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Spindle observation aids decision-making for early rescue ICSI

  • Embryo Biology
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Objective

To investigate whether spindle visualization using polarized light microscopy (PLM) can assist in identifying unfertilized oocytes prior to early rescue intracytoplasmic sperm injection (R-ICSI).

Methods

This retrospective cohort study included 356 early R-ICSI cycles, of which 24 were excluded from the analysis. The remaining 332 cycles were divided into study group and control group based on whether spindle observation had been performed before early R-ICSI. The fertilization rate, embryo development, and clinical outcome were compared between the two groups.

Results

Of the 356 participants included, 332 completed follow-up analysis. The study group demonstrated a significantly higher normal fertilization rate (82.55% vs. 71.49%, P < 0.01) and a lower 3PN rate (3.17% vs. 8.89%, P < 0.01) after following R-ICSI. For oocytes without visible spindles in the study group or those with fragmented polar bodies in the control group, in vitro fertilization (IVF) was performed, resulting in a higher normal fertilization rate in the study group (53.37% vs. 36.43%, P < 0.01). However, there was no significant difference between the two groups in terms of embryo development and implantation potential. In the high-age subgroup (over 35 years old), the normal cleavage rate was significantly higher in the spindle examination group compared to the non-observation group (38.60% vs. 22.47%, P < 0.05).

Conclusion

Utilizing PLM for spindle observation can effectively identify oocytes suitable for early R-ICSI to improve fertilization outcomes and optimize embryo development in women over 35 years old.

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Data availability

Data will be made available on request.

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Acknowledgements

We extend our sincere appreciation to all colleagues who were responsible for case recruitment, technical procedures, data documentation, and statistical evaluation.

Funding

This work was supported by the Natural Science Foundation Project of Chongqing, Chongqing Science and Technology Commission (Grant Number: CSTB2022 NSCQ-MSX0253).

Author information

Authors and Affiliations

  1. Center for Reproductive Medicine, Women and Children’s Hospital, Chongqing Medical University, Chongqing, China

    Yang Gao, Jiahong Zhu, Shun Xiong, Jiang Wang, Xiangwei Hao, Haiyuan Liao, Wei Han, Junxia Liu & Guoning Huang

  2. Chongqing Key Laboratory of Human Embryo Engineering, Chongqing, China

    Yang Gao, Jiahong Zhu, Shun Xiong, Jiang Wang, Xiangwei Hao, Haiyuan Liao, Wei Han, Junxia Liu & Guoning Huang

  3. Chongqing Clinical Research Centre for Reproductive Medicine, Chongqing, China

    Guoning Huang

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  1. Yang Gao
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Contributions

YG.: designed research, analyzed data, and wrote the manuscript. JHZ., SX., and JW.: recorded data and followed up the outcomes. XWH. and HYL.: implemented the technical operation. WH. and JXL.: recruited patients and collected informed consent. GNH.: guided the experiment. All authors read and approved the manuscript.

Corresponding authors

Correspondence to Yang Gao or Junxia Liu.

Ethics declarations

Ethical approval and consent to participate

This study was approved by the Ethics Committee Review Board of the Chongqing Health Center for Women and Children on 22 June 2021 (Approval No. 2021-RGI- 02). All patients provided informed consent prior to inclusion in the study.

Conflict of interest

The authors declare no competing interests.

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Gao, Y., Zhu, J., Xiong, S. et al. Spindle observation aids decision-making for early rescue ICSI. J Assist Reprod Genet (2025). https://doi.org/10.1007/s10815-025-03474-w

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