METHODS: Perivitelline space (PVS) of oocytes was evaluated at the time of ICSI, and those without sufficient PVS were judged as oocytes with narrow PVS (NPVS oocytes), and those with sufficient PVS formation were judged as oocytes with non-narrow PVS (non-NPVS oocytes). The analysis included 634 NPVS oocytes from 278 cycles and 12,121 non-NPVS oocytes from 1698 cycles. The fertilization and developmental potentials of NPVS and non-NPVS oocytes were compared by calculating odds ratios using a mixed-effects logistic regression model. We also compared the embryo transfer outcomes of those used for single vitrified-warmed blastocyst transfer after developing into the blastocyst stage.
RESULTS: NPVS oocytes had higher odds ratios for degeneration (adjusted odds ratio [aOR], 1.555; 95% confidence interval [CI], 1.096-2.206; p = 0.0133) and 0PN (aOR, 1.387; 95% CI, 1.083-1.775; p = 0.0095), resulting in a lower 2PN rate (aOR, 0.761; 95% CI, 0.623-0.929; p = 0.0072). Even embryos with confirmed 2PN had lower odds ratios for cleavage (aOR, 0.501; 95% CI, 0.294-0.853; p = 0.0109) and blastocyst development (Gardner criteria; CC-AA) rates (aOR, 0.612; 95% CI, 0.476-0.788; p = 0.0001). Blastocysts developed from NPVS oocytes had significantly lower odds ratios for clinical pregnancy (aOR, 0.435; 95% CI, 0.222-0.854; p = 0.0156) than those developed from non-NPVS oocytes.
CONCLUSIONS: Oocytes with NPVS have low fertilization and developmental potential, as well as low likelihood of pregnancy.
方法:在ICSI时评估卵母细胞的卵周间隙(PVS),那些没有足够的PVS被判定为具有狭窄PVS的卵母细胞(NPVS卵母细胞),和那些有足够的PVS形成被判定为具有非窄PVS(非NPVS卵母细胞)的卵母细胞。分析包括来自278个周期的634个NPVS卵母细胞和来自1698个周期的12,121个非NPVS卵母细胞。通过使用混合效应逻辑回归模型计算比值比,比较了NPVS和非NPVS卵母细胞的受精和发育潜力。我们还比较了在发育为胚泡期后用于单个玻璃化温热胚泡移植的胚胎移植结果。
结果:NPVS卵母细胞具有更高的变性优势比(调整后的优势比[aOR],1.555;95%置信区间[CI],1.096-2.206;p=0.0133)和0PN(aOR,1.387;95%CI,1.083-1.775;p=0.0095),导致较低的2PN率(AOR,0.761;95%CI,0.623-0.929;p=0.0072)。即使具有证实的2PN的胚胎也具有较低的卵裂比值比(aOR,0.501;95%CI,0.294-0.853;p=0.0109)和胚泡发育(Gardner标准;CC-AA)率(aOR,0.612;95%CI,0.476-0.788;p=0.0001)。从NPVS卵母细胞发育的囊胚具有明显较低的临床妊娠比值比(aOR,0.435;95%CI,0.222-0.854;p=0.0156)比非NPVS卵母细胞发育的那些。
结论:患有NPVS的卵母细胞受精和发育潜能低,以及怀孕的可能性低。