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Purpose  To investigate the relationship between the meiotic spindle size in human metaphase  II  oocytes and embryo developmental potential after intracytoplasmic sperm injection ( ICSI ).    Methods  Analyzed were 1302 oocytes with a visible meiotic spindle from 281 patients aged under 40 years undergoing  ICSI  cycles. The meiotic spindle was imaged by using PolScope before  ICSI . The oocytes were classified into three groups, according to spindle size: group A (<90 μm 2 ), group B (90‐120 μm 2 ), and group C (>120 μm 2 ).    Results  Overall, 389 (29.9%) oocytes were classified into group A, 662 (50.8%) into group B, and 251 (19.3%) into group C. The fertilization rate of the group B oocytes was significantly higher than for the A and C oocytes. The blastocyst formation rate in group B was significantly higher than in group A. In addition, the pregnancy rate in group B was significantly higher than in the other two groups.    Conclusion  The oocytes with a spindle size of 90‐120 μm 2  showed higher fertilization, blastocyst formation, and clinical pregnancy rates than those with larger or smaller spindles. The measurement of the meiotic spindle size thus has a positive predictive value for identifying human embryo developmental potential clinically.

Meiotic spindle size is a strong indicator of human oocyte quality