Mandelbaum J, Junca A M, Belaisch-Allart J, Salat-Baroux J, Plachot M, Antoine J M, Merviel P, Mayenga J M, Cohen J
Hôpital Necker, Paris.
Contracept Fertil Sex. 1996 Jul-Aug;24(7-8):534-8.
Intracytoplasmic sperm injection (ICSI), treatment of severe male infertility allows an accurate evaluation of oocyte maturity at recovery after corona-cell removal. In cycles comprising a GnRH analog desensitization and a stimulation by hMG or FSH, 12% of oocytes aspirated from follicles (> 14 mm), 34 hours post-hCG are still immature, in prophase or metaphase 1. They are able to achieve meiosis in vitro in 66% of the cases and will be fertilized (2 PN) by ICSI in 51% of the cases as the in vivo mature oocytes of the same cohort. Nevertheless, the quality of cytoplasmic maturation and consequently of embryonic viability remains to be assessed as there still are few pregnancies arising from in vitro matured oocytes. ICSI also represents the only way to obtain normal fertilization in some exceptional but observed anomalies of oocyte maturation, particularly when there is a lack of zona reaction leading to repetitive polyspermy in conventional IVF.
卵胞浆内单精子注射（ICSI）用于治疗严重男性不育症，在去除卵丘细胞后回收卵母细胞时，可对其成熟度进行准确评估。在采用促性腺激素释放激素（GnRH）类似物脱敏并用人绝经期促性腺激素（hMG）或促卵泡激素（FSH）刺激的周期中，注射人绒毛膜促性腺激素（hCG）34小时后，从直径大于14毫米的卵泡中吸出的卵母细胞中有12%仍未成熟，处于减数分裂前期或中期Ⅰ。在66%的情况下，这些未成熟卵母细胞能够在体外完成减数分裂，并且在51%的情况下，会像同一批体内成熟的卵母细胞一样通过ICSI受精（形成双原核）。然而，由于体外成熟卵母细胞导致的妊娠仍然很少，因此胞质成熟的质量以及胚胎活力仍有待评估。ICSI也是在一些特殊但已观察到的卵母细胞成熟异常情况下获得正常受精的唯一方法，特别是当缺乏透明带反应导致传统体外受精（IVF）中反复发生多精受精时。
