title: Ultrastructural and cytogenetic analyses of mature human oocyte dysmorphisms with respect to clinical outcomes.
abstract: OBJECTIVE
  The study aimed to describe the ultrastructure of two human mature oocyte intracytoplasmic dysmorphisms, the bull-eye inclusion and the granular vacuole, with evaluation of clinical outcomes after intracytoplasmic sperm injection (ICSI) treatment.
  
  
  METHODS
  We retrospectively evaluated 4099 consecutive ICSI cycles during the period 2003-2013. Three groups were compared: controls, those with a bulls-eye inclusion, and those with granular vacuoles. Oocyte dysmorphisms were evaluated by transmission electron microscopy and in situ fluorescence hybridization (FISH). Detailed data on demographic and stimulation characteristics, as well as on embryological, clinical, and newborn outcomes, are fully presented.
  
  
  RESULTS
  The bull-eye inclusion is a prominent smooth round structure containing trapped vesicles, being surrounded by lipid droplets. The presence of this dysmorphism in the oocyte cohort had no clinical impact except when transferred embryos were exclusively derived from dysmorphism oocytes. The granular vacuole is delimited by a discontinuous double membrane and contains lipid droplets and vesicles. As FISH analysis revealed the presence of chromosomes, they probably represent pyknotic nuclei. The presence of this dysmorphism in the oocyte cohort had no clinical impact except when at least one transferred embryo was derived from dimorphic oocytes.
  
  
  CONCLUSIONS
  Poor clinical outcomes were observed with transfer of embryos derived from dysmorphism oocytes, although without causing gestation or newborn problems. The bull-eye inclusion and granular vacuoles may thus be new prognostic factors for clinical outcomes.
authors.affiliation: Department of Microscopy, Laboratory of Cell Biology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal. msousa@icbas.up.pt.|Multidisciplinary Unit for Biomedical Research-UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal. msousa@icbas.up.pt.
authors.forename: Mário
authors.initials: M
authors.lastname: Sousa
authors.affiliation: Centre for Reproductive Genetics Alberto Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-009, Porto, Portugal.
authors.forename: Mariana
authors.initials: M
authors.lastname: Cunha
authors.affiliation: Centre for Reproductive Genetics Alberto Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-009, Porto, Portugal.
authors.forename: Joaquina
authors.initials: J
authors.lastname: Silva
authors.affiliation: Department of Microscopy, Laboratory of Cell Biology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.|Multidisciplinary Unit for Biomedical Research-UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
authors.forename: Elsa
authors.initials: E
authors.lastname: Oliveira
authors.affiliation: Department of Genetics, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Institute of Health Research an Innovation (I3S), UP, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Pinho
authors.affiliation: Department of Genetics, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Institute of Health Research an Innovation (I3S), UP, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Carolina
authors.initials: C
authors.lastname: Almeida
authors.affiliation: Department of Microscopy, Laboratory of Cell Biology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto (UP), Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.|Multidisciplinary Unit for Biomedical Research-UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
authors.forename: Rosália
authors.initials: R
authors.lastname: Sá
authors.affiliation: Centre for Reproductive Genetics Alberto Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-009, Porto, Portugal.
authors.forename: José Teixeira
authors.initials: JT
authors.lastname: da Silva
authors.affiliation: Centre for Reproductive Genetics Alberto Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-009, Porto, Portugal.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Oliveira
authors.affiliation: Centre for Reproductive Genetics Alberto Barros (CGR), Av. do Bessa, 240, 1° Dto. Frente, 4100-009, Porto, Portugal.|Department of Genetics, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Institute of Health Research an Innovation (I3S), UP, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Alberto
authors.initials: A
authors.lastname: Barros
mesh_terms: D020732:Cytogenetic Analysis; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D002479:Inclusion Bodies / Q000502:physiology*; D046529:Microscopy, Electron, Transmission; D054315:Oocyte Retrieval / Q000379:methods*; D009865:Oocytes / Q000166:cytology / Q000473:pathology / Q000648:ultrastructure*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D014617:Vacuoles / Q000502:physiology*
keywords: Bull-eye inclusion; Clinical outcomes; Granular vacuoles; Oocyte cytogenetics; Oocyte dysmorphisms; Ultrastructure