Analysis of meiotic spindle and zona pellucida birefringence of IVM oocytes in PCOS patients

Analysis of meiotic spindle and zona pellucida birefringence of IVM oocytes in PCOS patients

Background/aim: Polycystic ovarian syndrome (PCOS) is one of the most common causes of infertility. One of the best therapeutic options for PCOS patients is intracytoplasmic sperm injection (ICSI). In vitro maturation (IVM) can also be a useful technique for these women. The goal of this study was to evaluate both the zona pellucida (ZP) birefringence and meiotic spindle (MS) of in vivo- and in vitro-matured oocytes from PCOS patients using the PolScope system. Materials and methods: Immature oocytes undergoing IVM and MII oocytes were obtained from PCOS patients in an ICSI program. Using PolScope, the presence of MS and ZP birefringence was assessed in both in vivo-matured oocytes (n = 32) and IVM oocytes (n = 24). Oocytes were classified as having highly birefringent (HB) ZP and lowly birefringent (LB) ZP. Furthermore, the rates of fertilization after ICSI were evaluated. Results: The maturation rate was 68.5% after IVM. The percentage of a HB-ZP was significantly higher in the IVM oocytes than in vivomatured ones (58.3% vs. 31.2%, respectively; P = 0.04). There were similar outcomes for the fertilization rates and MS detection between the two groups (P = 0.80 and P = 0.53, respectively). Conclusion: Clinical IVM is a safe technology for the maturation and maintenance of oocyte integrity in PCOS patients. The use of the noninvasive PolScope is recommended for detection of healthy oocytes in ICSI.

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  • 1. Perales-Puchalt A, Legro RS. Ovulation induction in women with polycystic ovary syndrome. Steroids 2013; 78: 767-772.
  • 2. Cha KY, Chung HM, Lee DR, Kwon H, Chung MK, Park LS, Choi DH, Yoon TK. Obstetric outcome of patients with polycystic ovary syndrome treated by in vitro maturation and in vitro fertilization–embryo transfer. Fertil Steril 2005; 83: 1461-1465.
  • 3. Patel SS, Carr BR, editors. Oocyte Quality in Adult Polycystic Ovary Syndrome. Seminars in Reproductive Medicine. Stuttgart, Germany: Thieme Medical Publishers; 2008.
  • 4. Omidi M, Khalili MA, Nahangi H, Ashourzadeh S, Rahimipour M. Does women’s age influence zona pellucida birefringence of metaphase ΙΙ oocytes in in-vitro maturation program? Iran J Reprod Med 2013; 11: 823.
  • 5. Omidi M, Khalili MA, Ashourzadeh S, Rahimipour M. Zona pellucida birefringence and meiotic spindle visualisation of human oocytes are not influenced by IVM technology. Reprod Fert Develop 2014; 26: 407-413.
  • 6. Cobo AC, Requena A, Neuspiller F, Aragonés M, Mercader A, Navarro J, Simón C, Remohí J, Pellicer A. Maturation in vitro of human oocytes from unstimulated cycles: selection of the optimal day for ovum retrieval based on follicular size. Hum Reprod 1999; 14: 1864-1868.
  • 7. Revel A, Safran A, Benshushan A, Shushan A, Laufer N, Simon A. In vitro maturation and fertilization of oocytes from an intact ovary of a surgically treated patient with endometrial carcinoma: case report. Hum Reprod 2004; 19: 1608-1611.
  • 8. Khalili MA, Nottola SA, Shahedi A, Macchiarelli G. Contribution of human oocyte architecture to success of in vitro maturation technology. Iran J Reprod Med 2013; 11: 1.
  • 9. Piquette GN. The in vitro maturation (IVM) of human oocytes for in vitro fertilization (IVF): is it time yet to switch to IVMIVF? Fertil Steril 2006; 85: 833-835.
  • 10. Rienzi L, Martinez F, Ubaldi F, Minasi M, Iacobelli M, Tesarik J, Greco E. PolScope analysis of meiotic spindle changes in living metaphase II human oocytes during the freezing and thawing procedures. Hum Reprod 2004; 19: 655-659.
  • 11. Raju G, Prakash G, Krishna KM, Madan K. Meiotic spindle and zona pellucida characteristics as predictors of embryonic development: a preliminary study using PolScope imaging. Reprod Biomed Online 2007; 14: 166-174.
  • 12. Petersen CG, Vagnini LD, Mauri AL, Massaro FC, Silva LF, Cavagna M, Baruffi RLR, Oliveira JBA, Franco JG Jr. Evaluation of zona pellucida birefringence intensity during in vitro maturation of oocytes from stimulated cycles. Reprod Biol Endocrinol 2011; 9: 53.
  • 13. Khalil MA, Vahidi S, Aflatounian A, Karimzadeh MA, Amirarjmand H. intracytoplasmic sperm injection for the treatment of male factor infertility-the first preliminary report from Iran. Medical Journal of the Islamic Republic of Iran 1997; 11: 181- 185.
  • 14. Nazari S, Khalili MA, Esmaielzadeh F, Mohsenzadeh M. Maturation capacity, morphology and morphometric assessment of human immature oocytes after vitrification and in-vitro maturation. Iran J Reprod Med 2011; 9: 209-216.
  • 15. Halvaei I, Khalili MA, Razi MH, Nottola SA. The effect of immature oocytes quantity on the rates of oocytes maturity and morphology, fertilization, and embryo development in ICSI cycles. J Assist Reprod Gen 2012; 29: 803-810.
  • 16. Strassburger D, Friedler S, Raziel A, Kasterstein E, Schachter M, Ron‐El R. The outcome of ICSI of immature MI oocytes and rescued in vitro matured MII oocytes. Hum Reprod 2004; 19: 1587-1590.
  • 17. Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril 1994; 62: 353-362.
  • 18. Child TJ, Phillips SJ, Abdul-Jalil AK, Gulekli B, Tan SL. A comparison of in vitro maturation and in vitro fertilization for women with polycystic ovaries. Obstet Gynecol 2002; 100: 665- 670.
  • 19. Le Du A, Kadoch I, Bourcigaux N, Doumerc S, Bourrier M, Chevalier N, Fanchin R, Chian RC, Tachdjian G, Frydman R et al. In vitro oocyte maturation for the treatment of infertility associated with polycystic ovarian syndrome: the French experience. Hum Reprod 2005; 20: 420-424.
  • 20. Mikkelsen A, Lindenberg S. Benefit of FSH priming of women with PCOS to the in vitro maturation procedure and the outcome: a randomized prospective study. Reproduction 2001; 122: 587-592.
  • 21. Cha KY, Chian RC. Maturation in vitro of immature human oocytes for clinical use. Hum Reprod Update 1998; 4: 103-120.
  • 22. Barnes F, Kausche A, Tiglias J, Wood C, Wilton L, Trounson A. Production of embryos from in vitro-matured primary human oocytes. Fertil Steril 1996; 65: 1151-1156.
  • 23. Montag M, Schimming T, van der Ven H. Spindle imaging in human oocytes: the impact of the meiotic cell cycle. Reprod Biomed Online 2006; 12: 442-446.
  • 24. Moon JH, Hyun CS, Lee SW, Son WY, Yoon SH, Lim JH. Visualization of the metaphase II meiotic spindle in living human oocytes using the PolScope enables the prediction of embryonic developmental competence after ICSI. Hum Reprod 2003; 18: 817-820.
  • 25. Wang W, Meng L, Hackett R, Keefe D. Developmental ability of human oocytes with or without birefringent spindles imaged by PolScope before insemination. Hum Reprod 2001; 16: 1464- 1468.
  • 26. Li Y, Feng HL, Cao YJ, Zheng GJ, Yang Y, Mullen S, Crister JK, Chen ZJ. Confocal microscopic analysis of the spindle and chromosome configurations of human oocytes matured in vitro. Fertil Steril 2006; 85: 827-832.
  • 27. Wang WH, Meng L, Hackett RJ, Odenbourg R, Keefe DL. The spindle observation and its relationship with fertilization after intracytoplasmic sperm injection in living human oocytes. Fertil Steril 2001; 75: 348-353.
  • 28. Pickering S, Braude P, Johnson M, Cant A, Currie J. Transient cooling to room temperature can cause irreversible disruption of the meiotic spindle in the human oocyte. Fertil Steril 1990; 54: 102-108.
  • 29. Sun XF, Wang WH, Keefe DL. Overheating is detrimental to meiotic spindles within in vitro matured human oocytes. Zygote 2004; 12: 65-70.
  • 30. Nogueira D, Staessen C, Van de Velde H, Van Steirteghem A. Nuclear status and cytogenetics of embryos derived from in vitro–matured oocytes. Fertil Steril 2000; 74: 295-298.
  • 31. Racowsky C, Kaufman M. Nuclear degeneration and meiotic aberrations observed in human oocytes matured in vitro: analysis by light microscopy. Fertil Steril 1992; 58: 750-755.
  • 32. Emery BR, Wilcox AL, Aoki VW, Peterson CM, Carrell DT. In vitro oocyte maturation and subsequent delayed fertilization is associated with increased embryo aneuploidy. Fertil Steril 2005; 84: 1027-1029.
  • 33. Rienzi L, Ubaldi F, Iacobelli M, Minasi MG, Romano S, Greco E. Meiotic spindle visualization in living human oocytes. Reprod Biomed Online 2005; 10: 192-198.
  • 34. Epifano O, Liang L, Familari M, Moos M, Dean J. Coordinate expression of the three zona pellucida genes during mouse oogenesis. Development 1995; 121: 1947-1956.
  • 35. Soyal SM, Amleh A, Dean J. FIGalpha, a germ cell-specific transcription factor required for ovarian follicle formation. Development 2000; 127: 4645-4654.
  • 36. Pelletier C, Keefe DL, Trimarchi JR. Noninvasive polarized light microscopy quantitatively distinguishes the multilaminar structure of the zona pellucida of living human eggs and embryos. Fertil Steril 2004; 81: 850-6.
  • 37. de Almeida Ferreira Braga DP, de Cássia Savio Figueira R, Queiroz P, Madaschi C, Iaconelli A Jr, Borges E Jr. Zona pellucida birefringence in in vivo and in vitro matured oocytes. Fertil Steril 2010; 94: 2050-2053.
  • 38. Liu J, Lu G, Qian Y, Mao Y, Ding W. Pregnancies and births achieved from in vitro matured oocytes retrieved from poor responders undergoing stimulation in in vitro fertilization cycles. Fertil Steril 2003; 80: 447-449.
  • 39. Mikkelsen AL, Smith SD, Lindenberg S. In-vitro maturation of human oocytes from regularly menstruating women may be successful without follicle stimulating hormone priming. Hum Reprod 1999; 14: 1847-1851.
  • 40. Söderström-Anttila V, Mäkinen S, Tuuri T, Suikkari A-M. Favourable pregnancy results with insemination of in vitro matured oocytes from unstimulated patients. Hum Reprod 2005; 20: 1534-1540.
  • 41. Aboulghar MA, Mansour RT, Serour GI, Ramzy AM, Amin YM. Oocyte quality in patients with severe ovarian hyperstimulation syndrome. Fertil Steril 1997; 68: 1017-1021.
  • 42. Dor J, Shulman A, Levran D, Ben-Rafael Z, Rudak E, Mashiach S. The treatment of patients with polycystic ovarian syndrome by in-vitro fertilization and embryo transfer: a comparison of results with those of patients with tubal infertility. Hum Reprod 1990; 5: 816-818.
  • 43. Ebner T, Balaban B, Moser M, Shebl O, Urman B, Ata B, Tews G. Automatic user-independent zona pellucida imaging at the oocyte stage allows for the prediction of preimplantation development. Fertil Steril 2010; 94: 913-920.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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