Birth from cryopreserved embryos following in-vitro maturation of oocytes and intracytoplasmic sperm injection

Abstract

This case report describes the birth of a baby following the transfer of cryopreserved embryos generated from intracytoplasmic sperm injection (ICSI) carried out on the second day after oocyte pick-up of in-vitro-matured metaphase I and germinal vesicle stage oocytes. The couple had a history of three failed intrauterine insemination attempts and reduced fertilization rates in two previous in-vitro fertilization (IVF) cycles. In the IVF-ICSI treatment cycle, 6/11 mature oocytes became fertilized following ICSI on the first day. However, the patient failed to conceive following the transfer of three embryos. Five oocytes were immature (two at metaphase I stage and three with a germinal vesicle) and these were cultured overnight. All had extruded a polar body by the following day and ICSI was therefore performed; four oocytes became fertilized, and were cryopreserved at the pronulear stage in propanediol. In the next treatment cycle, transfer of frozen embryos was planned. The pronuclear zygotes were thawed and cultured for 24 h prior to the transfer of two embryos in a cycle stimulated with low doses of follicle stimulating hormone. This resulted in a pregnancy and the delivery of a healthy baby boy. In-vitro maturation of metaphase I and germinal vesicle oocytes which are routinely collected in IVF-ICSI cycles, followed by second day ICSI fertilization, may provide a valuable source of embryos for infertile couples.

Extended in vitro maturation of immature oocytes from stimulated cycles: an analysis of fertilization potential, embryo development, and reproductive outcomes

“…We initially felt that 24 h of IVM, with second day ICSI of those oocytes with delayed polar body extrusion, would improve the ultimate yield of MII oocytes, thus optimizing patient cycles. Successful pregnancies from such extended incubation have been reported in the literature, albeit with low incidence [14][15][16].…”

Rescue in vitro maturation (IVM) of immature oocytes in stimulated cycles in women with low functional ovarian reserve (LFOR)

“…Their oocytes also often are at much more divergent stages of maturation than in women with NFOR, where approximately 15-30 % of retrieved oocytes are immature at either germinal vesicle (GV) or metaphase I (MI) stages [5,6]. Most IVF centers consider such immature eggs unsuitable for use and, therefore, routinely discard them [7].…”

Mouse Oocyte Maturation and Blastocyst Culture In Vitro in Medium Adjusted to Human Follicular Fluid Composition.

“…However, the optimal concentrations of FSH and leutenizing hormone (LH) supplemented in the culture medium for in vitro oocyte maturation are not yet known. Edirisinghe et al [21] described the number of immature oocytes collected as being dependent on the individual, and the incidence of immature oocytes retrieved varied from 0 to 50%. Immature oocytes retrieved after hCG injection consisted of prophase I and metaphase I oocytes [22].…”