Visualization of the mitotic spindle in oocytes of patients with ovarian endometriosis as a prognostic factor for the effectiveness of fertilization and early embryonic development in IVF/ICSI programs

K.V. Krasnopolskaya, I.Yu. Ershova, A.L. Konkova, K.M. Isakova, T.V. Bocharova
In: Russian Journal of Human Reproduction · 2025 · vol. 31(3) , pp. 55 · doi:10.17116/repro20253103155 · W4411863124
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In ovarian endometriosis patients, mature oocytes from affected ovaries were fewer, but those with visible meiotic spindles showed better fertilization and blastocyst rates than those without, regardless of endometriosis.

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Abstract

The objective of the study was to clarify the frequency of meiotic spindle visualization in MII oocytes from infertile women with ovarian endometriosis undergoing stimulated IVF/ICSI cycles, and to evaluate the relationship of this factor with the processes of fertilization and good quality blastocyst formation. Material and methods. The meiotic spindle presence was studied in 345 MII oocytes of women without endometriosis (the control group), 115 MII oocytes retrieved from unaffected gonads of patients with unilateral ovarian endometriosis (the first comparison group), and 104 oocytes retrieved from affected gonads of patients with unilateral or bilateral ovarian endometriosis (the second comparison group). In selected groups, the reproductive potential of MII oocytes was assessed by their ability to normal fertilization and to form high-quality blastocyst. For visual spindle assessment was used an inverted microscope, equipped with polarization optical system OCTAX PolarAID. Results. The number of MII oocytes obtained from gonads affected by endometrioses was almost three times less compare to control group (p<0.001), however, oocyte quality assessed by meiotic spindle presence remained unchanged. MII oocytes with meiotic spindle presence derived from both endometriosis-affected and unaffected gonads show normal fertilization 15 percent more often, and provide 10 percent increase of good quality blastocyst rate compare to mature oocytes with no visible spindle. Conclusion. In ovarian endometriosis the number of retrieved mature eggs from the affected gonads significantly reduced, but the quality of MII oocytes assessed in terms of spindle visualization remain uninfluenced. Taking into account the possibility of reproductive potential realization of MII oocytes without visible meiotic spindle it seems reasonable to perform their fertilization using ICSI method, especially in stimulated cycles with poor response.

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endometriosis

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