title: Vacuolated oocytes: fertilization and embryonic arrest following intra-cytoplasmic sperm injection in a patient exhibiting persistent oocyte macro vacuolization--case report.
abstract: OBJECTIVE
  To describe a case of homogeneous macro vacuolar formation in oocytes from a patient undergoing IVF/ICSI over 3 cycles and implications thereof.
  
  
  METHODS
  Case report and analysis of cycle outcomes including spindle visualization to determine severity of internal disruption caused.
  
  
  RESULTS
  Characteristic macro vacuoles (>25 microm diameter) were identified in the vast majority of oocytes. Spindle visualization identified that macro vacuoles were not associated with spindle displacement. IVF resulted in failed fertilization. Low numbers of fertilized oocytes were obtained through ICSI. The vast majority of embryos exhibited maturation arrest on day 2.
  
  
  CONCLUSIONS
  It is likely that persistent Oocyte Macro Vacuolization is the cause of infertility in this patient. It probably has a biological basis and possibly a genetic cause, resulting in either uncontrollable endocytosis or poor exocytosis and consequent vacuolar formation.
authors.affiliation: Shropshire & Mid-Wales Fertility Centre, Shrewsbury and Telford Hospitals NHS Trust, Mytton Oak Road, Shrewsbury, Shropshire, SY3 8XQ, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wallbutton
authors.forename: Jason
authors.initials: J
authors.lastname: Kasraie
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D047108:Embryonic Development; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D009865:Oocytes / Q000166:cytology / Q000502:physiology*; D010060:Ovulation; D020554:Sperm Injections, Intracytoplasmic; D014617:Vacuoles / Q000473:pathology*