Embryo development and chromosomal anomalies after ICSI: effect of the injection procedure.

Intracytoplasmic sperm injection (ICSI) is a delicate procedure requiring considerable skills of the person performing it. Theoretically, the injection procedure could damage cytoplasmic structures in the oocyte, resulting in sublethal cellular injury and/or numerical chromosomal abnormalities that could lead to impaired embryonic development. In the present study, features of the injection procedure were evaluated in a total of 2924 oocytes from 305 cycles. Development to the blastocyst stage was found to be compromised in a group of surplus embryos originating from oocytes in which >6 pl of cytoplasm was aspirated into the injection pipette during the ICSI procedure. Characteristics of the injection procedure as well as blastocyst development of surplus embryos was shown to be significantly different between the four technicians performing the ICSI. Neither the volume of cytoplasm aspirated during the injection procedure, nor the position of the polar body (6 o'clock or 12 o'clock) influenced the mean incidence of disomic cells per blastocyst as revealed by fluorescence in-situ hybridization using probes specific for chromosomes X, Y and 18. In conclusion, certain technical aspects of the injection procedure can affect subsequent embryonic development to the blastocyst stage, but do not seem to influence the rate of chromosomal abnormalities that occur in human pre-implantation embryos.