Immature oocyte incidence: Contributing factors and effects on mature sibling oocytes in intracytoplasmic sperm injection cycles

Abstract

Objective: The aim of this study was to investigate which factors contribute to the incidence of immature oocytes (germinal vesicle-GV-and metaphase I-MI-) and how they impact the intracytoplasmic sperm injection (ICSI) outcomes of sibling mature oocytes. Methods: Data from 3,920 cycles performed from June/2010 to August/2016 in a private university-affiliated IVF center were evaluated for the influence of controlled ovarian stimulation protocol (COS) on immature oocytes incidence and its effects on ICSI outcomes. Results: MI (p=0.004) and GV (p=0.029) number were negatively correlated with gonadotropin dose. Patients stimulated by rFSH had increased GV/oocyte rate in both GnRH agonists (p<0.001) and antagonist (p=0.042) protocols, in comparison to rFSH associated with rLH protocol. MI and GV/oocyte rates were negatively correlated to fertilization (p<0.001), high-quality embryo on da p<0.001; GV/oocyte p=0.033) and pregnancy (MI/oocyte p=0.002; GV/oocyte p=0.013) rates. Cycles above a 10.5% MI/oocyte cutoff were correlated to higher response to ovarian stimulation, poor embryo development and almost two times lower pregnancy rate. Immature oocyte incidence is affected by COS and impacts on ICSI outcomes. Conclusion: Our evidence suggests that oocytes derived from a cohort with high incidence of maturation fail may have detrimental clinical outcomes.

The usefulness of metaphase I oocytes in women who undergo controlled ovarian hyperstimulation for intracytoplasmic sperm injection

“…We found a rescued maturation rate of 57% of MI oocytes after 4 hours of incubation in culture medium, and these rates were similar to those of other studies that reported rates between 43 and 54% in the first 4-6 hours (Shu et al, 2007;Vanhoutte et al, 2005;Álvarez et al, 2013). Regarding incubation time, Strassburger et al (2004) found that 13% of MI oocytes subjected to rescue maturation matured within 1 hour and that another 41% matured within 2.5 hours, revealing that most MI oocytes (54%) matured in vitro to MII oocytes after 2.5 hours of incubation; however, the performance of these oocytes with respect to embryonic development appears to be reduced compared with MII oocytes (Braga et al, 2020).…”

“…Regarding incubation time, Strassburger et al . (2004 ) found that 13% of MI oocytes subjected to rescue maturation matured within 1 hour and that another 41% matured within 2.5 hours, revealing that most MI oocytes (54%) matured in vitro to MII oocytes after 2.5 hours of incubation; however, the performance of these oocytes with respect to embryonic development appears to be reduced compared with MII oocytes ( Braga et al ., 2020 ).…”

“…During aspiration, oocytes are collected from heterogeneous groups of follicles, and mature oocytes in metaphase II (MII) or meiotically immature oocytes in metaphase I (MI) or prophase I (PI) may be captured ( Stouffer & Zelinski-Wooten, 2004 ). The proportion of immature oocytes among collected oocytes generally ranges from 10 to 20%, and a high number of immature oocytes can negatively affect the ICSI outcomes of mature oocytes from the same woman ( Braga et al ., 2020 ).…”

Evaluation of Protocols of Controlled Ovarian Stimulation in Obtaining Mature Oocytes (MII): Retrospective Study on Assisted Reproductive Technology Procedures

“…Different COS protocols entail different combinations of hormones that may lead to follicular asynchrony and variations in the quantity, quality, viability, and competence of oocytes. Therefore, it is extremely important to analyze the quantity and quality of stimulation given to patients (Braga et al, 2020;Quaas & Legro, 2019) It is important that patients undergo preparation before the initiation of COS. To facilitate scheduling for women undergoing treatment and ART centers, combined oral contraceptives (COC) have been prescribed prior to the initiation of treatment cycles to schedule and date menstruation. According to studies (Biljan et al, 1998;Griesinger et al, 2008), the use of COC provides other advantages, such as improved follicular timing during ovulation stimulation, lower cancellation rates in hyper-responsive women, and greater number of aspirated oocytes.…”

Oocyte Competence Biomarkers Associated With Oocyte Maturation: A Review

“…The protocols generally comprise of administering a combination of gonadotrophin analogs namely gonadotropins-releasing hormone (GnRH) agonist or antagonist, estradiol inhibitors, recombinant follicle-stimulating hormone (FSH), and luteinizing hormone (LH) (Gallos et al, 2017). While the drug regimens hold paramount importance for IVF and have been established and refined through years of clinical practice and research, the incidence of asynchronous ovarian response persists (Braga et al, 2020). This is evident in the miscellaneous yield of abnormal, immature, and poor-quality oocytes at retrieval.…”