Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as bioc...Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes.There are some crucial steps known to clearly explain the process of fertilization,starting with hyperactivation of spermatozoa,mutual recognition,and binding of gametes mediated by receptors located on the surface membranes of both gametes.The final step is followed by oocyte activation,which is primarily triggered via sperm-derived factors,inducing a sharp increase in intracellular calcium levels,eventually leading to polyspermy block.This review integrates current knowledge of the molecular and physiological events governing fertilization,emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation.Special attention is given to sperm-derived factors such as phospholipase C zeta(PLCζ)and post-acrosomal sheath WW domain-binding protein(PAWP),which play essential roles in triggering calcium release and supporting early embryonic development.展开更多
Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activ...Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activation deficiency(OAD),in which fertilization is impeded due to the oocyte’s inability to initiate embryogenesis,commonly attributed to inadequate intracellular calcium(Ca^(2+))release following sperm injection.Patient concerns:The couple repeatedly experienced complete or near-complete fertilization failure in previous ICSI cycles,raising suspicion of an underlying oocyte activation defect.Diagnosis:Based on the repeated absence of fertilization post-ICSI and clinical history,a diagnosis of suspected OAD leading to recurrent ICSI fertilization failure was considered.Interventions:Artificial oocyte activation(AOA)using the calcium ionophore A23187 was performed.After ICSI,unfertilized oocytes were exposed to the ionophore to induce Ca^(2+)influx,simulating physiological calcium oscillations essential for oocyte activation.The efficacy of intervention was evaluated through subsequent embryonic development,morphological grading,and chromosomal integrity.Outcomes:Following AOA treatment,successful oocyte activation occurred,resulting in the formation of high-grade embryos with normal developmental progression.Chromosomal analysis revealed no detectable abnormalities,indicating genomic stability.Lessons:Calcium ionophore–mediated AOA may serve as an effective adjunct in cases of recurrent ICSI failure attributed to OAD.This case highlights the importance of individualized therapeutic strategies in assisted reproduction;however,further research is needed to refine protocols,validate broader clinical efficacy,and assess long-term safety,including potential epigenetic risks.展开更多
目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随...目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随机数字表法分为对照组和观察组,各46例。对照组患者接受常规护理,观察组患者接受Guided Care护理模式,两组均持续护理2 m。比较两组心理状态、治疗依从性、生活质量以及护理满意度。结果:护理后,观察组抑郁-焦虑-压力量表(Depression Anxiety Stress Scales,DASS)各项评分均较对照组低,Morisky改良版服药依从性量表(Morisky Medication Adherence Scale,MMAS-8)评分、(The Mos 36-item Short Form Health Survey,SF-36)评分及护理满意度均高于对照组(P<0.05)。结论:Guided Care护理模式能够有效改善不孕症患者接受IVF-ET治疗期间的焦虑、抑郁情绪,增强其治疗依从性,对于顺利妊娠具有积极意义,从而获得更高的护理满意度。展开更多
文摘Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes.There are some crucial steps known to clearly explain the process of fertilization,starting with hyperactivation of spermatozoa,mutual recognition,and binding of gametes mediated by receptors located on the surface membranes of both gametes.The final step is followed by oocyte activation,which is primarily triggered via sperm-derived factors,inducing a sharp increase in intracellular calcium levels,eventually leading to polyspermy block.This review integrates current knowledge of the molecular and physiological events governing fertilization,emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation.Special attention is given to sperm-derived factors such as phospholipase C zeta(PLCζ)and post-acrosomal sheath WW domain-binding protein(PAWP),which play essential roles in triggering calcium release and supporting early embryonic development.
文摘Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activation deficiency(OAD),in which fertilization is impeded due to the oocyte’s inability to initiate embryogenesis,commonly attributed to inadequate intracellular calcium(Ca^(2+))release following sperm injection.Patient concerns:The couple repeatedly experienced complete or near-complete fertilization failure in previous ICSI cycles,raising suspicion of an underlying oocyte activation defect.Diagnosis:Based on the repeated absence of fertilization post-ICSI and clinical history,a diagnosis of suspected OAD leading to recurrent ICSI fertilization failure was considered.Interventions:Artificial oocyte activation(AOA)using the calcium ionophore A23187 was performed.After ICSI,unfertilized oocytes were exposed to the ionophore to induce Ca^(2+)influx,simulating physiological calcium oscillations essential for oocyte activation.The efficacy of intervention was evaluated through subsequent embryonic development,morphological grading,and chromosomal integrity.Outcomes:Following AOA treatment,successful oocyte activation occurred,resulting in the formation of high-grade embryos with normal developmental progression.Chromosomal analysis revealed no detectable abnormalities,indicating genomic stability.Lessons:Calcium ionophore–mediated AOA may serve as an effective adjunct in cases of recurrent ICSI failure attributed to OAD.This case highlights the importance of individualized therapeutic strategies in assisted reproduction;however,further research is needed to refine protocols,validate broader clinical efficacy,and assess long-term safety,including potential epigenetic risks.
文摘目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随机数字表法分为对照组和观察组,各46例。对照组患者接受常规护理,观察组患者接受Guided Care护理模式,两组均持续护理2 m。比较两组心理状态、治疗依从性、生活质量以及护理满意度。结果:护理后,观察组抑郁-焦虑-压力量表(Depression Anxiety Stress Scales,DASS)各项评分均较对照组低,Morisky改良版服药依从性量表(Morisky Medication Adherence Scale,MMAS-8)评分、(The Mos 36-item Short Form Health Survey,SF-36)评分及护理满意度均高于对照组(P<0.05)。结论:Guided Care护理模式能够有效改善不孕症患者接受IVF-ET治疗期间的焦虑、抑郁情绪,增强其治疗依从性,对于顺利妊娠具有积极意义,从而获得更高的护理满意度。
