The presence of vacuol es in human oocyt es
J . Ot suki ，
Y. Monma，
K. Takahashi ，
Y. Nagai
Nagai Cl i ni c
Summar y: Dur i ng the cumul us cel l s-denudi ng procedure we 合equentl y come out wi th t wo types of
vacuol e in oocyt opl asm. Typel vacuol e is known 血at is rel ated to apoptosi s. Type 2 vacuol e is al so
企equentl y
Wl血
observed，however ，no study has ever been done on the vacuol e 百 出 study deal t excl usi vel y
Type 2 vacuol es . We researched several areas to di scover the e宜ects of these vacuol es on the
out come of pregnanci es and to f md the causes of these vacuol es . A mong pati ents where vacuol es were
present ，onl y one baby was bom and the baby had Beckwi t h- Wi edemann syndrome. W hat was
statistically si gni fi cant was a hi gher rate of chemical pregnanci es in pati ents wi th vacuol es ，even 也ough
the grade of their embryos transferred was si gni fi cantl y hi gher 白an in pati ents where vacuol es were not
present; it suggests some chromosomal errors may be present.
I nt roduct i on
It is k nown that the presence of vacuol es duri ng the embr yoni c stage is one of the
morphol ogi cal characteri sti cs of apoptosi s.
1)
Those whi ch are generat ed i n oocyt es and al so
all embr yoni c stages of Type 1 vacuol es. Howev er a di 町erent t ype of vacuol e ( Type2
vacuol e) is 仕equent l y observed i n oocyt es and the mec hani s m responsi bl e for its
appearance is unknown. Type1 vacuol e ( Fi gur e1A，1 B，andl C) can be seen very cl earl y
and t hey l ook l i ke l unar craters. On the ot her hand，Type2 vacuol es ( Fi gur e1D and 1E) are
not as obvi ous as Type 1 vacuol es ，and are flat and mor e l i ke a bul ge t han a crater. These
Type2 vacuol es are f requent l y seen i n oocyt es after denudi ng in the I CSI procedure and are
mos t c ommonl y observed in the M 11 st age. Thi s st udy deal t excl usi vel y wi t h Type2
vacuol es. The ai ms of thi s st udy wer e to i denti 今 the reasons t hese vacuol es occur and
det ermi ne thei r effect on the out come of pregnanci es .
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Fi gure 1. Type J vacuoJ e present ω
，i n M n stage ( A) ，
2PN 瑚 ge ( B) ，
4ceJl s
E)
Stage ( C) and Type 2 vac∞le presented in M n 血 ge( D，
Mat eri al s and met hods
Consecut i ve I CSI attempts and both I VF&I CSI attempts
合o mJ 油 田 町
2000 to Apri l
2001 in our clinic were retrospecti vel y covered by this study. Subj ects were assi gned as
pati ents whose oocytes di d not have vacuol es ( Group1) and pati ents whose oocytes had
vacuol es ( Group2) . The t wo groups were compar ed in rel ati on to the sti mul ati on met hod;
hor mone levels; p剖 i ent' s age; number of retri eved oocytes; fertilization rate; cell di vi si on
rate; exi stence of endometri osi s in ovari es; thi ckness of endomet ri um and grade of
transferred embryos usi ng Veeck' s cl assi fi cati on to fi nd a rel evancy of vacuol ati on in
oocytes. Cl i ni cal pregnancy rate and chemical pregnancy rate were compared among the
groups. Wit hi n Gr oup2，serumoestradi ol e consentrati on on the day of h C G admini strati on
and serumoestradi ol e consentrati on per one oocyte were compared bet ween their cycl es
where vacuol e was present ( Group2A) and their cycl es where vacuol e was not p詑 sent
( Group2B)
St i n蹴 l ati on met hods: We mai nl y uti l i zed a l ong protocol and for some pati ents we uti l i zed
a short protocol on their subsequent A R T tria.1
Hor mone assay: Ser um oestradi ol and progesterone concentrati ons were anal yzed by
E L F A ( Enzyme Li nked Fl uorescent Assay; bi oMeri eux ，J apan).
St atistical anal i si s: Obt ai ned data were anal yzed usi ng χ 2 test or St udent' s {- tes.t
The
results were consi dered as statistically si gni fi cant i fthe P val ue was <0.05.
Resul ts
Vacuol es were f ound in 19 cycl es ( 16 pati ents) out of 193 cycl es ( 134 pati ents) ，whi ch
was 9.8 %(1l. 9%) in tota.1 A mong patents where vacuol es were present the average number
of oocytes wi th vacuol es was 2.3，for an average % of 25. 3%. Fi gure 2 shows serum
oestradi ol and progesterone concentrati ons on the day of h C G admini strati on in groups 1
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