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A case report of a successful pregnancy after intracytoplasmic sperm injection when all oocytes contained abnormal inclusions in the perivitelline space

Published online by Cambridge University Press:  21 March 2025

Juan Peng ,
Wenda Zou ,
Liyu Zhu ,
Xinlin Guo ,
Juan Zhang  and
Hui Li Open the ORCID record for Hui Li [Opens in a new window]
Juan Peng
Affiliation:
Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, HN, China
Wenda Zou
Affiliation:
Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, HN, China
Liyu Zhu
Affiliation:
Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, HN, China
Xinlin Guo
Affiliation:
Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, HN, China
Juan Zhang
Affiliation:
Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, HN, China
Hui Li*
Affiliation:
Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, HN, China
*
Corresponding author: Hui Li; Email: [email protected]
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Abstract

Background:

The relationship between oocyte morphology and developmental potential has been a hot research topic in assisted reproductive technology (ART). Whether inclusions in the perivitelline space (PVS) affect ART outcomes remains controversial.

Case Presentation:

We present a case report of a 34-year-old G3P1A2 woman who sought ART treatment because of sequelae of pelvic disease. As her husband had severe oligospermia due to the stress on the day of oocyte retrieval, intracytoplasmic sperm injection (ICSI) was performed. After denudation, varying degrees of debris were found in the PVS, but all the oocytes were subjected to ICSI. Among the eleven retrieved oocytes, eight were fertilized. The morphology of the embryos was scored on Days 2 and 3. Five embryos were frozen on Day 3, and two best-quality embryos were subsequently transferred via frozen embryo transfer.

Conclusion:

Severe debris in the PVS seems to affect embryo quality but not fertilization. Mild debris in the PVS may have little effect on the outcome of ART treatment. In our patient, after two embryos that were derived from oocytes with relatively few debris in the PVS were transferred, a successful live birth occurred.

Keywords

case reportdebrisembryoperivitelline spaceoocyte
Type
Research Article
Information
Zygote , First View , pp. 1 - 6
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Alpha Scientists In Reproductive Medicine & Eshre Special Interest Group Embryology. (2011) Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Human Reproduction, 26(6), 1270–1283. doi: 10.1093/humrep/der037.Google Scholar
Balaban, B., Urman, A., Sertac, C., Alatas, S., Aksoy, R. (1998) Oocyte morphology does not affect fertilization rate, embryo quality and implantation rate after intracytoplasmic sperm injection. Human Reproduction 13(12), 3431–3433. doi: 10.1093/humrep/13.12.3431.Google Scholar
Bartolacci, A., Intra, G., Coticchio, G., dell’Aquila, M., Patria, G., Borini, A. (2022) Does morphological assessment predict oocyte developmental competence? A systematic review and proposed score. Journal of Assisted Reproduction and Genetics 39(1), 3–17. doi: 10.1007/s10815-021-02370-3.Google ScholarPubMed
Bosch, E., Labarta, E., Kolibianakis, E., Rosen, M., Meldrum, D. (2016) Regimen of ovarian stimulation affects oocyte and therefore embryo quality. Fertility and Sterility 105(3), 560–570. doi: 10.1016/j.fertnstert.2016.01.022.Google ScholarPubMed
Braga, D.P.A.F., Setti, A.S., Figueira, R.D.C.S., Machado, R.B., Jr, A.I., Edson Borges, E.B. Jr (2013) Influence of oocyte dysmorphisms on blastocyst formation and quality. Fertility and Sterility 100(3), 748–754. doi: 10.1016/j.fertnstert.2013.05.021.Google ScholarPubMed
Chamayou, S., Ragolia, C., Alecci, C., Storaci, G., Guglielmino, A. (2006) Meiotic spindle presence and oocyte morphology do not predict clinical icsi outcomes: a study of 967 transferred embryos. Reproductive Biomedicine Online 13(5), 661–667. doi: 10.1016/s1472-6483(10)60656-6.Google Scholar
Farhi, J., Nahum, H., Weissman, A., Zahalka, N., Glezerman, M., Levran, D. (2002) Coarse granulation in the perivitelline space and ivf-icsi outcome. Journal of Assisted Reproduction & Genetics 19(12), 545–549. doi: 10.1023/a:1021243530358.Google ScholarPubMed
Ferrarini Zanetti, B., Paes, D.A.F.B.D., Souza Setti, A., de Cássia Sávio Figueira, R., Iaconelli, A., Borges, E. (2018) Is perivitelline space morphology of the oocyte associated with pregnancy outcome in intracytoplasmic sperm injection cycles?. European Journal of Obstetrics & Gynecology and Reproductive Biology 231, 225–229. doi: 10.1016/j.ejogrb.2018.10.053.Google ScholarPubMed
Ferri, D., Baldini, D., Baldini, G.M. (2023) A successful twin healthy live birth achieved from eggs with a rare perivitelline space abnormality: a case report. International Journal of Reproductive Biomedicine 21(3), 263–267. doi: 10.18502/ijrm.v21i3.13202.Google ScholarPubMed
Figueira, R.D.C.S., Aoki, T., Borges Junior, E. (2015) Limitações e controvérsias na determinação do valor preditivo de critérios de morfologia oocitária e embrionária. Revista Brasileira Ginecologia e Obstetricia 37(11), 533–546. doi: 10.1590/SO100-720320150005330.Google Scholar
Guimarães, R.M.G.C., Ribeiro, L.M., Sasaki, L.P., Nakagawa, H.M., Cabral, I. O. (2021). Oocyte morphology and reproductive outcomes-case report and literature review. JBRA Assisted Reproduction 25(3), 500–507. doi: 10.5935/1518-0557.20210001.Google ScholarPubMed
Hassa, H., Aydin, Y., Taplamacioglu, F. (2014) The role of perivitelline space abnormalities of oocytes in the developmental potential of embryos. Journal of the Turkish German Gynecological Association 15(3), 161–163. doi: 10.5152/jtgga.2014.13091.Google ScholarPubMed
Hassan-Ali, H., Hisham-Saleh, A., El-Gezeiry, D., Baghdady, I., Ismaeil, I., Mandelbaum, J. (1998) Perivitelline space granularity: a sign of human menopausal gonadotrophin overdose in intracytoplasmic sperm injection. Human Reproduction 13(12), 3425–3430. doi: 10.1093/humrep/13.12.3425.Google ScholarPubMed
Kuran, S.B., Altun, A., Karakus, F.N., Kotil, T., Selcuk, B.O. (2023) Ultrastructure of coarse granules in the perivitelline space and association with ovulation induction protocols. JBRA Assisted Reproduction 27(4), 660–667. doi: 10.5935/1518-0557.20230032.Google Scholar
Lazzaroni-Tealdi, E, Barad, D.H., Albertini, D.F., Yu, Y., Kushnir, V.A., Russell, H., Wu, Y.G., Gleicher, N. (2015) Oocyte scoring enhances embryo-scoring in predicting pregnancy chances with IVF where it counts most. PLoS One 10(12), e0143632. doi: 10.1371/journal.pone.0143632.Google Scholar
Meriano, J.S., Alexis, J., Visram-Zaver, S., Cruz, M., Casper, R. F. (2001) Tracking of oocyte dysmorphisms for ICSI patients may prove relevant to the outcome in subsequent patient cycles. Human Reproduction 16, 2118–2123. doi: 10.1093/humrep/16.10.2118.Google Scholar
Minasi, M.G., Anagnostopoulou, C., Boitrelle, F., Vogiatzi, P., Sallam, H., Saleh, R., Colpi, G., Agarwal, A. (2023) Oocytes evaluation and in-vitro fertilization/intra cytoplasmic sperm injection outcomes. Panminerva Medica 65(2), 179–187. doi: 10.23736/S0031-0808.23.04838-3.Google ScholarPubMed
Nikiforov, D., Grøndahl, M.L., Hreinsson, J., Andersen, C.Y. (2022) Human oocyte morphology and outcomes of infertility treatment: a systematic review. Reproductive Sciences 29(10), 2768–2785. doi: 10.1007/s43032-021-00723-y.Google ScholarPubMed
Rankin, T., Talbot, P., Lee, E., Dean, J. (1999) Abnormal zonae pellucidae in mice lacking ZP1 result in early embryonic loss. Development (Cambridge, England) 126(17), 3847–3855. doi: 10.1242/dev.126.17.3847.Google ScholarPubMed
Rienzi, L., Vajta, G., Ubaldi, F. (2011) Predictive value of oocyte morphology in human IVF: a systematic review of the literature. Human Reproduction Update 17(1), 34–45. doi: 10.1093/humupd/dmq029.Google Scholar
Sutter, P. D., Dozortsev, D., Qian, C., Dhont, M. (1996) Oocyte morphology does not correlate with fertilization rate and embryo quality after intracytoplasmic sperm injection. Human Reproduction 11(3), 595–597. doi: 10.1093/humrep/11.3.595.Google Scholar
Talbot, P., Dandekar, P. (2003) Perivitelline space: does it play a role in blocking polyspermy in mammals? Microscopy Research and Technique 61(4), 349–357. doi: 10.1002/jemt.10348.Google ScholarPubMed
Ten, J., Mendiola, J., Vioque, J., De Juan, J., Bernabeu, R. (2007) Donor oocyte dysmorphisms and their influence on fertilization and embryo quality. Reproductive Biomedcine Online 14(1), 40–48. doi: 10.1016/s1472-6483(10)60762-6.Google ScholarPubMed
Van Blerkom, J., Henry, G. (1992) Oocyte dysmorphism and aneuploidy in meiotically mature human oocytes after ovarian stimulation. Human Reproduction (Oxford, England) 7(3), 379–390. doi: 10.1093/oxfordjournals.humrep.a137655.Google ScholarPubMed
Vollenhoven, B., Hunt, S. (2018) Ovarian ageing and the impact on female fertility. F1000Research 7: F1000 Faculty Rev-1835. doi: 10.12688/f1000research.16509.1.Google ScholarPubMed
Xia, P. (1997) Intracytoplasmic sperm injection: correlation of oocyte grade based on polar body, perivitelline space and cytoplasmic inclusions with fertilization rate and embryo quality. Human Reproduction 12(8), 1750–1755. doi: 10.1093/humrep/12.8.1750.Google ScholarPubMed
Yu, B., Van Tol, H.T.A., Stout, T.A.E., Roelen, B.A.J. (2021) Cellular fragments in the perivitelline space are not a predictor of expanded blastocyst quality. Frontiers in Cell and Developmental Biology 8, 616801. doi: 10.3389/fcell.2020.616801.Google Scholar
Yu, E.J., Ahn, H., Lee, J.M., Jee, B.C., Kim, S.H. (2015) Fertilization and embryo quality of mature oocytes with specific morphological abnormalities. Clinical and Experimental Reproductive Medicine 42(4), 156–162. doi: 10.5653/cerm.2015.42.4.156.Google ScholarPubMed