Fertilization failures and abnormal fertilization after intracytoplasmic sperm injection
Fertilization failures and abnormal fertilization after intracytoplasmic sperm injection
复制标题
DOI：
10.1093/humrep/13.suppl_1.155
复制
发表时间：
1998-04-01
影响因子：
6.1
通讯作者：
Matthews, CD
中科院分区：
文献类型：
--
作者：
Flaherty, SP;Payne, D;Matthews, CD
本研究探讨了卵胞浆内单精子注射（ICSI）后失败（0%）和次优（< 50%）受精的发生率，特定夫妇ICSI受精率的变化，以及ICSI后受精失败和异常受精的原因。1343个周期中只有37个发生受精失败（3%）。当只注射一个卵母细胞时失败的风险最高（37%），当收集五个或更多卵母细胞时失败的风险最低（0.8%）。对87对夫妇进行了次优受精的发生率和受精率的变化进行了研究，这些夫妇每人进行了三个周期的ICSI，其中四个卵母细胞被注射了射出的精子。大约74%的夫妇在每个周期中实现了> 50%的受精。只有26%的夫妇在一个或多个周期中受精率< 50%，其中大多数（17%）只有一个周期受精率不佳。87对夫妇中只有4对（5%）在所有三个周期中的受精都不理想。用一对夫妇的最大和最小受精率之差作为受精率变化的指标。发现47对夫妇（54%）有0-25%的变异，33对夫妇（38%）有26-50%的受精，只有7对夫妇（8%）有> 50%的变异。用Hoechst 33342染色后，在未受精和异常受精的卵母细胞中研究了失败和异常受精的原因。总共研究了1005个未受精的卵母细胞，其中828个（82%）仍处于中期II，177个（18%）被激活。大多数卵母细胞（83%）含有精子，并且在大多数这些卵母细胞中，精子头部部分或完全去致密化。因此，卵母细胞激活失败是受精失败的主要原因。在活化的未受精卵母细胞中观察到类似的模式，尽管与中期II未受精卵母细胞相比，这些卵母细胞中完整精子的发生率较高。有趣的是，56%的激活的卵母细胞含有未被加工成雄性原核的去致密精子头。共169个异常受精卵也进行了研究。发现两个异常：由于第二极体的保留及其随后转化为第三原核，以及异常原核大小和数量而导致的二雌蕊。
This study addresses the incidence of failed (0%) and suboptimal (< 50%) fertilization after intracytoplasmic sperm injection (ICSI), variation in the ICSI fertilization rate for specific couples, and the causes of fertilization failure and abnormal fertilization after ICSI. Failed fertilization occurred in only 37 of 1343 cycles (3%). The risk of failure was highest (37%) when only one oocyte was injected, and was lowest (0.8%) when five or more oocytes were collected. The incidence of suboptimal fertilization and the variation in the fertilization rate were studied in 87 couples who each had three cycles of ICSI in which four oocytes were injected with ejaculated spermatozoa. Approximately 74% of these couples achieved > 50% fertilization in every cycle. Only 26% of the couples had < 50% fertilization in one or more cycles, and most of these (17%) had only a single cycle with suboptimal fertilization. Only four of the 87 couples (5%) had suboptimal fertilization in all three cycles. The difference between the maximum and minimum fertilization rate for a couple was used as an index of variation of the fertilization rate. It was found that 47 couples (54%) had 0-25% variation, 33 couples (38%) had 26-50% fertilization and only seven couples (8%) had > 50% variation. The causes of failed and abnormal fertilization were studied in unfertilized and abnormally fertilized oocytes after staining with Hoechst 33342. In total, 1005 unfertilized oocytes were studied, of which 828 (82%) were still at metaphase II and 177 (18%) were activated. Most of the oocytes (83%) contained a spermatozoon and, in the majority of these oocytes, the sperm head was partially or completely decondensed. Hence, failure of oocyte activation was the principal cause of fertilization failure. A similar pattern was observed in activated, unfertilized oocytes, although there was a higher incidence of intact spermatozoa in these oocytes compared with metaphase II, unfertilized oocytes. Interestingly, 56% of the activated oocytes contained a decondensed sperm head which was not processed into a male pronucleus. A total of 169 abnormally fertilized oocytes was also studied. Two anomalies were found: digyny due to retention of the second polar body and its subsequent transformation into a third pronucleus, and abnormal pronuclear size and number.