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目的研究体内成熟与体外成熟卵母细胞的纺锤体位置及其与胚胎发育的关系。方法对134个体内成熟卵母细胞在卵母细胞胞质内单精子注射法(ICSI)操作时用纺锤体实时观察仪进行纺锤体位置的观察,体内成熟卵母细胞来自单纯因男性不育而进行 ICSI 治疗的患者15例(体内成熟组)。另外对45个体外成熟的卵母细胞观察纺锤体位置,体外成熟卵母细胞来自因多囊卵巢综合征致不孕而进行治疗的患者5例(体外成熟组)。纺锤体的位置按照其与第一极体之间的角度不同分为Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ级。并观察两组成熟卯母细胞的受精及其胚胎发育情况。结果体内成熟组和体外成熟组患者的卵母细胞中可观察到纺锤体的分别占83.6%(112/134)和82.2%(37/45)。体内成熟组患者卵母细胞纺锤体的位置Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ级分别为22.4%、55.2%、3.0%、3.0%、16.4%,体外成熟组则分别为17.8%、51.1%、8.9%、4.4%、17.8%,两组各级间分别比较,差异均无统计学意义(P>0.05)。在体内成熟组卵母细胞中,纺锤体离第一极体较近(Ⅰ级)者受精率较高(93.3%),显著高于其他各级(分别为73.0%、2/4、1/4、63.6%,P<0.05)。结论体内成熟与体外成熟卵母细胞间纺锤体位置未见显著差异;纺锤体的位置与卵母细胞受精率有一定相关性。
Objective To study the spindle position of in vitro matured and in vitro mature oocytes and its relationship with embryonic development. Methods The spindle position of 134 in vitro mature oocytes during operation in the cytoplasm by intracytoplasmic sperm injection (ICSI) was observed by a spindle real-time observation instrument. The oocytes matured in vitro were from male infertility Fifteen patients underwent ICSI (in vivo maturation group). In addition, 45 in vitro matured oocytes were observed for spindle position. In vitro matured oocytes were obtained from 5 patients (in vitro maturation group) treated with polycystic ovary syndrome and infertility. Spindle position in accordance with the first polar body between the angle is divided into Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ level. The fertilization and embryo development of mature primiparous cells in two groups were observed. Results Spindles were observed in 83.6% (112/134) and 82.2% (37/45) of the oocytes in the in vivo and in vitro maturation groups, respectively. The in vitro maturation group had 22.4%, 55.2%, 3.0%, 3.0% and 16.4% of spindle position oocytes, respectively. The in vitro maturation group was 17.8% and 51.1% respectively, 8.9%, 4.4% and 17.8% respectively. There was no significant difference between the two groups (P> 0.05). In in vitro maturation group oocytes, the spindle rate was higher (93.3%) than that of the first polar body (P <0.05), which was significantly higher than that of other groups (73.0%, 2/4, 4,63.6%, P <0.05). Conclusion There is no significant difference in spindle position between oocytes matured in vitro and mature oocytes in vitro. The position of spindle and oocyte fertilization rate are related to each other.