之间排出第一极体的卵母细胞（MI-MII卵母细胞）进行ICSI。比较了MII和MI-MII卵母细胞的受精和早期胚胎发育情况。为了研究MI-MII卵母细胞的妊娠潜力，分析了24个在取卵时仅含有未成熟卵母细胞的ICSI周期的妊娠结局。
MI-MII卵母细胞的受精率（37.0%）显著低于MII卵母细胞（72.3%）。延迟胚胎和受损胚胎的发生率没有显著差异。在24个仅取到未成熟卵母细胞的周期中，共取到81个未成熟卵母细胞，其中61个（75.3%）处于MI期。对36个（59.0%）在ICSI前排出第一极体的卵母细胞进行了ICSI，9个MI-MII卵母细胞（25.0%）受精。在5个周期中进行了胚胎移植。在1个周期中观察到妊娠，但以生化妊娠告终。
在ICSI周期中，在剥除和ICSI之间排出第一极体的卵母细胞可作为精子注射的卵母细胞来源。然而，它们的受精和妊娠潜力低于成熟卵母细胞。因此，对于取卵时获得的成熟卵母细胞，应谨慎进行卵巢刺激，尤其是在取到的卵母细胞数量较少的周期中。
