The Center for Human Reproduction, New York, New York.
The Center for Human Reproduction, New York, New York.
Fertil Steril. 2021 Nov;116(5):1330-1340. doi: 10.1016/j.fertnstert.2021.06.026. Epub 2021 Jul 20.
To determine whether the ooplasm granulation patterns of donor oocytes, like those of oocytes from poor-prognosis patients, are predictive of in vitro fertilization (IVF) outcomes.
Retrospective cohort study.
Academically affiliated private clinical infertility and research center.
PATIENT(S): 770 fresh and 381 vitrified-thawed metaphase II oocytes from young donors (aged 21.0-34.6 years) used for IVF during 2017-2020.
INTERVENTION(S): Determination of granulation patterns in every oocyte during intracytoplasmic sperm injection as fine, central, uneven, dispersed, and peripheral (thawed only).
MAIN OUTCOME MEASURE(S): Fertilization, pregnancy, and live birth rates in fresh and thawed donor oocytes. Both overall and known-outcome analyses were performed for pregnancy and live birth.
RESULT(S): In fresh donor oocytes, 2 pronuclei rates trended down from 96.1% to 90.2%, 88.9%, and 69.7% from fine to central, uneven, and dispersed granulations; overall pregnancy rates trended down from 50.4% to 29.0%, 17.7%, and 6.9%, as well as live birth rates (43.4%, 21.6%, 12.5%, and 6.4%), from fine to uneven, central, and dispersed granulations. Known pregnancy and known-live birth analyses showed similar findings. Thawed donor oocytes demonstrated similar trends in differences in fertilization, pregnancy, and live birth analyses with relatively worse outcomes. Peripheral granulation, unique to vitrification and thawing, always demonstrated the worst IVF outcomes. Moreover, granulation patterns were relatively disassociated from embryo morphological grades in fresh and largely disassociated in thawed donor oocytes.
CONCLUSION(S): Predictive values of oocyte granulation patterns for fertilization, pregnancy, and live birth in IVF cycles are even more pronounced in young donors than results in older poor-prognosis patients, further supporting integration of oocyte granulation patterns into embryo selection.
确定供体卵母细胞的卵质颗粒模式是否与预后不良患者的卵母细胞一样，可以预测体外受精（IVF）结局。
回顾性队列研究。
学术附属的私人临床不孕不育和研究中心。
2017 年至 2020 年期间，用于 IVF 的年轻供体（年龄 21.0-34.6 岁）的 770 个新鲜和 381 个玻璃化冷冻解冻的中期 II 卵母细胞。
在胞浆内单精子注射过程中确定每个卵母细胞的颗粒模式，分为精细、中央、不均匀、分散和周边（仅解冻时）。
新鲜和解冻供体卵母细胞的受精、妊娠和活产率。对妊娠和活产进行了总体和已知结局分析。
在新鲜供体卵母细胞中，2 原核率从 96.1%下降到 90.2%、88.9%和 69.7%，从精细到中央、不均匀和分散的颗粒；总妊娠率从 50.4%下降到 29.0%、17.7%和 6.9%，以及活产率（43.4%、21.6%、12.5%和 6.4%），从精细到不均匀、中央和分散的颗粒。已知妊娠和已知活产分析显示出类似的发现。解冻供体卵母细胞在受精、妊娠和活产分析中显示出类似的差异，结果相对较差。仅在玻璃化和解冻时出现的周边颗粒模式始终显示出最差的 IVF 结局。此外，在新鲜卵母细胞中，颗粒模式与胚胎形态学等级相对不相关，而在解冻卵母细胞中则基本不相关。
卵母细胞颗粒模式对 IVF 周期中受精、妊娠和活产的预测价值在年轻供体中比在年龄较大的预后不良患者中更为明显，进一步支持将卵母细胞颗粒模式纳入胚胎选择。
