Infertility and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Gynecol Endocrinol. 2020 Mar;36(3):265-267. doi: 10.1080/09513590.2019.1653277. Epub 2019 Aug 14.
Intracytoplasmic sperm injection (ICSI) was introduced in 1992 as a method to treat couples with severe male infertility. However, in the last two decades, the use of ICSI has increased substantially even among patients without male factor infertility. In ICSI the oocytes are scrutinized for maturity upon insemination and the immature oocytes are discarded. The aim of the present study was to assess the ability of an experienced embryologist to identify the maturity of the oocytes prior to their denudation.In the present prospective observational study, four experienced embryologists examined the oocytes prior to their denudation and decided whether the oocytes were mature or immature. Later, the oocytes were denudated and the embryologist again examined the oocytes to confirm their prior assumptions.483 oocytes were examined by four embryologists. Three hundred and fifty one of the oocytes were mature (72.7%) and 132 were immature (27.3%). The embryologists were able to correctly identify oocytes maturation status in 85.3% of cases. The embryologists were able to correctly identify 90% of the mature oocytes and 72.7% of the immature oocytes. When they assumed that the oocytes were mature they were correct in 89.% of the cases, while only 74.6% of their prediction that the oocytes were immature were true. To conclude, the embryologists are able to identify the oocytes maturation status before denudation at the majority of the cases. Whenever the oocytes are suspected to be immature, further consideration should be made whether to proceed to ICSI or not.
胞浆内单精子注射（ICSI）于 1992 年作为一种治疗严重男性不育症夫妇的方法被引入。然而，在过去的二十年中，即使在没有男性因素不育症的患者中，ICSI 的使用也大幅增加。在 ICSI 中，在受精时仔细检查卵母细胞的成熟度，不成熟的卵母细胞被丢弃。本研究的目的是评估有经验的胚胎学家在卵母细胞去核前识别其成熟度的能力。
在本前瞻性观察研究中，四位有经验的胚胎学家在卵母细胞去核前对其进行检查，并决定卵母细胞是成熟还是不成熟。随后，对卵母细胞进行去核处理，胚胎学家再次检查卵母细胞以确认他们之前的假设。
四位胚胎学家共检查了 483 个卵母细胞。其中 351 个卵母细胞成熟（72.7%），132 个不成熟（27.3%）。胚胎学家能够正确识别 85.3%的卵母细胞成熟状态。胚胎学家能够正确识别 90%的成熟卵母细胞和 72.7%的不成熟卵母细胞。当他们假设卵母细胞成熟时，他们在 89%的情况下是正确的，而他们预测卵母细胞不成熟的情况只有 74.6%是正确的。
总之，胚胎学家能够在大多数情况下在去核前识别卵母细胞的成熟状态。只要怀疑卵母细胞不成熟，就应进一步考虑是否进行 ICSI。
