Revista Brasileira de Ginecologia e Obstetrícia (Aug 2008)
Anomalias meióticas de oócitos de pacientes com endometriose submetidas à estimulação ovariana Meiotic abnormalities of oocytes from patients with endometriosis submitted to ovarian stimulation
Abstract
OBJETIVO: avaliar o fuso meiótico e a distribuição cromossômica de oócitos maturados in vitro, obtidos de ciclos estimulados de mulheres inférteis com endometriose e fatores masculino e/ou tubário de infertilidade (Grupo Controle), comparando as taxas de maturação in vitro (MIV) entre os dois grupos avaliados. MÉTODOS: quatorze pacientes com endometriose e oito com fator tubário ou masculino, submetidas à estimulação ovariana para injeção intracitoplasmática de espermatozóide, foram selecionadas, prospectiva e consecutivamente, e constituíram os Grupos de Estudo e Controle, respectivamente. Oócitos imaturos (46 e 22, respectivamente, dos Grupos Endometriose e Controle) foram submetidos à MIV. Oócitos que apresentaram a extrusão do primeiro corpúsculo polar foram fixados e corados para avaliação dos microtúbulos e cromatina por técnica de imunofluorescência. A análise estatística foi realizada utilizando o teste exato de Fisher, com significância estatística quando pPURPOSE: to evaluate the meiotic spindle and the chromosome distribution of in vitro mature oocytes from stimulated cycles of infertile women with endometriosis, and with male and/or tubal infertility factors (Control Group), comparing the rates of in vitro maturation (IVM) between the two groups evaluated. METHODS: fourteen patients with endometriosis and eight with male and/or tubal infertility factors, submitted to ovarian stimulation for intracytoplasmatic sperm injection have been prospectively and consecutively selected, and formed a Study and Control Group, respectively. Immature oocytes (46 and 22, respectively, from the Endometriosis and Control Groups) were submitted to IVM. Oocytes presenting extrusion of the first polar corpuscle were fixed and stained for microtubules and chromatin evaluation through immunofluorescence technique. Statistical analysis has been done by the Fisher's exact test, with statistical significance at p<0.05. RESULTS: there was no significant difference in the IVM rates between the two groups evaluated (45.6 and 54.5% for the Endometriosis and Control Groups, respectively). The chromosome and meiotic spindle organization was observed in 18 and 11 oocytes from the Endometriosis and Control Groups, respectively. In the Endometriosis Group, eight oocytes (44.4%) presented themselves as normal metaphase II (MII), three (16.7%) as abnormal MII, five (27.8%) were in telophase stage I and two (11.1%) underwent parthenogenetic activation. In the Control Group, five oocytes (45.4%) presented themselves as normal MII, three (27.3%) as abnormal MII, one (9.1%) was in telophase stage I and two (18.2%) underwent parthenogenetic activation. There was no significant difference in meiotic anomaly rate between the oocytes in MII from both groups. CONCLUSIONS: the present study data did not show significant differences in the IVM or in the meiotic anomalies rate between the IVM oocytes from stimulated cycles of patients with endometriosis, as compared with controls. Nevertheless, they have suggested a delay in the outcome of oocyte meiosis I from patients with endometriosis, shown by the higher proportion of oocytes in telophase I observed in this group.
Keywords
