Can in vitro maturation overcome cycles with repeated oocyte maturation arrest? A classification system for maturation arrest and a cohort study

Hatırnaz, Şafak; Başbuğ, Alper; Hatırnaz, Ebru; Tannus, Samer; Hatırnaz, Kaan; Bakay, Kadir; Dahan, Michael H.

doi:10.1002/ijgo.13490

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Oocyte maturation failure was defined as bad egg syndrome and its subtypes were mentioned in a previous study ( 5 ), which focused on oocytes instead of patients. An Hatirnaz and Dahan classification standard has been proposed for patients, which, however, merely applied to patients in whom all oocytes were immature ( 17 ). Considering that patients often obtained both mature and immature oocytes, even after modified ovarian stimulation in subsequent IVF cycles, and there were no appropriate classification criteria for them, we proposed a modified classification standard based on the existing one to classify patients with different OMA phenotype.…”

Section: Methodsmentioning

confidence: 99%

Oocyte phenotype, genetic diagnosis, and clinical outcome in case of patients with oocyte maturation arrest

Zhu

Yang²,

Jin³

et al. 2022

Front. Endocrinol.

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Backgroundoocyte maturation arrest (OMA) is currently one of the major causes of in vitro fertilization (IVF) failure, and several gene mutations were found to be associated with OMA. The purpose of this study was to identify the oocyte phenotype, genetic diagnosis, and clinical outcomes of patients with OMA and explore their possible interrelationships, thus providing a more individualized and efficient treatment strategy guidance accordingly.MethodsA retrospective study was conducted, involving 28 infertile women with OMA in the Reproductive Medicine Center of Tongji Hospital from 2018 to 2021. Whole-exome sequencing was performed for the detection of gene mutations. Patients were classified into three groups based on their oocyte phenotype, and for each group, the immature oocytes were cultured in vitro and mature oocytes were fertilized to evaluate both the maturation capacity and developmental potential. The clinical outcomes of OMA patients with different gene mutations or from different groups were further analyzed and compared.ResultsTwenty-eight women with OMA were evaluated in this study. According to the stage of OMA, 14 (50.0%) women were classified as OMA Type-1 (GV arrest), 5 (17.9%) were OMA Type-2 (MI arrest), and 9 (32.1%) were OMA Type-3 (with both GV and MI arrest). Immature oocytes from OMA patients exhibited significantly lower maturation rates even after IVM, compared to those in general patients. Seven patients (25.0%) were detected to have deleterious variations in two genes (PATL2 and TUBB8), known to be associated with the OMA phenotype. Patients with identified mutations were found to have little opportunity to obtain offspring with their own oocytes. Among the patients without mutations identified, those classified as OMA Type-1 or Type-3 still had a chance to obtain offspring through IVF or natural pregnancy, while all patients in the Type-2 group failed to obtain live birth.ConclusionsThree different phenotypes were observed in patients with OMA. The clinical outcomes of patients were associated with the presence of gene mutations and the classification of oocyte phenotype, thus a reasonable triage system was proposed to optimize the allocation of health care resources and maximize patient benefit.

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Section: Methodsmentioning

confidence: 99%

Oocyte phenotype, genetic diagnosis, and clinical outcome in case of patients with oocyte maturation arrest

Zhu

Yang²,

Jin³

et al. 2022

Front. Endocrinol.

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show abstract

“…The Hatirnaz and Dahan classification systemin 2019 and the Beall et al in 2011 classification also both excluded patients with the diagnosis of EFS, premature ovarian failure (POI) and resistant ovary syndrome (ROS). Hatirnaz et al reported on a large number of OMA cases treated by FSH and hCG primed IVM cycles; however, no pregnancies were reported [ 6 ]. In the Hatirnaz and Dahan classification system, GV arrest was defined as Type I, MI arrest was defined as Type II, MII arrest was defined as Type III, GV-MI arrest was defined as Type IV and mixed arrest (GV, MI and MII) was defined as Type V [ 6 ].…”

Section: Nomenclature Of the Oocyte Maturation Abnormalitiesmentioning

confidence: 99%

“…Hatirnaz et al reported on a large number of OMA cases treated by FSH and hCG primed IVM cycles; however, no pregnancies were reported [ 6 ]. In the Hatirnaz and Dahan classification system, GV arrest was defined as Type I, MI arrest was defined as Type II, MII arrest was defined as Type III, GV-MI arrest was defined as Type IV and mixed arrest (GV, MI and MII) was defined as Type V [ 6 ].…”

Section: Nomenclature Of the Oocyte Maturation Abnormalitiesmentioning

confidence: 99%

“…Contrary to the present nomenclature that restricts the diagnosis of OMAS to certain subtypes, it seems that the diagnostic evaluation of OMAS needs to be extended. Two classification systems of oocyte maturation arrest were previously published [ 4 , 5 , 6 ]. These systems are based on excluding other abnormalities [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Two classification systems of oocyte maturation arrest were previously published [ 4 , 5 , 6 ]. These systems are based on excluding other abnormalities [ 4 , 5 , 6 ]. However, our ongoing study on OMAS revealed that there are novel subsets of oocyte maturation arrest and other pathologies such as oocyte degeneration, empty follicle syndrome (EFS), some forms of premature ovarian failure (POF) and resistant ovarian syndrome (ROS) that could be included in the OMAS classification [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unraveling the Puzzle: Oocyte Maturation Abnormalities (OMAS)

Hatırnaz¹,

Hatırnaz²,

Çelik

et al. 2022

Diagnostics

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Oocyte maturation abnormalities (OMAS) are a poorly understood area of reproductive medicine. Much remains to be understood about how OMAS occur. However, current knowledge has provided some insight into the mechanistic and genetic origins of this syndrome. In this study, current classifications of OMAS syndromes are discussed and areas of inadequacy are highlighted. We explain why empty follicle syndrome, dysmorphic oocytes, some types of premature ovarian insufficiency and resistant ovary syndrome can cause OMAS. We discuss live births in different types of OMAS and when subjects can be offered treatment with autologous oocytes. As such, we present this review of the mechanism and understanding of OMAS to better lead the clinician in understanding this difficult-to-treat diagnosis.

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TUBB8 mutations as a cause of oocyte maturation abnormalities: presentation of oocyte and embryo profiles and novel mutations

Ebru,

Dahan,

Sezer

et al. 2023

Reproductive BioMedicine Online

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Can in vitro maturation overcome cycles with repeated oocyte maturation arrest? A classification system for maturation arrest and a cohort study

Cited by 8 publications

References 15 publications

Oocyte phenotype, genetic diagnosis, and clinical outcome in case of patients with oocyte maturation arrest

Oocyte phenotype, genetic diagnosis, and clinical outcome in case of patients with oocyte maturation arrest

Unraveling the Puzzle: Oocyte Maturation Abnormalities (OMAS)

TUBB8 mutations as a cause of oocyte maturation abnormalities: presentation of oocyte and embryo profiles and novel mutations

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