H. Hassan-ali et al., Perivitelline space granularity: a sign of human menopausal gonadotrophin overdose in intracytoplasmic sperm injection, HUM REPR, 13(12), 1998, pp. 3425-3430
The significance of the presence of coarse dark granules in the perivitelli
ne space of oocytes has not been studied before. The study included 2288 in
tact oocytes [2063 in metaphase II (MII), 136 in metaphase I (MI), and 89 i
n germinal vesicle (GV)] retrieved in 206 intracytoplasmic sperm injection
cycles stimulated by a long agonist protocol. The incidence of granules var
ied with oocyte maturity, It was detected in 34.3% and 4% of the MII and MI
oocytes respectively, while none of the GV oocytes contained granules. The
woman's age, hormonal values (oestradiol and progesterone), human chorioni
c gonadotrophin/oocyte retrieval interval, number of oocytes retrieved, and
oocyte retrieval/injection interval were not related to the percentage of
granular oocytes, Moreover, there was no correlation between the percentage
of granular oocytes and the fertilization and cleavage rates, pregnancy ou
tcome, as well as the implantation rate. Patients were divided into three g
roups according to the total human menopausal gonadotrophin (HMG) dose they
received. There was a statistically significant difference between the thr
ee groups in the percentage of granular oocytes [17.4 +/- 5.2% versus 26.7
+/- 3.2% versus 45.4 +/- 4.2% in the bow-dose (< 30 ampoules), intermediate
dose (31-45 ampoules), and high-dose (>45 ampoules) groups respectively].
We conclude that granularity in the perivitelline space is probably a physi
ological phenomenon related to the maturational events in oocytes and enhan
ced by exposure to high dosages of HMG.