Relatively poor oocyte quality is an indication for intracytoplasmic sperminjection

Objective: To determine the relation between the insemination method used a nd the quality of oocytes and embryos. Design: Prospective study. Setting: Assisted reproductive centers at Yamagata University Hospital and Kuramoto Women's Clinic in Yamagata, Japan. Patient(s): Forty patients undergoing IVF and 40 patients undergoing intrac ytoplasmic sperm injection (ICSI). Intervention(s): To estimate oocyte quality, the granulosa cells surroundin g the oocyte were fixed and stained with a commercial dye in both groups of patients. One thousand granulosa cells were examined under a fluorescence microscope. Main Outcome Measure(s): The incidence of apoptotic granulosa cells surroun ding each oocyte. Result(s): The incidence of apoptosis in the granulosa cells enclosing the oocytes that were fertilized by IVF was significantly lower than that in th e oocytes that were fertilized by ICSI. Moreover, the incidence of apoptosi s in the granulosa cells enclosing the oocytes that grew into good-quality or fair-quality embryos was significantly lower after conventional IVF than after ICSI. With ICSI, the incidence of apoptosis was not significantly di fferent among the granulosa cells surrounding the oocytes that were insemin ated, were fertilized, or developed into good-quality or fair-quality embry os. With IVF, the incidence of apoptosis was highest in the granulosa cells surrounding the oocytes that were inseminated and lowest in the granulosa cells surrounding the oocytes that developed into good-quality and fair-qua lity embryos. Conclusion(s): A good-quality oocyte is necessary for the development of a good-quality embryo with IVF but not with ICSI. Thus, relatively poor oocyt e quality is a good indication for the use of ICSI. (C) 2000 by American So ciety for Reproductive Medicine.