Human egg pathology: Oocyte recovery, and egg morphology as related to patient diagnosis, fertilization rate, and early development

In a program of in vitro fertilization, patient diagnosis from previous medical history was used to classify patients as 'tubal', 'idiopathic', and 'male factor related' infertility. In 47 cycles, 26 'tubal' patients 16, 'idiopathic', and 7 'male factor' infertility cases were treated. While 58% of tubal patients had eggs which cleaved to the 4-cell stage, only 18% of idiopathics and 0% of male factor cases did. In five of the idiopathic patients (31%), as compared with 2 (8%) of tubal cases, no oocytes were recovered. Histological evaluation of ovarian biopsies of 2 of these women indicated the presence only of few or atretic follicles. This suggests that patient diagnosis may be important in predicting success in oocyte recovery and fate of eggs in culture. Egg morphology was assessed at 16 hours post insemination by measurement of egg diameter and shape. Eggs were measured from 38 cycles (104 eggs). 63% measured 110-120 μM in diameter and were roughly spherical in sharp. The remaining 37% were of exceptional size and/or shape. 70% of the 110-120 μM eggs cleaved, as compared with 34% of the exceptionally sized eggs. Of the resulting 27 symmetrical 4-cell embryos, 24 (89%) were products of 110-120 μM eggs and only 3 (11%) arose from exceptionally sized eggs. This suggests that egg fate may be predicted by size and shape.