Xie Philip, Aluko Ashley, Cheung Stephanie, Goldschlag Dan, Davis Owen, Rosenwaks Zev, Palermo Gianpiero D
The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York.
F S Rep. 2022 Dec 30;4(1):72-76. doi: 10.1016/j.xfre.2022.12.006. eCollection 2023 Mar.
To treat couples with total fertilization failure (TFF) based on a combined oocyte- and sperm-related oocyte activation deficiency by optimizing oocyte response to chemical activation with calcium ionophore.
Case report.
Tertiary Hospital.
Two couples with a history of TFF after intracytoplasmic sperm injection intracytoplasmic sperm injection (ICSI).
To overcome oocyte-related oocyte activation deficiency (OAD), extended oocyte maturation was performed to enhance ooplasmic maturity; to address sperm-related OAD, assisted gamete treatment (AGT) was performed to trigger oocyte activation.
Treatment cycle outcomes for the 2 couples undergoing ICSI with extended oocyte maturation (EOM) and AGT.
We identified 2 couples with TFF after ICSI because of a combined factor of OAD confirmed by phospholipase C zeta expression and genomic assessment. Initial AGT treatment alone failed to enhance fertilization, suggesting superimposed oocyte dysmaturity prohibiting oocytes from responding to chemical stimuli. To address this complex form of OAD, in couple 1, 27 oocytes out of 34 retrieved presented normal metaphase II spindles after EOM; ICSI with AGT yielded a fertilization rate of 63.0% (17/27). All 17 zygotes were cryopreserved initially. Two embryos were thawed and transferred, yielding a monochorionic diamniotic twin pregnancy. Couple 2 underwent 3 ICSI cycles with EOM and AGT; 91.4% (32/35) of oocytes displayed normal metaphase II spindle and achieved an overall fertilization rate of 43.8% (14/32). A total of 12 blastocysts were cryopreserved. A single 46XY blastocyst was thawed and transferred, resulting in a singleton pregnancy.
Our study has demonstrated the usefulness of EOM by targeting spindle presence to enhance chemical responses to AGT.
通过优化卵母细胞对钙离子载体化学激活的反应，治疗因卵母细胞和精子相关的卵母细胞激活缺陷共同导致的完全受精失败（TFF）夫妇。
病例报告。
三级医院。
两对在卵胞浆内单精子注射（ICSI）后有TFF病史的夫妇。
为克服与卵母细胞相关的卵母细胞激活缺陷（OAD），进行延长卵母细胞成熟培养以提高卵质成熟度；为解决与精子相关的OAD，进行辅助配子处理（AGT）以触发卵母细胞激活。
两对接受ICSI联合延长卵母细胞成熟培养（EOM）和AGT治疗的夫妇的治疗周期结果。
我们确定了两对ICSI后出现TFF的夫妇，原因是通过磷脂酶Cζ表达和基因组评估证实的OAD综合因素。仅初始AGT治疗未能提高受精率，提示叠加的卵母细胞发育不成熟阻止了卵母细胞对化学刺激的反应。为解决这种复杂形式的OAD，在第1对夫妇中，34个回收的卵母细胞中有27个在EOM后呈现正常的中期II纺锤体；ICSI联合AGT的受精率为63.0%（17/27）。所有17个受精卵最初均被冷冻保存。解冻并移植了2个胚胎，获得单绒毛膜双羊膜囊双胎妊娠。第2对夫妇接受了3个ICSI周期的EOM和AGT治疗；91.4%（32/35）的卵母细胞显示正常的中期II纺锤体，总体受精率为43.8%（14/32）。共冷冻保存了12个囊胚。解冻并移植了1个46XY囊胚，获得单胎妊娠。
我们的研究证明了通过靶向纺锤体存在进行EOM以增强对AGT的化学反应的有效性。
Zotero 插件
