Abstract: 【Abstract】 Objective To study the effects of the clinical and M Ⅱ phase cell morphology on embryonic development in intracytoplasmic sperm injection (ICSI) cycles. Methods The clinical data of female patients treated with ICSI from January to May 2019 in Changzheng Hospital affiliated to Naval Military Medical University and the morphological description of oocyte cells in M Ⅱ phase were selected (30 patients, 285 M Ⅱ phase oocytes). The influence of the clinical factors of female spouse including infertility type, infertility life, body mass index (BMI), follicle-stimulating hormone (FSH), estradiol, treatment scheme, transparent space,peripheral egg clearance, polar fragmentation, polar form, cell morphology, central particles, intracgranulesorigami, and other M Ⅱ follicles on embryo development were investigated. Chi-square test was used to examine the difference in frequency in two groups. Univariate and multivariate Logistic regression were used to analyze the relationship between clinical and oocyte morphology and embryo quality, the Nomogramanalysis and predictive model were constructed using the R language, and the prediction efficiency was evaluated using the ROC curve. Results ① A total of 285 M Ⅱ phase oocytes were included, of which 87.7% of the MⅡ stage oocytes were abnormal in morphology, and the most common was the abnormality of ytoplasm. ② There were differences between normal and abnormal groups of phase M Ⅱ egg morphology in excellent embryo acquisition probability, with statistically significant (P=0.004). ③ Multi-factor Logistic regression analysis found infertility types only (OR=2.964, 95%CI : 1.564-5.615, P=0.001) and egg morphology (OR=2.992, 95%CI : 1.368-6.545, P=0.006) had statistical differences in the clinical factors. ④Single and multifactor Logistic regression analysis found central zone particles (OR=0.244, 95%CI : 0.091-0.654,P=0.005) and perivitelline space (OR=0.377, 95%CI : 0.173-0.660, P=0.001) were related to embryo quality.⑤ Clinical factors and morphology were included in Logistics regression again, and P<0.2 factors were included to construct the Nomogram prediction model. ROC curve was drawn and the efficiency of the prediction model was evaluated (the area under the curve was 0.787, 95%CI : 0.730-0.844). Conclusion The abnormality of central granule and perioocyte space of M Ⅱ phase oocyte cells has a great influence on embryo quality, and the probability of obtaining high quality embryo is low in primary infertile female spouse.
2021, Vol. 9 
