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极体大的卵母细胞获得活产:罕见病例报告。

Live birth derived from a markedly large polar body oocyte: a rare case report.

机构信息

Department of Reproductive Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China.

Health Center of Chini Town, Huadu District, Guangzhou, Guangdong Province, People's Republic of China.

出版信息

Zygote. 2024 Apr;32(2):170-174. doi: 10.1017/S0967199424000054. Epub 2024 Apr 15.

DOI:10.1017/S0967199424000054
PMID:38619002
Abstract

Oocytes with excessively large first polar bodies (PB1) often occur in assisted reproductive procedures. Many times these oocytes are discarded without insemination and, as a result, the application of this portion of oocytes has scarcely been reported to date. Few studies have examined large PB1 oocytes in infertile women and have virtually entirely studied genetic variations for large PB1 oocyte abnormalities. Here, we describe an unusual case of a live birth from a remarkably large PB1 oocyte in a frozen embryo transfer (FET) cycle. This is the first instance of a successful live birth resulting from a PB1 oocyte with an extremely large polar body measuring 80 μM × 40 μM in size. The large PB1 oocyte was performed by an early rescue intracytoplasmic sperm injection (r-ICSI) and was formed into a blastocyst on day 5. Following FET, a healthy boy baby weighing 3100 g was finally delivered by caesarean section at 37 weeks and 5 days after conception. Additionally, there were no complications throughout the antenatal period or the perinatal phase of this following full-term delivery. In this study, it is revealed for the first time that a huge PB1 oocyte can be fertilized, resulting in the growth of a blastocyst, a subsequent pregnancy, and a live birth. This new information prompts us to reconsider the use of large PB1 oocytes. More insightful talks should be given attention to prevent the waste of embryos because not all oocytes with aberrant morphology are unavailable.

摘要

第一极体过大的卵母细胞(PB1)在辅助生殖过程中经常出现。许多时候,这些卵母细胞在没有受精的情况下被丢弃,因此迄今为止,很少有关于这部分卵母细胞应用的报道。少数研究检查了不孕妇女中 PB1 过大的卵母细胞,几乎完全研究了 PB1 过大卵母细胞异常的遗传变异。在这里,我们描述了一个不寻常的冷冻胚胎移植(FET)周期中,一个来自非常大的 PB1 卵母细胞的活产病例。这是首例 PB1 卵母细胞成功活产的实例,该卵母细胞的第一极体非常大,大小为 80μm×40μm。这个大的 PB1 卵母细胞通过早期拯救胞浆内单精子注射(r-ICSI)进行受精,并在第 5 天形成囊胚。FET 后,终于在受孕 37 周零 5 天后通过剖宫产分娩出一名健康的男婴,体重为 3100 克。此外,在这次足月分娩的整个产前和围产期都没有并发症。在这项研究中,首次揭示了一个巨大的 PB1 卵母细胞可以受精,形成囊胚,随后怀孕并活产。这一新信息促使我们重新考虑使用大 PB1 卵母细胞。应该更加关注有意义的讨论,以防止胚胎浪费,因为并非所有形态异常的卵母细胞都无法使用。

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引用本文的文献

1
The Istanbul consensus update: a revised ESHRE/ALPHA consensus on oocyte and embryo static and dynamic morphological assessment†,‡.《伊斯坦布尔共识更新:ESHRE/ALPHA关于卵母细胞和胚胎静态与动态形态学评估的修订共识》†,‡
Hum Reprod. 2025 Jun 1;40(6):989-1035. doi: 10.1093/humrep/deaf021.