Predictive value of oocyte morphology in human IVF: a systematic review of the literature

Abstract

BACKGROUNDNon-invasive selection of developmentally competent human oocytes may increase the overall efficiency of human assisted reproduction and is regarded as crucial in countries where legal, social or religious factors restrict the production of supernumerary embryos. The purpose of this study was to summarize the predictive value for IVF success of morphological features of the oocyte that can be obtained by light or polarized microscopic investigations.METHODSStudies about oocyte morphology and IVF/ICSI outcomes were identified by using a systematic literature search.RESULTSFifty relevant articles were identified: 33 analysed a single feature, 9 observed multiple features and investigated the effect of these features individually, 8 summarized the effect of individual features. Investigated structures were the following: meiotic spindle (15 papers), zona pellucida (15 papers), vacuoles or refractile bodies (14 papers), polar body shape (12 papers), oocyte shape (10 papers), dark cytoplasm or diffuse granulation (12 papers), perivitelline space (11 papers), central cytoplasmic granulation (8 papers), cumulus–oocyte complex (6 papers) and cytoplasm viscosity and membrane resistance characteristics (2 papers). None of these features were unanimously evaluated to have prognostic value for further developmental competence of oocytes.CONCLUSIONSNo clear tendency in recent publications to a general increase in predictive value of morphological features was found. These contradicting data underline the importance of more intensive and coordinated research to reach a consensus and fully exploit the predictive potential of morphological examination of human oocytes.

A direct action for GH in improvement of oocyte quality in poor-responder patients

“…This outcome can be explained by the presence of GHR on human granulosa cells (Sharara & Nieman 1994) and the significant increase in the levels of FSH and LH receptors observed in granulosa cells of human preovulatory follicles after GH treatment (Regan et al 2012). Nonetheless, we acknowledge that multiple studies have demonstrated that there is no correlation between COC morphology and fertilisation, embryo cleavage and clinical pregnancy rates (Rattanachaiyanont et al 1999, Rienzi et al 2011.…”

“…Non-invasive selection of developmentally competent human oocytes is of particular importance within modern fertility treatments (Rienzi et al 2011). Typically, gross morphological assessment of denuded oocytes or oocyte-cumulus complex is evaluated using simple, non-invasive light microscopy in order to ascertain oocyte quality (Rienzi et al 2011) and its developmental potential (Balaban & Urman 2006).…”

“…Typically, gross morphological assessment of denuded oocytes or oocyte-cumulus complex is evaluated using simple, non-invasive light microscopy in order to ascertain oocyte quality (Rienzi et al 2011) and its developmental potential (Balaban & Urman 2006). However, the integrity of important intra-cellular organelles and ultra-structures such as mitochondria and microtubules cannot be accurately determined through such gross morphological assessment, hence concerns have been raised regarding the predictive value of these parameters (Rienzi et al 2011). Instead, we have demonstrated that more detailed, non-invasive biochemical and/or ultra-structural evaluation is necessary to adequately assess true oocyte developmental competence (Seet et al 2013).…”

Oocyte morphology does not affect post-warming survival rate in an egg-cryobanking donation program

“…Rienzi et al [25], in a systematic review of the literature, concluded that their analysis did not entirely support the average opinion about the features of "good" and "bad" quality and respective developmental competence. Nonetheless, Otsuki et al [26] demonstrated that the presence of SER is associated with lower chances of successful pregnancy and even if normal oocytes from the same IU international units cohort are transferred, pregnancy rates are compromised.…”

The role of morphological evaluation of oocyte and embryo quality in ART programs (a review)

“…По данным отечественных источников [5], суще-ствует ограниченное количество работ, посвящен-ных данной теме, при этом отсутствуют указания на взаимосвязь тех или иных критериев качества с ос-новными показателями результативности ЭКО. От-носительно недавно в клиническую практику стала внедряться система оценки ооцитов на стадии MII -MOMS (MII oocyte morphological score), которая продемонстрировала значимую взаимосвязь уровня баллов по шкале MOMS и наступления беременно-сти [6]. Наиболее точную оценку ооцита возможно про-извести после денудации ооцита из ооцит-кумулюс-ного комплекса в программе интрацитоплазматиче-ской инъекции сперматозоида в ооцит (ИКСИ) [6][7][8].…”