Polarization microscopy imaging for the identification of unfertilized oocytes after short-term insemination

The presence of a spindle is an accurate indicator for unfertilized oocytes, that when combined with rescue measures, will effectively prevent fertilization failure and decrease the polyspermy rate.

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Volume 108, Issue 1, Pages 78–83

Authors:

Yi Guo, M.D., Wenqiang Liu, Ph.D., Yu Wang, M.D., Jiaping Pan, M.D., Shanshan Liang, M.D., Jingling Ruan, M.D., Xiaoming Teng, M.D.

Abstract:

Objective

To develop a unique approach using polarization microscopy (PM) to determine whether the presence of a spindle can be used as an indicator associated with fertilization failure 5 hours after short-term insemination.

Design

Observational study.

Setting

Assisted reproduction center.

Patient(s)

Eighty-five patients undergoing short-term insemination.

Intervention(s)

Oocytes imaged via PM at 4, 5, and 6 hours after standard insemination.

Main Outcome Measure(s)

Spindle visualization and fertilization rate, with rescue intracytoplasmic sperm injection (ICSI) results determined by rates of normal fertilization, abnormal fertilization, and good-quality embryo formation.

Result(s)

After standard insemination, comparisons of spindle visualization at three time points indicated that the predictive accuracy rates were 84.30% at 5 hours, 86.80% at 6 hours, and 62.20% at 4 hours, with the rates at 5 and 6 hours statistically significantly higher than at 4 hours. A spindle was present in 242 of the 788 metaphase-II oocytes 5 hours after insemination, and there were 204 failed fertilizations on day 1. The positive predictive value was 0.84. After rescue ICSI, the abnormal fertilization rate of the polar body group (assessed using the polar body visualization method) was statistically significantly higher than that of the PM group (assessed using the spindle visualization method) and the regular ICSI group (9.37%, 5.88%, and 4.87%, respectively).

Conclusion(s)

The presence of a spindle 5 hours after insemination in in vitro fertilization is an accurate indicator of unfertilized oocytes. Spindle imaging combined with rescue measures effectively prevents fertilization failure and decreases the polyspermy rate.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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