In vitro maturation and fertilization of oocytes from unstimulated ovaries in infertile women with polycystic ovary syndrome

Zhao, Junzhao; Zhou, Wei; Zhang, Wei; Ge, Heng; Huang, Xuefeng; Lin, Jie

doi:10.1016/j.fertnstert.2008.03.059

Cited by 48 publications

(44 citation statements)

References 13 publications

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“…However, these data have been questioned after a meta-analysis showed that there are no randomized controlled trials upon which one can base a conclusion on the use of IVM or conventional IVF for patients with PCOS [16]. On the other hand, a recent report [21] and our own experience show that implantation and pregnancy rates around 16 and 32-36%, respectively, after IVM are much superior to the first reports and close to results attained after classical IVF/ICSI cycles. This observation, together with the fact that we had five multiple gestations suggests that, although day-3 embryo quality seems to be impaired after IVM, their developmental potential is not affected and an IVM-own embryo scoring system should be proposed to compensate for their developmental delay.…”

Section: Discussionmentioning

confidence: 99%

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Fertilization outcome, embryo development and birth after unstimulated IVM

Bös-Mikich

Ferreira²,

Höher³

et al. 2010

J Assist Reprod Genet

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Background/Purposes A common observation in oocyte in vitro maturation (IVM) cycles is poor embryo quality. However, no study was dedicated to assess zygote and early cleavage embryo quality in IVM cycles. The objective of this study is to analyze fertilization outcome, embryo development and the resulting pregnancy and births in unstimulated IVM cycles. Methods IVM oocytes were collected 36 h post hCG and matured in vitro for 28-30 h. All oocytes were inseminated by ICSI. Resulting zygotes and embryos were assessed on day-1, 2 and 3, when transfers were made. Results The overall oocyte maturation and fertilization rates were 63% and 62%, respectively. Abnormal fertilization rate was 1.7%. Ninety five and 14.6% of the 2Pn zygotes reached the 2-cell and 8 -cell stage at day-2 and day-3, respectively. Embryo quality assessment on day-3 at transfer revealed that only 9% of the embryos were of very good quality. Most embryos showed developmental delay. An average of 3.29 embryos were transferred per patient resulting in implantation and clinical gestation rates of 16% and 32%, respectively. Overall 14 healthy babies were born and there is one ongoing pregnancy. ConclusionResults show a significant rate of abnormal fertilization and poor embryo quality after IVM, which is reflected in a higher than average number of embryos being transferred. However, pregnancy, implantation and birth rates are reasonably high and allow us to consider IVM a valuable approach for the treatment of infertility in PCO or PCOS patients.

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Section: Discussionmentioning

confidence: 99%

“…IVM reported success rates vary considerably among services [1,2,4,8,11,17,18,19,21]. It is acknowledged that the methodology for IVM of oocytes collected from unstimulated ovaries and embryo development is still not ideal [12].…”

Section: Introductionmentioning

confidence: 99%

Fertilization outcome, embryo development and birth after unstimulated IVM

Bös-Mikich

Ferreira²,

Höher³

et al. 2010

J Assist Reprod Genet

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“…Retrieved oocytes are cultured in the laboratory and after they achieve maturity, oocytes are treated as in conventional IVF. Usually 60-80 % of oocytes will become mature and the fertilization rate is similar to that of conventional IVF [1,2,7,11,17]. Some studies suggest that successful pregnancy with IVM is correlated with the number oocytes retrieved [3].…”

Section: Introductionmentioning

confidence: 96%

A comparison of the Cook single lumen immature ovum IVM needle to the Steiner-Tan pseudo double lumen flushing needle for oocyte retrieval for IVM

Rose¹,

Laky²

2013

J Assist Reprod Genet

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Purpose This study compared the impact of using the Steiner-Tan pseudo double lumen needle for antral follicle oocyte retrieval to using a conventional non-flushing needle. The Steiner-Tan needle has a much smaller dead space than the needles commonly used for IVM oocyte retrievals. Methods This was a retrospective cohort study. The patient population was determined by the time period in which a patient underwent IVM in a single physician's IVF practice. The following data was abstracted from clinical and embryology records: oocytes retrieved, oocytes matured, early maturing oocytes, oocytes fertilized, embryo quality measures, retrieval time, needle punctures, clot formation, and clinical pregnancy rate. Results The Steiner-Tan needle did not increase the number of oocytes retrieved. It also did not increase the time required for retrieval. However, flushing of antral follicles significantly decreased clot formation in fluid aspirates. Use of the Steiner-Tan needle also significantly decreased the number of vaginal needle punctures during each case. There was a trend toward improved embryo quality, but statistical power was inadequate to show a difference. Conclusions The primary benefit of the Steiner-Tan needle was on the embryological aspects of IVM. Decreased blood and blood clots in the aspirates made an IVM retrieval more like conventional IVF for the embryologist. The patient also experienced less tissue trauma without increasing anesthesia or surgical time. There was no improvement in the number of oocytes retrieved, but based on the results, we hypothesized that oocytes were more commonly retrieved from slightly large follicles than when using a routine needle.

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“…Several studies have reported pregnancies after IVM in PCOS with unstimulated cycles, also in cycles with FSH and hCG priming [2][3][4][5]. We believe that this is the first case report in which FSH priming was delayed until 13 th day of the cycle, when endometrial thickness reached 7 mm by endogenous estrogen.…”

Section: Discussionmentioning

confidence: 74%

“…Women with polycystic ovarian syndrome (PCOS) are considered as the target population for this approach. This group of patients is extremely sensitive to ovarian stimulation and have a high potential for developing of OHSS [3].…”

Section: Introductionmentioning

confidence: 99%