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Relationship between visualization of meiotic spindle in human oocytes and ICSI outcomes: a meta-analysis

  • CG Petersen
    Affiliations
    Center for Human Reproduction Prof. Franco Junior, Av. Prof. João Fiusa, 689, 14025–310, Ribeirão Preto, SP, Brazil

    Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University–UNESP, Botucatu, SP, Brazil
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  • JBA Oliveira
    Affiliations
    Center for Human Reproduction Prof. Franco Junior, Av. Prof. João Fiusa, 689, 14025–310, Ribeirão Preto, SP, Brazil
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  • AL Mauri
    Affiliations
    Center for Human Reproduction Prof. Franco Junior, Av. Prof. João Fiusa, 689, 14025–310, Ribeirão Preto, SP, Brazil
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  • FC Massaro
    Affiliations
    Center for Human Reproduction Prof. Franco Junior, Av. Prof. João Fiusa, 689, 14025–310, Ribeirão Preto, SP, Brazil
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  • RLR Baruffi
    Affiliations
    Center for Human Reproduction Prof. Franco Junior, Av. Prof. João Fiusa, 689, 14025–310, Ribeirão Preto, SP, Brazil
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  • A Pontes
    Affiliations
    Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University–UNESP, Botucatu, SP, Brazil
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  • JG Franco Jr
    Correspondence
    Correspondence: Tel/Fax: +55 16 3911 1100
    Affiliations
    Center for Human Reproduction Prof. Franco Junior, Av. Prof. João Fiusa, 689, 14025–310, Ribeirão Preto, SP, Brazil

    Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University–UNESP, Botucatu, SP, Brazil
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      Abstract

      The objective of this meta-analysis was to investigate the influence of meiotic spindle visualization in human oocytes on intracytoplasmic sperm injection (ICSI) outcomes. Search strategies included on-line surveys of databases (MEDLINE, EMBASE, Science Citation Index, Cochrane Controlled Trials Register and Ovid). The fixed effect was used for odds ratio. Ten trials fulfilled the inclusion criteria comparing in-vitro and clinical ICSI outcomes with or without visualization of meiotic spindle in fresh and in-vivo matured oocytes. According to the meta-analysis, the results showed statistically significant higher fertilization rate (P < 0.0001) when the meiotic spindle was viewed than when it was not. Moreover, the percentage of pro-nuclear-stage embryos with good morphology (P = 0.003), cleavage rate (P < 0.0001), percentage of day-3 top-quality embryos (P = 0.003) and percentage of embryos that reached the blastocyst stage (P < 0.0001) were statistically significantly better among embryos derived from oocytes in which meiotic spindle was viewed compared with those in which meiotic spindle was not observed. However, these differences were not observed in the clinical pregnancy or implantation rates. This observation has clinical relevance mainly in countries where there is a legal limit on the number of oocytes to be fertilized. However, additional controlled trials are needed to further confirm these results.

      Keywords

      References

        • Balaban B
        • Urman B
        Effect of oocyte morphology on embryo development and implantation.
        Reproductive BioMedicine Online. 2006; 12: 608-615
        • Battaglia DE
        • Goodwin P
        • Klein NA
        • Soules MR
        Fertilization and early embryology: influence of maternal age on meiotic spindle assembly oocytes from naturally cycling women.
        Human Reproduction. 1996; 11: 2217-2222
        • Borini A
        • Lagalla C
        • Cattoli M
        • et al.
        Predictive factors for embryo implantation potential.
        Reproductive BioMedicine Online. 2005; 15: 653-668
        • Chamayou S
        • Alecci C
        • Ragolia C
        • et al.
        Meiotic spindle presence and oocyte morphology do not predict clinical ICSI outcomes: a study of 967 transferred embryos.
        Reproductive BioMedicine Online. 2006; 13: 661-666
        • Cohen Y
        • Malcov M
        • Schwartz T
        • et al.
        Spindle imaging: a new marker for optimal timing of ICSI.
        Human Reproduction. 2004; 19: 649-654
        • Cooke S
        • Tyler JPP
        • Driscoll GL
        Meiotic spindle location and identification and its effect on embryonic cleavage plane and early development.
        Human Reproduction. 2003; 18: 2397-2405
        • Coticchio G
        • Sereni E
        • Serrao L
        • et al.
        What criteria for the definition of oocyte quality?.
        Annals of the New York Academy of Sciences. 2004; 1034: 132-144
        • Ebner T
        • Moser M
        • Tews G
        Is oocyte morphology prognostic of embryo potential after ICSI?.
        Reproductive BioMedicine Online. 2006; 12: 512-517
        • Eichenlaub-Ritter U
        • Peschke M
        Expression in in-vivo and in-vitro growing and maturing oocytes: focus on regulation of expression at the translational level.
        Human Reproduction Update. 2002; 8: 21-41
        • Eichenlaub-Ritter U
        • Shen Y
        • Tinneberg H-R
        Manipulation of the oocyte: possible damage to the spindle apparatus.
        Reproductive BioMedicine Online. 2002; 5: 117-124
        • Fang C
        • Mandy T
        • Li T
        • et al.
        Visualization of meiotic spindle and subsequent embryonic development in in-vitro and in-vivo matured human oocytes.
        Journal of Assisted Reproduction and Genetics. 2007; 24: 547-551
        • Griesinger G
        • Diedrich K
        The role of LH in ovarian stimulation: considerations.
        Reproductive BioMedicine Online. 2006; 12: 404-406
        • Hardarson T
        • Lundin K
        • Hamberger L
        The position of the metaphase II spindle cannot be predicted by the location of the first polar body in the human oocyte.
        Human Reproduction. 2000; 15: 1372-1376
        • Higgins JP
        • Thompson SG
        • Deeks JJ
        • Altman DG
        Measuring inconsistency in meta-analyses.
        British Medical Journal. 2003; 327: 557-560
        • Hu Y
        • Betzendahl I
        • Cortvrindt R
        • et al.
        Effects of low O2 and ageing on spindles and chromosomes in mouse oocytes from pre-antral follicle culture.
        Human Reproduction. 2001; 16: 737-748
        • Konc J
        • Kanyo K
        • Cseh S
        Visualization and examination of the meiotic spindle in human oocytes with PolScope.
        Journal of Assisted Reproduction and Genetics. 2004; 21: 349-353
        • Madaschi C
        • de Souza Bonetti TC
        • de Almeida Ferreira Braga DP
        • et al.
        Spindle imaging: a marker for embryo development and implantation.
        Fertility and Sterility. 2008; 90: 194-198
        • Montag M
        • Schimming T
        • van der Ven H
        Spindle imaging in human oocytes: the impact of the meiotic cell cycle.
        Reproductive BioMedicine Online. 2006; 12: 442-446
        • Moon JH
        • Hyun CS
        • Lee SW
        • et al.
        Visualization of the metaphase II meiotic spindle in living human oocytes using PolScope enables the prediction of embryonic development competence after ICSI.
        Human Reproduction. 2003; 18: 817-820
        • Rama Raju GA
        • Prakash GJ
        • Krishna KM
        • Madan K
        Meiotic spindle and zona pellucida characteristics as predictors of embryonic development: a preliminary study using PolScope imaging.
        Reproductive BioMedicine Online. 2007; 14: 166-174
        • Rienzi L
        • Ubaldi F
        • Martinez F
        • et al.
        Relationship between meiotic spindle location with regard to the polar body position and oocyte development potential after ICSI.
        Human Reproduction. 2003; 18: 1289-1293
        • Roberts R
        • Franks S
        • Hardy K
        Culture environment modulates maturation and metabolism of human oocytes.
        Human Reproduction. 2002; 17: 2950-2956
        • Shen Y
        • Stalf T
        • Mehnert C
        • et al.
        Light retardance by human oocyte spindle is positively related to pronuclear score after ICSI.
        Reproductive BioMedicine Online. 2006; 12: 737-751
        • Silva CS
        • Kapura K
        • Odenberg R
        • Keefe DL
        The first polar body does not predict accurately the location of the metaphase II meiotic spindle in mammalian oocytes.
        Fertility and Sterility. 1999; 71: 719-721
        • Taylor TH
        • Gitlin S
        • Wrigth G
        • et al.
        The meiotic spindle of human oocytes as viewed under the oosight and its relationship to chromosomal aneuploidy of subsequent embryo.
        Human Reproduction. 2006; 21: i23
        • Varghese AC
        • Goldberg E
        • Agarwal A
        Current and future perspectives on intracytoplasmic sperm injection: a critical commentary.
        Reproductive BioMedicine Online. 2007; 15: 719-727
        • Wang WH
        • Keefe DL
        Prediction of chromosome misalignment among in-vitro matured human oocytes by spindle imaging with the PolScope.
        Fertility and Sterility. 2002; 78: 1077-1081
        • Wang WH
        • Meng L
        • Hackett RJ
        • et al.
        Rigorous thermal control during intracytoplasmic sperm injection stabilizes the meiotic spindle and improves fertilization and pregnancy rates.
        Fertility and Sterility. 2002; 77: 1274-1277
        • Wang WH
        • Meng L
        • Hackett RJ
        • Keefe DL
        Developmental ability of human oocytes with or without birefringent spindles imaged by PolScope before insemination.
        Human Reproduction. 2001; 16: 1464-1468
        • Wang W
        • Meng L
        • Hackett RJ
        • et al.
        The spindle observation and its relationship with fertilization after intracytoplasmic sperm injection in living human oocytes.
        Fertility and Sterility. 2001; 75: 348-353

      Biography

      Claudia Petersen is a graduate of the Master's programme in Clinical Embryology through the University of Leeds, UK. Since July 1990 she has been working as a permanent embryologist in the Centre for Human Reproduction, Prof. Franco Jr, Ribeirao Preto, Brazil, with focus on in-vitro culture and micromanipulation techniques. Her current research interests have focused on gamete and embryo morphology, implantation and cryobiology.