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Rescue of human embryos by micromanipulation
1Department of Obstetrics and Gynaecology, New York Hospital-Cornell University Medical Center, NY 10021.
Bailliere'S Clinical Obstetrics and Gynaecology
|March 1, 1994
Summary
Clinical micromanipulation techniques can rescue abnormally developing embryos. Removing excess material and selective assisted hatching improve embryo development and implantation rates, especially in specific patient groups.
Area of Science:
- Embryology
- Assisted Reproductive Technology (ART)
Background:
- Abnormally developing zygotes and embryos pose challenges in assisted reproduction.
- Micromanipulation offers potential solutions for rescuing compromised embryos.
Purpose of the Study:
- To evaluate clinical micromanipulation techniques for rescuing abnormally developing zygotes and embryos.
- To assess the impact of pronuclei extraction and degenerate material removal on embryo development and hatching.
- To analyze the efficacy of assisted hatching strategies, including selective assisted hatching.
Main Methods:
- Evaluating pronuclei extraction from dispermic zygotes to restore diploidy.
- Assessing sex chromosome ratios (X:Y) using duplex PCR or FISH.
- Investigating the effect of removing extracellular degenerate material on embryo hatching.
- Analyzing outcomes of assisted hatching based on zona pellucida thickness and breaching methods.
- Implementing and evaluating selective assisted hatching in specific patient populations.
Main Results:
- Procedures altering pronuclei ratios suggest potential for correcting dispermic zygotes, though female pronuclei removal risk exists.
- Removal of degenerate material by micromanipulation can improve embryo hatching, with immediate removal being more beneficial.
- Selective assisted hatching, tailored to zona pellucida thickness and embryo characteristics, shows success in older women and those with elevated FSH.
- Zona drilling without selection may be detrimental in certain cases, while selective approaches demonstrate improved outcomes.
Conclusions:
- Clinical micromanipulation techniques, including pronuclei manipulation and degenerate material removal, show promise in rescuing compromised embryos.
- Selective assisted hatching is a valuable strategy, particularly for patients with specific embryo characteristics or demographic factors, improving implantation potential.
- Careful consideration of zona pellucida characteristics and procedural methods is crucial for successful assisted hatching outcomes.