Abstract：Objective To evaluate the effect of oocytes with large polar bodies on intracytoplasmic sperm injection(ICSI) outcomes. Methods We retrospective analyzed the clinical data of infertile patients undergoing assisted reproductive technology treatment from January 2017 to December 2021. A total of 112 fresh cycles of ICSI containing oocytes with large polar bodies were involved as the research objects, and 880 mature oocytes(MII) from ICSI were divided into large polar body group and normal polar body group according to the size of the first polar body. The fertilization, developmental potential and clinical outcomes of the two groups were compared. Results The follicle-stimulating Hormone in large polar body group was higher than that in normal polar body group(P<0.05), and the remaining basic data of the two groups showed not statistical differences(P>0.05).The fertilization rate of 2 pronucleus was significantly lower than that in normal polar body group(P<0.05); the ≥3PN rate was significantly higher than normal polar body group(P<0.001); the 1PN rate and degradation rate(DA) increased, but there was no significant difference between them(P>0.05). Compared with the normal polar body group, the 2PN cleavage rate of Day 2 in large polar body group showed a decreasing trend, the good quality embryo rate of Day 3, blastocyst formation rate, usable blastocyst rate and high-quality blastocyst rate in large polar body group were significantly decreased, but only the blastocyst formation rate was significantly different(P<0.01) .Logistic regression analysis indicated that compared with the normal polar body group, large polar body group had a significantly lower rate of 2PN(OR:0.63, 95% CI:0.44-0.91, P<0.05) and a significantly higher rate of ≥3PN(OR:3.99, 95% CI:1.95-8.16, P<0.001); the good quality embryo rate of Day 3(OR:0.54, 95% CI:0.31-0.93, P<0.05) and the rate of blastocyst formation(OR:0.42, 95% CI:0.23-0.78, P<0.01) were significantly decreased. Among the four cases of single embryo fresh cycle transfer in large polar body group, one case had clinical pregnancy and one case had abortion; among the eight cases combined embryo fresh cycle transfer in large polar body group and normal polar body group, none of them was pregnant. There were six cases of thawed blastocysts transfer from large polar body oocytes(three cases in large polar body group, three cases in large polar body group and normal polar body group), two cases(one case in large polar body group, one case in large polar body group and normal polar body group) had clinical pregnancy and two cases had livebirth. Conclusions In ICSI cycle, oocytes with large polar bodies have affected fertilization, embryo development and clinical outcome. The presence of a large polar body can be used as one of the indicators for selecting embryo transfer. It is suggested to culture embryos from large polar body oocytes to blastocyst, which may improve its clinical outcome.
李丹, 任新玲, 江亚萍, 张思佳. 卵母细胞大极体对ICSI周期受精、胚胎发育及临床结局的影响[J]. 中国生育健康杂志, 2023, 34(5): 440-444.
LI Dan, REN Xinling, JIANG Yaping, ZHANG Sijia. Effect of oocytes with large polar bodies on fertilization,embryo development and clinical outcomes in ICSI cycle. Chinese Journal of Reproductive Health, 2023, 34(5): 440-444.
1 Lasiene K,Vitkus A,Valanciūte A,et al.Morphological criteria of oocyte quality.Medicina(Kaunas),2009,45:509-515. 2 Gardner DK,Lane M,Stevens J,et al.Blastocyst score affects implantation and pregnancy outcome:towards a single blastocyst transfer.Fertil Steril,2000,73:1155-1158. 3 Eichenlaub-Ritter U,Schmiady H,Kentenich H,et al.Recurrent failure in polar body formation and premature chromosome condensation in oocytes from a human patient:indicators of asynchrony in nuclear and cytoplasmic maturation.Hum Reprod,1995,10:2343-2349. 4 Ebner T,Moser M,Yaman C,et al.Elective transfer of embryos selected on the basis of first polar body morphology is associated with increased rates of implantation and pregnancy.Fertil Steril,1999,72:599-603. 5 Ebner T,Yaman C,Moser M,et al.Prognostic value of first polar body morphology on fertilization rate and embryo quality in intracytoplasmic sperm injection.Hum Reprod,2000,15:427-430. 6 Verlinsky Y,Lerner S,Illkevitch N,et al.Is there any predictive value of first polar body morphology for embryo genotype or developmental potential? Reprod Biomed Online,2003,7:336-341. 7 De Sutter P,Dozortsev D,Qian C,et al.Oocyte morphology does not correlate with fertilization rate and embryo quality after intracytoplasmic sperm injection.Hum Reprod,1996,11:595-597. 8 Balaban B,Urman B,Sertac A,et al.Oocyte morphology does not affect fertilization rate,embryo quality and implantation rate after intracytoplasmic sperm injection.Hum Reprod,1998,13:3431-3433. 9 Choi T,Fukasawa K,Zhou R,et al.The Mos/mitogen-activated protein kinase(MAPK) pathway regulates the size and degradation of the first polar body in maturing mouse oocytes.Proc Natl Acad Sci U S A,1996,93:7032-7035. 10 Coticchio G,CantoMD,Renzini MM,et al.Oocyte maturation:gamete-somatic cells interactions,meiotic resumption,cytoskeletal dynamics and cytoplasmic reorganization.Hum Reprod Update,2015,21:427-454. 11 Huang X,Ding L,Pan R,et al.WHAMM is required for meiotic spindle migration and asymmetric cytokinesis in mouse oocytes.Histochem Cell Biol,2013,139:525-534. 12 Fancsovits P,Tothne ZG,Murber A,et al.Correlation between first polar body morphology and further embryo development.Acta Biol Hung,2006,57:331-338. 13 Navarro PA,de Araújo MM,de Araújo CM,et al.Relationship between first polar body morphology before intracytoplasmic sperm injection and fertilization rate,cleavage rate,and embryo quality.Int J Gynaecol Obstet ,2009,104:226-229. 14 李澎涛,王娜,殷晨星,等.卵母细胞第一极体形态对受精结局的影响.广东医学,2016,37:3732-3734. 15 Sun SC,Kim NH.Molecular Mechanisms of Asymmetric Division in Oocytes.Microsc Microanal,2013,19:883-897. 16 陈雯,Schmutzler A,Weimer J,等.第一极体形态学与人类卵细胞非整倍体相关关系的研究.现代妇产科进展杂志,2003,12:321-323. 17 贾婵维,梁毓,王树玉.IVF-ET周期中第一极体形态与未受精卵母细胞非整倍体相关性研究.中国优生与遗传杂志,2010,18:125.
