Significance of metaphase II human oocyte morphology on ICSI outcome.
OBJECTIVE
To evaluate the influence of specific oocyte morphologic features (morphotypes) on intracytoplasmic sperm injection (ICSI) outcome. The identification of oocyte quality markers is particularly important when a low number of oocytes can be used for IVF.


METHODS
Retrospective analysis.


METHODS
Medical center.


METHODS
Five hundred sixteen consecutive ICSI cycles. Only couples affected by severe male factor infertility were excluded.


METHODS
A total of 1,191 metaphase II (MII) oocytes (1-3 per patient) were randomly selected from the cohort of oocytes obtained from each patient and evaluated for morphologic appearance.


METHODS
Fertilization, pronuclear morphology, embryo quality, pregnancy rate.


RESULTS
There was a presence of vacuoles, abnormal I polar body, and large perivitelline space related to a lower fertilization rate. Pronuclear morphology was effected by the presence of a large perivitelline space, diffused cytoplasmic granularity, and/or centrally located granular area. The latter characteristic also negatively related to day 2 embryo quality. According to the odds ratios obtained for each oocyte morphotype to reach at least one outcome, an MII oocyte morphologic score (MOMS) was calculated. A significant relationship was found between MOMS and female age, female basal FSH, and clinical outcome.


CONCLUSIONS
Morphologic evaluation before ICSI helps to identify MII oocytes with higher developmental potential.
Rienzi
Laura
L
Reproductive Medicine, European Hospital, Rome, Italy. laurarienzi@fastwebnet.it
Ubaldi
Filippo Mari
FM
Iacobelli
Marcello
M
Minasi
Maria Giulia
MG
Romano
Stefania
S
Ferrero
Susanna
S
Sapienza
Fabio
F
Baroni
Elena
E
Litwicka
Katarzyna
K
Greco
Ermanno
E
D000328:Adult; D000367:Age Factors; D053144:Cell Nucleus Shape; D048430:Cell Shape; D003594:Cytoplasmic Granules / Q000473:pathology; D010064:Embryo Implantation; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007246:Infertility / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D008297:Male; D008677:Metaphase; D008875:Middle Aged; D009865:Oocytes / Q000473:pathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome; D014617:Vacuoles / Q000473:pathology; D014817:Vitelline Membrane / Q000473:pathology; D055815:Young Adult
D005640:Follicle Stimulating Hormone