논문 상세보기
pp.213-221
세포질내 정자주입술은 불임치료에 도입된 이후 남성불임 극복에 성공적으로 이용되고 있다. 세포질내 정자주입술 시행 후 수정률, 난할률과 발생된 배아의 상태는 여러 가지 요인에 의해 영향을 받으며, 난자의 상태에 따라 영향을 받는 지에 대해서 아직까지는 논란이 많다. 본 연구에서는 세포질내 정자주입술의 결과가 난자의 상태에 따라 영향을 받는지를 알아보기 위하여 세포질내 정자주입술을 시행한 44례에서 전과정을 현미경에 부착된 CCD 카메라를 통하여 녹화하였다
Intracytoplasmic sperm injection (ICSI) has been widely used to treat couples with infertility due to severely impaired sperm charateristics and for whom conventional in-vitro fertilization (IVF) had failed. The extent to which the morphology of the oocyte at the light microscopy level is related to the results of ICSI vis controversial. In this study, oocytes from 44 patients were reviewed. The ICSI procedure was recorded through CCD camera. The oocytes were divided into five groups according to the presence of cytoplasmic inclusions, the width of perivitelline space (PVS), the presence of cell debris in PVS, the status of first polar body and the flexibility of oolemma. The results showed that the fertilization rate and embryonic development were not associated with the morphological criteria of oocyte. The degeneraton rate of oocytes after ICSI was significantly higher (P<0.001) in the oocytes whose membranes were broken at the moment of insertion (17.7%) than the oocytes whose membranes were broken by aspiration of cytoplasm (1.6%). More oocytes with cytoplasmic inclusions (48.4% vs. 25.1%, p<0.001), wide PVS (35.2% vs. 19.0%, p<0.001), or cell debris in PVS (53.3% vs. 38.4%, p<0.05) were observed in patients with female factor infertility compared to patients with male factor infertility. These results .suggest that the fertilization rate and embryonic development after ICSI are not correlated with oocyte morphology based on the presence of cytoplasmic inclusions, size of PVS, the presence of cell debris in PVS and the status of polar body. And the degeneration rate of oocytes after ICSI was associated with the flexibility of oolemma.
