الفهرس 
CELL DIVISION AND ITS PHYSIOLOGYOnly 14 pages are availabe for public view
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Abstract
Since the introduction of ICSI into the clinical human IVF
laboratory, fertilization and development rates have surpassed all
previous microsurgical fertilization methods and have further improved
as experience was gained in performing the injection.
Nevertheless, there are still unexplored aspects of the actual sperm
injection that may affect the success of the procedure.
Our study was carried out on 40 infertile patients attended the
ART unit in Obst. & Gyne. department in Benha University Hospital.
All these patients were subjected to the same evaluation program
which included history taking, examinations (general, abdominal and
local), radiological (pelive ultrasound, hystrosalpingogrophy) and
laboratory evaluation Post Coital test (PCT), semen analysis, hormones
such as T.S.H, day 3 FSH, LH, E2, PRL.
Aetiology of the infertility was tubal factor in 14 cases (35%),
ovarian factor in 10 cases (25%), male factor in 8 cases (20%) and
unexplained infertility in 8 cases (20%),
Regarding the type of infertility, it was primary in 32 (80%) and
secondary in 8 cases (20%).
The mean age of the patients was 28.1 years, and the mean
duration of infertility was 8.67 years.
16 Cases (40%) had done IUI trials before and only 2 cases had
previous IVF trials .
SUMMARY
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Thirty three cases (82.5%) were subjected to long protocol of
ovarian stimulation, 4 cases (10%) were subjected to short protocol
while 3 cases (7.5%) had clomid plus HMG stimulation.
These patients underwent 52 Cycles of ICSI treatment. Semen
samples were obtained by masturbation and were prepared by standard
swim up technique in all patients. Oocyte retrieval was done 36 hours
after HCG administration.
A total number of 422 oocytes were collected, 347 (82.22%) were
mature at Mll stage and considered for ICSI while 75 (17.78%) were
immature and not included in the study.
Out of 422, 267 oocytes were injected at 3 o’clock position (site 1), 40
oocytes midway between 1 o’clock and 3 o’clock (site 2) and 40 oocytes
were injected midway between 3 o’clock and 6 o’clock (site 3).
The first polar body was positioned at 12 o’clock in all sites of
injection .
The fertilization rate in site 1 was (77.9%) and cleavage rate of the
fertilized oocyte was (87.98%).
The fertilization rate in site 2 was (12.5%) and the cleavage rate
was (0%) while the fertilization rate in site 3 was (60%) and cleavage
rate was (79.1%) .
The difference between site 1 and site 2 was statistically highly
significant ( P < 0.00l) .
There is higher rate of fertilization and cleavage in site I than in
site 3.and the difference was statistically significant .
SUMMARY
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So from this study we conclude that :
1- The best site of injection during ICSI is at 3 o’clock position of oocyte
while the first polar body is at 12 o’clock due to highest rate of
fertilization and cleavage than other sites of sperm injection .
1- The first polar body is an accurate marker for spindle location
2- The disturbances in spindle function may predispose oocytes to
fertilization arrest .
There are still unexplored aspects of the actual sperm injection
that may affect the success of the procedure.
A greater understanding of cytoplasmic compartmentalization will
in turn lead to refinements in manipulative procedures and improvement
in the development of manipulated eggs.