Ashrafi Mahnaz, Karimian Leila, Eftekhari-Yazdi Poopak, Hasani Fatemeh, Arabipoor Arezoo, Bahmanabadi Akram, Akhond Mohammad Reza
Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Obstetrics and Gynecology Department, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran.
J Obstet Gynaecol Res. 2015 Dec;41(12):1912-20. doi: 10.1111/jog.12818. Epub 2015 Sep 30.
The aim of this study was to identify the influence of oocyte dysmorphisms on clinical outcomes after intracytoplasmic sperm injection cycle in normal responders.
In the prospective study, morphology of 1999 metaphase II oocytes retrieved from 316 intracytoplasmic sperm injection cycles was evaluated from March 2011 to March 2013 at Royan Institute. Controlled ovarian stimulation was performed by long standard agonist protocol. Oocyte morphology was assessed before sperm injection by one embryologist. The associations between fertilization rate, embryo quality and the independent variables were analyzed using odds ratio (OR) calculated with unconditional logistic regression test.
From all retrieved oocytes, 1543 (77.1%) showed at least one morphologic aberration. Presence of cytoplasmic vacuoles and high cytoplasmic viscosity were associated with a significant decrease in the fertilization rate (OR: 0.5; P = 0.004 and OR: 0.6; P = 0.03, respectively). The results showed that oocyte morphology did not affect embryo quality. The number of gonadotrophin injections used showed a direct relation with presence of large perivitelline space. No significant difference was observed among four groups (women with total normal morphologic oocytes [group 1], women with total extracytoplasmic dysmorphic oocytes [group 2], women with total cytoplasmic dysmorphic oocytes [group 3] and women with total oocytes containing multiple dysmorphic features [group 4]) in terms of implantation and clinical pregnancy rates.
Metaphase II oocyte morphology had minor impacts on fertilization rate, pronuclear morphology and embryo quality in women with normal ovarian response.
本研究旨在确定正常反应者卵胞浆内单精子注射周期中卵母细胞形态异常对临床结局的影响。
在这项前瞻性研究中，于2011年3月至2013年3月在罗扬研究所对从316个卵胞浆内单精子注射周期中获取的1999个中期II卵母细胞的形态进行了评估。采用长效标准激动剂方案进行控制性卵巢刺激。在注射精子前由一名胚胎学家评估卵母细胞形态。使用无条件逻辑回归检验计算的优势比（OR）分析受精率、胚胎质量与自变量之间的关联。
在所有获取的卵母细胞中，1543个（77.1%）显示至少一种形态学异常。胞质空泡的存在和高胞质粘度与受精率显著降低相关（OR分别为：0.5；P = 0.004和OR：0.6；P = 0.03）。结果表明卵母细胞形态不影响胚胎质量。使用的促性腺激素注射次数与大卵周间隙的存在呈直接关系。在种植率和临床妊娠率方面，四组（形态完全正常的卵母细胞的女性[第1组]、完全胞质外形态异常的卵母细胞的女性[第2组]、完全胞质形态异常的卵母细胞的女性[第3组]和含有多种形态异常特征的卵母细胞的女性[第4组]）之间未观察到显著差异。
在卵巢反应正常的女性中，中期II卵母细胞形态对受精率、原核形态和胚胎质量影响较小。
