反复卵母细胞胞质中央颗粒化并ICSI受精失败的1例病例报道并文献复习

A case report and literature review of repeated centrally located granular cytoplasm and ICSI fertilization failure

目的探究辅助助孕过程中人卵母细胞发生胞质中央颗粒化(centrally located granular cytoplasm,CLGC)的原因及其对胚胎发育潜能的影响。方法对本中心1例卵母细胞均表现为CLGC并且行卵胞质内单精子注射(intracytoplasmic sperm injection,ICSI)受精失败的病例进行报道,结合文献分析CLGC形成的原因及其对胚胎发育潜能的影响。结果该患者使用不同的促排卵方案及自然周期方案后,取得的卵母细胞均为CLGC,进行ICSI后均未完成正常受精。结论CLGC对胚胎质量及发育潜能评估有重要参考价值,患者全部卵母细胞均为CLGC的情况较少见,当发生CLGC时,询问是否有毒物接触暴露史,适当调整促排卵方案也许可以改善CLGC发生,但并非绝对,需对卵母细胞的形态评估加以重视。

Objective To explore the causes of centrally located granular cytoplasm(CLGC)in human oocytes during assisted fertilization and its effect on embryonic developmental potential.MethodsA case report was made on a patient in our center whose oocytes showed CLGC in intracytoplasmic sperm injection(ICSI)cycles,and the causes of CLGC formation and its impact on embryonic developmental potential were analyzed in combination with literature.ResultsThe oocytes obtained from this patient were all CLGC after using different ovulation induction programs and natural cycle programs,and normal fertilization was not completed after ICSI.ConclusionCLGC has an important reference value for the evaluation of embryo quality and developmental potential.It is rare that all the oocytes of the patient are CLGC.When CLGC occurs,it may be possible to improve the occurrence of CLGC by asking whether there is a history of toxic exposure or adjusting the ovarian stimulation protocol,but it is not absolute.Attention should be paid to the evaluation of oocytes.