A influência da ativação oocitária artificial com ionóforo de cálcio A23187 em pacientes submetidos a ciclos de injeção intracitoplasmática utilizando diferentes origens de espermatozóides
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Data
2007-11-23
Autores
Borges Júnior, Edson [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Desde o primeiro relato de sucesso em humanos, a Injeção Intracitoplasmática de Espermatozóide (ICSI) tem sido particularmente indicada para casos de alterações seminais graves, sendo já demonstrada uma relação diretamente proporcional entre os resultados deste procedimento e a qualidade seminal. Tem sido sugerido que a incapacidade de o espermatozóide iniciar a ativação oocitária seja uma das principais causas de falha de fertilização após a ICSI. Estudos prévios identificaram o cálcio como um importante segundo mensageiro durante a ativação oocitária e que o tratamento com ionoforo do calcio e capaz de favorecer a ativação oocitária, resultando em fertilização, desenvolvimento embrionário e gestações normais. O objetivo deste estudo foi avaliar o efeito da Ativação Oocitária Artificial (AOA) com ionoforo do calcio A23187 em ciclos de ICSI quando utilizados espermatozóides de diferentes origens. Foram avaliados 314 ciclos de ICSI divididos em tres Grupos: EJACULADO (n = 92), EPIDIDIMARIO (n = 82) e TESTICULAR (n = 140), sendo cada um deles dividido em subgrupos, dependendo da realizacao (Subgrupo AOA) ou nao de AOA (Subgrupo Controle . CT). Foram avaliados tambem separadamente os ciclos de mulheres com idade inferior a 36 anos, objetivando minimizar o efeito da idade sobre os resultados dos tratamentos. Para a ativação oocitária, os oócitos foram mantidos por 30 minutos apos a ICSI em meio de cultivo para AOA, contendo 5ÊM de ionoforo de calcio A23187 e em aproximadamente 20 horas a fertilizacao foi confirmada pela presenca de 2 Pro-Nucleos. Para cada grupo experimental foram comparados, entre os Subgrupos AOA e CT, os seguintes parametros: taxa de fertilizacao normal, taxa de falha parcial de fertilizacao, porcentagem de bons embrioes no dia da transferencia, taxa de gestacao clinica, taxa de implantacao e taxa de abortamento...
Since the first report of a birth after ICSI, it has been specially used for severe male factor of infertility and it was demonstrated that the semen quality influences the ICSI outcomes. Previous studies suggested that failure of fertilization after ICSI may be due to a spermatozoa inability in trigger the oocyte activation. Calcium has long been identified as a universally important second messenger during oocyte activation and many studies demonstrated that treatment with calcium ionophore may increase the free intracellular calcium, promoting oocyte activation, resulting in fertilization, embryo development and pregnancies. The aim of this study was to evaluate the effect of artificial oocyte activation (AOA) with calcium ionophore A23187 in ICSI cycles using sperm from different origins. It was evaluated 314 ICSI cycles divided in groups according to the origin of spermatozoa: EJACULATED group (n = 92), EPIDIDYMAL group (n = 82) and TESTICULAR group (n = 140). Each group was split into sub-groups depending on the AOA treatment: sub-group AOA, when it was performed AOA and sub-group Control-CT, when it was not performed AOA. Furthermore, it was evaluated separately only cycles in each woman were younger then 36 years old. After ICSI, oocytes were incubated in culture medium containing calcium ionophore A23187 (5ìM concentration) for 30 minutes and in approximately 20 hours oocytes were checked for normal fertilization, defined as observation of two distinct pronucleous. For each experimental group the following parameters were compared between the sub-groups AOA and CT: normal fertilization rate; partial fertilization fail rate; percentage of high quality embryos on the transfer day; implantation rate; pregnancy rate and miscarriage rate. For all the evaluated parameters, it was not observed any significant difference between the subgroups for the three spermatozoa origin groups.... (Complete abstract click electronic access below)
Since the first report of a birth after ICSI, it has been specially used for severe male factor of infertility and it was demonstrated that the semen quality influences the ICSI outcomes. Previous studies suggested that failure of fertilization after ICSI may be due to a spermatozoa inability in trigger the oocyte activation. Calcium has long been identified as a universally important second messenger during oocyte activation and many studies demonstrated that treatment with calcium ionophore may increase the free intracellular calcium, promoting oocyte activation, resulting in fertilization, embryo development and pregnancies. The aim of this study was to evaluate the effect of artificial oocyte activation (AOA) with calcium ionophore A23187 in ICSI cycles using sperm from different origins. It was evaluated 314 ICSI cycles divided in groups according to the origin of spermatozoa: EJACULATED group (n = 92), EPIDIDYMAL group (n = 82) and TESTICULAR group (n = 140). Each group was split into sub-groups depending on the AOA treatment: sub-group AOA, when it was performed AOA and sub-group Control-CT, when it was not performed AOA. Furthermore, it was evaluated separately only cycles in each woman were younger then 36 years old. After ICSI, oocytes were incubated in culture medium containing calcium ionophore A23187 (5ìM concentration) for 30 minutes and in approximately 20 hours oocytes were checked for normal fertilization, defined as observation of two distinct pronucleous. For each experimental group the following parameters were compared between the sub-groups AOA and CT: normal fertilization rate; partial fertilization fail rate; percentage of high quality embryos on the transfer day; implantation rate; pregnancy rate and miscarriage rate. For all the evaluated parameters, it was not observed any significant difference between the subgroups for the three spermatozoa origin groups.... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Reprodução humana, Inseminação artificial humana, Injeção Intracitoplasmática de Espermatozóide (ICSI), Ativação Oocitária Artificial (AOA), Artificial Oocyte Activation (AOA)
Como citar
BORGES JÚNIOR, Edson. A influência da ativação oocitária artificial com ionóforo de cálcio A23187 em pacientes submetidos a ciclos de injeção intracitoplasmática utilizando diferentes origens de espermatozóides. 2007. 91 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2007.