Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Int J Environ Res Public Health. 2021 Sep 6;18(17):9409. doi: 10.3390/ijerph18179409.
The presence of empty zona pellucida (EZP) in oocytes following oocyte retrieval (OR) during an in vitro fertilization (IVF) cycle presents a major clinical and laboratory challenge in assisted reproduction. It has been attributed to several factors such as the ovarian stimulation protocol employed, the damaging of the follicles during oocyte retrieval (OR) mainly through the high aspiration pressure, during the denudation technique, and the degeneration of oolemma within the zona pellucida (ZP) through apoptosis. The role of ZP is pivotal from the early stages of follicular development up to the preimplantation embryo development and embryo hatching. Polymorphisms or alterations on the genes that encode ZP proteins may contribute to EZP. We present a critical review of the published literature hitherto on EZP and available options when encountered with the phenomenon of EZP. Concerning the former, we found that there is rare data on this phenomenon that merits documentation. The latter includes technical, genetic, and pathophysiological perspectives, along with specific treatment options. In conclusion, we identify the lack of a definitive management proposal for couples presenting with this phenomenon, we underline the need for an algorithm, and indicate the questions raised that point towards our goal for a strategy when addressing a previous finding of EZP.
在体外受精 (IVF) 周期中取卵 (OR) 后卵母细胞中出现透明带空泡 (EZP)，这是辅助生殖中的一个主要临床和实验室挑战。它归因于多种因素，如所使用的卵巢刺激方案、卵母细胞采集 (OR) 过程中对卵泡的损伤，主要是通过高抽吸压力，在去透明带技术中，以及卵母细胞透明带 (ZP) 内卵母细胞膜的退化通过细胞凋亡。ZP 的作用从卵泡发育的早期到着床前胚胎发育和胚胎孵化都至关重要。编码 ZP 蛋白的基因的多态性或改变可能导致 EZP。我们对迄今为止关于 EZP 的已发表文献进行了批判性回顾，并介绍了遇到 EZP 现象时的可用选择。关于前者，我们发现关于这种现象的数据很少，值得记录。后者包括技术、遗传和病理生理方面，以及特定的治疗选择。总之，我们确定了缺乏针对出现这种现象的夫妇的明确管理建议，我们强调需要制定一个算法，并指出提出的问题，这些问题表明我们在解决之前发现的 EZP 时需要一个策略。
