Sometimes multiple IVF attempts with oocytes that are good from the point of view of embryology fail: for example, an implanted embryo does not take root and dies.
Why can this happen? The morphology of the oocyte division spindle is of great importance.
The structure of the egg, and what is the spindle of division?
The quality of the embryo and its development potential depend on the quality of the oocyte. The shape of the cell, the structure of the cytoplasm, the shell and the polar body (the cell separating from the oocyte during maturation) are usually evaluated. The egg itself may have an abnormal shape – oval or amorphous. The cytoplasm may have vacuoles (cavities inside the cell filled with cell juice), various inclusions, and an abnormal shape. The oocyte shell can be thick, thin, or carry any abnormalities: the polar body may be absent, fragmented, or located separately from the cell itself. All these anomalies affect the further development of the embryo to varying degrees.
There is another very important element in the oocyte – the spindle of division (Fig.1).
Who is shown the procedure for evaluating the division spindle?
1. For patients aged 40+. It is a well-known fact that with age, the percentage of oocytes with problems with chromosome separation increases. These problems lead to genetic mutations.
2. Patients with a large number of oocytes and poor embryo development (in particular, polycystic ovary syndrome).
3. Patients who have had multiple IVF attempts with good eggs from the point of view of embryology, but with embryos that do not take root after transplantation, or with early pregnancy losses.
How can the division spindle be evaluated?
It is impossible to see it with a conventional microscope, so no one evaluates it in routine practice. It is necessary to have a special polarizing installation for visualization. In world practice, only a few clinics have the necessary equipment in their arsenal and evaluate the spindle of division.
The importance of the quality of the division spindle in fertilization
The spindle of division can be either normal or abnormal. Normally, it should be clearly visualized and located close to the polar taurus. But there are various anomalies: vacuolization, the spindle is broken into fragments, poorly visualized, and may be completely absent (Fig. 2).
If the oocytes have a normal division spindle, the fertilization efficiency is 90%, and the embryo yield is 76%. In case of abnormal fertilization, the efficiency of fertilization is 72%, and the yield of embryos decreases to 31%. The probability of implantation of embryos that were obtained from oocytes with a normal spindle reaches 60%.
The size of the division spindle is also important. With a fission spindle from 90 to 120 microns2 , the chances of pregnancy are highest.
And one more important point: at the time of ICSI (injection of sperm into the cytoplasm), the embryologist must correctly position the oocyte. Usually, the marker is the polar body, under which the spindle of division should theoretically be located. In order not to damage the spindle, the oocyte is oriented for 6 or 12 hours, to maximize the removal of the spindle from the injection site. However, the spindle can be positioned in a cage in different ways (Fig. 3).
And since it is impossible to see the spindle during routine ICSI, there is a high probability of damage to it. The imaging system of the division spindle used in the EMC minimizes the risk of damage to it.
EMC capabilities in the evaluation of the division spindle
Specialists from the EMC Clinic for Reproductive and Prenatal Medicine conduct a detailed assessment of the spindle division. For this purpose, the European Medical Center has all the necessary equipment and experienced specialists who have worked and trained in leading clinics in Europe.
Who is shown the procedure for evaluating the division spindle?
1. For patients aged 40+. It is a well-known fact that with age, the percentage of oocytes with problems with chromosome separation increases. These problems lead to genetic mutations.
2. Patients with a large number of oocytes and poor embryo development (in particular, polycystic ovary syndrome).
3. Patients who have had multiple IVF attempts with good eggs from the point of view of embryology, but with embryos that do not take root after transplantation, or with early pregnancy losses.
How can the division spindle be evaluated?
It is impossible to see it with a conventional microscope, so no one evaluates it in routine practice. It is necessary to have a special polarizing installation for visualization. In world practice, only a few clinics have the necessary equipment in their arsenal and evaluate the spindle of division.
The importance of the quality of the division spindle in fertilization
The spindle of division can be either normal or abnormal. Normally, it should be clearly visualized and located close to the polar taurus. But there are various anomalies: vacuolization, the spindle is broken into fragments, poorly visualized, and may be completely absent (Fig. 2).
If the oocytes have a normal division spindle, the fertilization efficiency is 90%, and the embryo yield is 76%. In case of abnormal fertilization, the efficiency of fertilization is 72%, and the yield of embryos decreases to 31%. The probability of implantation of embryos that were obtained from oocytes with a normal spindle reaches 60%.
The size of the division spindle is also important. With a fission spindle from 90 to 120 microns2 , the chances of pregnancy are highest.
And one more important point: at the time of ICSI (injection of sperm into the cytoplasm), the embryologist must correctly position the oocyte. Usually, the marker is the polar body, under which the spindle of division should theoretically be located. In order not to damage the spindle, the oocyte is oriented for 6 or 12 hours, to maximize the removal of the spindle from the injection site. However, the spindle can be positioned in a cage in different ways (Fig. 3).And since it is impossible to see the spindle during routine ICSI, there is a high probability of damage to it. The imaging system of the division spindle used in the EMC minimizes the risk of damage to it.
EMC capabilities in the evaluation of the division spindle
Specialists from the EMC Clinic for Reproductive and Prenatal Medicine conduct a detailed assessment of the spindle division. For this purpose, the European Medical Center has all the necessary equipment and experienced specialists who have worked and trained in leading clinics in Europe.
It is impossible to see it with a conventional microscope, so no one evaluates it in routine practice. It is necessary to have a special polarizing installation for visualization. In world practice, only a few clinics have the necessary equipment in their arsenal and evaluate the spindle of division.
The importance of the quality of the division spindle in fertilization
The spindle of division can be either normal or abnormal. Normally, it should be clearly visualized and located close to the polar taurus. But there are various anomalies: vacuolization, the spindle is broken into fragments, poorly visualized, and may be completely absent (Fig. 2).
If the oocytes have a normal division spindle, the fertilization efficiency is 90%, and the embryo yield is 76%. In case of abnormal fertilization, the efficiency of fertilization is 72%, and the yield of embryos decreases to 31%. The probability of implantation of embryos that were obtained from oocytes with a normal spindle reaches 60%.
The size of the division spindle is also important. With a fission spindle from 90 to 120 microns2 , the chances of pregnancy are highest.
And one more important point: at the time of ICSI (injection of sperm into the cytoplasm), the embryologist must correctly position the oocyte. Usually, the marker is the polar body, under which the spindle of division should theoretically be located. In order not to damage the spindle, the oocyte is oriented for 6 or 12 hours, to maximize the removal of the spindle from the injection site. However, the spindle can be positioned in a cage in different ways (Fig. 3).And since it is impossible to see the spindle during routine ICSI, there is a high probability of damage to it. The imaging system of the division spindle used in the EMC minimizes the risk of damage to it.
EMC capabilities in the evaluation of the division spindle
Specialists from the EMC Clinic for Reproductive and Prenatal Medicine conduct a detailed assessment of the spindle division. For this purpose, the European Medical Center has all the necessary equipment and experienced specialists who have worked and trained in leading clinics in Europe.
And since it is impossible to see the spindle during routine ICSI, there is a high probability of damage to it. The imaging system of the division spindle used in the EMC minimizes the risk of damage to it.
Specialists from the EMC Clinic for Reproductive and Prenatal Medicine conduct a detailed assessment of the spindle division. For this purpose, the European Medical Center has all the necessary equipment and experienced specialists who have worked and trained in leading clinics in Europe.
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Questions and answers
LASIK
Whether LASIK fits everyone?
The main age group for this operation are patients over 18 years with myopia, hyperopia and astigmatism. There are number contraindications for LASIC such as some chronic diseases, including eye diseases.
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Elias Raid
08 September 2016
Sudden rises of blood pressure
How to stabilize sudden rises of blood pressure, accompanied by nausea and vomiting in a patient with chronic hypertension (it is not always clear what comes first - nausea and vomiting and, as a consequence, the blood pressure increase, or Vice versa).
An adjustment of appropriate permanent antihypertensive therapy is required for blood pressure to be stabilized. It is best to schedule a consultation with the cardiologist and undergo heart ultrasound, 24-hour blood pressure monitoring and ECG. You can make an appointment by phone +7 (495) 933-66-55. Specialists of
the Cardiology Department will be happy to help you.
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Extrasystoles
Extrasystoles appeared on my husband’s ECG following smoking cessation. He has a serious intension to undergo a thorough examination. What kind on up-to-date methods are used in your clinic?
EMS offers the most up-to-date methods of examination for your husband to clarify the nature of arrhythmias. ECHO-cardiography, 24 hour Holter monitoring ECG, loading tests, and, if needed, 24-hour blood pressure monitoring as well as all laboratory tests are available at EMC’s cardiology department. There is an
option to undergo a comprehensive examination under the program "Health Status after 40", which includes specialists' consultations, diagnostic laboratory and instrumental tests. We will be happy to help you. You can make an appointment by phone +7 (495) 933-66-55.
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Dyagileva Mariya
08 September 2016
How soon another attempt is possible?
Twin pregnancy resulted from IVF, but cervical dilatation occurred and water broke at 20 weeks, so the pregnancy was not maintained. How soon another attempt is possible?
At least a year interval between childbirth and repeated IVF program is required. It is advisable to be prepared and to make every effort to get a singleton pregnancy.
Рolyp of the cervical canal
Hysteroscopy revealed a polyp of the cervical canal, it was removed, but there are plenty of micropolips. May I do IVF or they should be treated?
Usually, all polyps are removed at therapeutic and diagnostic hysteroscopy. It makes no sense to leave them in the uterus cavity. I think that if manipulation such as "Hysteroscopy with separate diagnostic curettage" was done, you have no polyps now and may safely prepare for IVF.
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