# The Implications of the Meiotic Spindle Visualization Technique on In Vitro Fertilization (IVF) Outcome in a Perimenopausal Patient

## TL;DR

A perimenopausal woman undergoing IVF had a successful pregnancy after using a meiotic spindle visualization technique to time ICSI.

## Contribution

Demonstrates the potential of meiotic spindle visualization to improve IVF outcomes in perimenopausal patients.

## Key findings

- Meiotic spindle visualization helped time ICSI accurately in a perimenopausal patient.
- The technique led to successful blastocyst formation and a positive pregnancy outcome.
- The patient had a successful embryo transfer and confirmed pregnancy.

## Abstract

An infertile couple visited an in vitro fertilization center situated in Maharashtra, India, seeking treatment for primary infertility. The 39-year-old premenopausal woman had a history of two intrauterine inseminations and intracytoplasmic sperm injections (ICSI), along with a history of tuberculosis from six years, and a normal hormonal range. The male was normozoospermic. The patient was given a gonadotropin-releasing hormone antagonist treatment and triggered before 36 hours of ovum pickup (OPU), but the cycle failed. Due to normal blood parameters, it was decided to use an optimal microscope using a polarizing filter to check the timing of meiotic spindle (MS) formation in the oocytes. The patient was triggered again for OPU, and during the procedure, 14 oocytes were retrieved. It was decided to perform ICSI after seven and a half hours of OPU post-observation of MS formation around the same hour. On day 21, the patient was suggested for embryo transfer (ET), where two blastocysts (4AA and 3AA) were transferred into the uterus. After a successful ET, the patient was discharged from the hospital. On day 14, a beta-human chronic gonadotrophin report revealed a positive pregnancy (910 mIU/mL).