体内成熟与体外成熟的卵母细胞纺锤体位置及其与胚胎发育的关系

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。并观察两组成熟卵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．O％、3．O％、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。

Meiotic spindle location and embryo development of in vivo and in vitro matured human oocytes

OBJECTIVE: To analyze the relationship between meiotic spindle location and embryo developmental potential of in vivo and in vitro matured human oocytes. METHODS: One hundred and thirty-four in vivo matured oocytes and 45 in vitro matured oocytes were observed with polscope at the time of intracytoplasm sperm injection (ICSI). RESULTS: Meiotic spindle was detected in 83.6% (112/134) and 82.2% (37/45) in in vivo and in vitro matured oocytes respectively. In vivo matured oocytes which showed a minimal angle (0-5 degrees ) between the meiotic spindle and the first polar body had a higher fertilization rate (93.3%) than the others. The frequency of the oocytes which had a 0-5 degrees spindle angle in in vivo and in vitro matured oocytes was 22.4% and 17.8%, respectively, and that of oocytes which had a 6 degrees - 45 degrees, 46 degrees-90 degrees and > 90 degrees spindle angle was 55.2% vs 51.1%, 3.0% vs 8.9%, and 3.0% vs 4.4%. No significant difference was found between them. No relationship was found between the position of meiotic spindle and embryo quality. CONCLUSIONS: There is some relationship between the angle of the meiotic spindle with the first polar body and fertilization rate. No significant difference is found in the position of the meiotic spindle between in vivo and in vitro matured human oocytes.