Human Egg Maturity Assessment and Its Clinical Application

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Authors

HOLUBCOVÁ Zuzana KYJOVSKA Drahomira MARTONOVA Martina PARALOVA Dana KLENKOVA Tereza KLOUDOVA Sona

Year of publication 2019
Type Article in Periodical
Magazine / Source JOVE-JOURNAL OF VISUALIZED EXPERIMENTS
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.3791/60058
Doi http://dx.doi.org/10.3791/60058
Keywords Developmental Biology; Issue 150; in vitro fertilization; assisted reproduction; human oocyte maturation; immature oocytes; timing of ICSI; polarized light microscopy; meiotic spindle
Description The optimal timing of intracytoplasmic sperm injection (ICSI) is of a serious concern for fertility programs because untimely sperm entry diminishes the egg's developmental competence. Presence of the first polar body (PB) together with the meiotic spindle indicates completion of the oocyte maturation and the egg's readiness for fertilization. In clinical practice, it is customary to assume that all oocytes displaying a PB are mature metaphase (MII) oocytes. However, PB extrusion precedes the formation of the bipolar MII spindle. This asynchrony makes the mere presence of PB an unreliable marker of oocyte maturity. Noninvasive spindle imaging using polarized light microscopy (PLM) allows quick and easy inspection of whether the PB-displaying oocyte actually reassembled a meiotic spindle prior to ICSI. Here, we present a standard protocol to perform human egg maturity assessment in the clinical laboratory. We also show how to optimize the time of ICSI with respect to the oocyte's developmental stage in order to prevent premature sperm injection of late-maturing oocytes. Using this approach, even immature oocytes extruding PB in vitro can be clinically utilized. Affirmation that MII spindle is present prior to sperm injection and individual adjustment of the time of ICSI is particularly important in poor prognosis in-vitro fertilization (IVF) cycles with a low number of oocytes available for fertilization.
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