Dib Luciana Azôr, Broi Michele Gomes Da, Navarro Paula Andrea
Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, Sao Paulo, Brazil National Institute of Hormones and Women's Health, Ribeirão Preto, São Paulo, Brazil.
Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, Sao Paulo, Brazil National Institute of Hormones and Women's Health, Ribeirão Preto, São Paulo, Brazil
Reprod Sci. 2014 Aug;21(8):984-992. doi: 10.1177/1933719113519174. Epub 2014 Jan 15.
Considering the scarcity of literature data about the predictive capacity of polarization microscopy (PM) in identifying meiotic normality in human in vivo-matured oocytes, the main objective of the present study was to determine whether qualitative analysis of the spindle through PM can predict meiotic normality in fresh in vivo-matured human oocytes.
Infertile patients undergoing controlled ovarian stimulation to intracytoplasmic sperm injection (ICSI) were selected. Fresh in vivo-matured oocytes were evaluated by PM and, immediately afterward, fixed for confocal microscopy (CM) analysis for evaluation of the spindle and chromosome distribution. We evaluated the percentage of oocytes with meiotic normality and abnormality determined by CM among oocytes with visible and nonvisible spindle and between oocytes with the spindle located at 0° to 60° angle to the first polar body (PB; normal position) and at 60° to 90° angle to the first PB (risky position) according to PM.
From 23 patients, 73 oocytes were analyzed. There were no significant differences in the percentage of oocytes with meiotic abnormalities among oocytes with visible and nonvisible spindles and among oocytes with the spindle in the normal and risky positions.
Under the conditions tested, qualitative evaluation of the spindle through PM is not consistent with CM analysis and has limited predictive value of meiotic normality in fresh in vivo-matured human oocytes, which needs to be confirmed in larger studies. Our findings make questionable the usefulness of this methodology as a tool for noninvasive oocyte selection for ICSI.
鉴于关于偏振显微镜(PM)在识别体内成熟的人类卵母细胞减数分裂正常性方面预测能力的文献数据稀缺,本研究的主要目的是确定通过PM对纺锤体进行定性分析是否能够预测新鲜的体内成熟人类卵母细胞的减数分裂正常性。
选择接受控制性卵巢刺激以进行胞浆内单精子注射(ICSI)的不孕患者。对新鲜的体内成熟卵母细胞进行PM评估,随后立即固定用于共聚焦显微镜(CM)分析,以评估纺锤体和染色体分布。我们根据PM评估了在纺锤体可见和不可见的卵母细胞之间,以及纺锤体与第一极体(PB)呈0°至60°角(正常位置)和与第一PB呈60°至90°角(危险位置)的卵母细胞中,由CM确定的减数分裂正常和异常的卵母细胞百分比。
对23例患者的73个卵母细胞进行了分析。在纺锤体可见和不可见的卵母细胞之间,以及纺锤体处于正常和危险位置的卵母细胞之间,减数分裂异常的卵母细胞百分比没有显著差异。
在测试条件下,通过PM对纺锤体进行定性评估与CM分析不一致,对新鲜的体内成熟人类卵母细胞减数分裂正常性的预测价值有限,这需要在更大规模的研究中得到证实。我们的研究结果使这种方法作为ICSI无创卵母细胞选择工具的实用性受到质疑。