卵母细胞胞质内单精子注射的形态学观察

目的 了解卵母细胞胞质内单精子注射（ｉｎｔｒａｃｙｔｏｐｌａｓｍｉｃ ｓｐｅｍｒｍ ｉｎｊｅｃｔｉｏｎ，ＩＣＳＩ）过程中配子及卵裂球期胚胎各种异常形态与ＩＣＳＩ结果的相关性。方法 对１９９８年１１月至１９９９年８月在我中心接受ＩＣＳＩ治疗的４３个周期进行观察、分析。促性腺激素释放激素激动剂降调节长方案进行超促排卵，ＩＣＳＩ常规操作，比较配子及卵裂球期胚胎正常与各种异常形态同ＩＣＳＩ结果的相关性。结

Analysis of the Relevant Morphological Characteristics Observed in Intracytoplasmic Sperm Injection

OBJECTIVE: To analyze the morphological characteristics of oocyte, sperm and blastomere-stage embryo and correlate with intracytoplasmic sperm injection (ICSI) embryo score. METHODS: ICSIs were done in M II oocytes harvested after superovulation with long-protocol gonadotropin releasing homone agonist. Various morphological characteristics of oocyte, sperm and blastomere-stage embryo were identified and correlated with the embryo score. RESULTS: Forty-three ICSI cycles were completed. Twelve out of 31 male factor infertile couples and 2 out of 12 with fertilization failure during previous standard in vitro fertilization-embryo transfer cycles achieved clinical pregnancy, resulting in a pregnancy rate of 38.7% and 16.7% per transfer respectively. Severe teratospermia and abnormal cytoplasm of the oocytes, such as cytoplasmic central dark granulas, inclusions, had significantly low embryo score (P < 0.01). The size of perivitelline space had no influence on the result. The oocytes without oolemma elasticity during ICSI process had a lower oocyte survival rate compared with those with oolemma elasticity (P < 0.01). The clinical pregnancy rate per transfer between transferred embryo with average score higher and lower than 3 was significantly different (52% vs 10%, P < 0.001). CONCLUSION: Some morphological characteristics of gamates correlate with the embryo quality and clinical pregnancy rate. They can be used to assess and improve the clinical management during ICSI.