Successful delivery after the transfer of embryos obtained from a cohort of incompletely in vivo matured oocytes at retrieval time (original) (raw)
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Fertility and Sterility, 2007
To evaluate the fertilization and developmental potential of immature oocytes obtained from controlled ovarian hyperstimulated cycles of patients undergoing intracytoplasmic sperm injection (ICSI).Retrospective study.Academic assisted reproductive technology program.Two hundred patients with at least one mature oocyte and one immature oocyte (study 1), and 44 patients with no mature oocytes (study 2) at time of oocyte denudation.Oocyte denudation was performed immediately after retrieval. Oocytes were cultured in vitro for 4–6 hours before ICSI and then categorized into four groups: group I, metaphase II (MII) oocytes at denudation; group II, in vitro matured MII oocytes; group III, metaphase I (MI) oocytes that did not progress to MII; and group 4, germinal-vesicle (GV) oocytes that converted to MI.Fertilization and embryo development were compared among groups in study 1. Pregnancy and implantation rates were evaluated in study 2.Although the fertilization rate in group III was significantly lower than in groups I and II, no significant difference was found between groups I and II. Day 3 embryos in group I had the highest mean number of blastomeres, proportions of good embryos, and blastocyst formation rate when compared with groups II and III. Two clinical pregnancies were achieved from 26 transfer cycles in study 2, resulting in pregnancy and implantation rates of 7.7% and 4% per transfer cycle, respectively.Although our results show that immature oocytes from stimulated cycles can be normally fertilized and used to increase the number of embryos available for transfer, the increase in number of embryos derived from immature oocytes cannot be efficiently translated into pregnancies and live births. The clinical significance of using immature oocytes in stimulated cycles needs further investigation.
Archives of Andrology, 2000
To ascertain the value of using immature oocytes in an intracytoplasmic sperm injection (ICSI) program, the authors designed a schedule, at 5 p.m. on day 1 (the day of oocyte retrieval) and at 8 a.m. and 2 p.m. on day 2, to recognize and inject the in vitro matured (IVM) oocytes. For the 1166 oocytes retrieved in 107 ICSI cycles, 128 (11.0%) were at the stage of metaphase I (MI) and 113 (9.7%) at germinal vesicle. Routine ICSI for metaphase II oocytes was performed at 2 p.m. on day 1 (initial ICSI). In culture medium of human tubal fluid with 15% maternal serum, 85.1% (205/241) immature oocytes progressed to maturation in which 16.4% (21/128) of MI oocytes matured at 5 p.m. of day 1. The rate of normal fertilization for IVM oocytes (58.5%) was not significantly different from that of initial ICSI (64.0%). One patient received a transfer of two fertilized IVM oocytes alone that were injected at 5 p.m. of day 1, maturing from the MI stage, and achieved a normal pregnancy. The fertilized IVM oocytes were replaced along with the embryos from initial ICSI for 40 cycles that led to 14 (35%) clinical pregnancies. In 43 fertilized IVM oocytes donated for research, we observed that cleavage (95.3%) to the 2-to 4-cell stage was not distinct from that of initial ICSI (94.6%); however, the percentage of embryos of grade I and II morphology was significantly smaller (24.4% vs. 62.5%). Only five (11.6%) developed to blastocysts in vitro. Twenty-one fertilized IVM oocytes were frozen for future transfer. A schedule to inject IVM oocytes in ICSI cycles may generate more accessible embryos for fresh transfer or cryopreservation to increase the chance of pregnancy, although the embryo quality was relatively poor.
Fertility and Sterility, 2012
Objective: To determine the incidence of fragmented oocytes in intracytoplasmic sperm injection (ICSI) cycles, describe the developmental potential of their sibling oocytes, and define clinical outcomes from affected cycles. (n ¼ 2,844) were reviewed for the presence of fragmented oocytes at cumulus stripping or fertilization check (n ¼ 93). Sibling oocytes and corresponding embryos from index cycles were compared with matched control cycles without fragmented oocytes. Intervention(s): None. Main Outcome Measure(s): Cycle characteristics, embryo quality, and pregnancy rates per retrieval. Result(s): The incidence of ICSI cycles containing at least one fragmented oocyte was 3.3% (93/2,844). Twelve patients were represented more than once in these 93 index cycles. Only the first cycles (n ¼ 81) were included, of which 28 contained fragmented oocytes at cumulus stripping, 48 at fertilization check, and five at both. Compared with matched controls, index cycles had fewer good-quality embryos available for transfer (18.8% vs. 32.1%) and significantly lower rates of implantation (20.3% vs. 32.7%), clinical pregnancy (33.3% vs. 58.0%), and ongoing delivery (29.6% vs. 49.4%). The cumulative ongoing delivered rate was also significantly lower for index cycles (32.1% vs. 55.6%), with no difference in the percentage of cycles with cryopreserved embryos remaining at study conclusion (13.5% vs. 23.5%). Conclusion(s): Cohorts containing fragmented oocytes have decreased developmental potential. The biologic mechanisms underlying this occurrence merit further investigation, and patient counseling should reflect the possible decreased success rates associated with this aberrant developmental pattern. (Fertil Steril Ò 2012;97:338-43.
1995
Immature oocyte recovery followed by in-vitro oocyte maturation and in-vitro fertilization is a promising new technology for the treatment of human infertility. The technology is attractive to potential oocyte donors and infertile couples because of its reduced treatment intervention. Immature oocytes were recovered by ultrasoundguided transvaginal follicular aspiration. Oocytes were matured in vitro for 36-48 h followed by intracytoplasmic sperm injection (ICSI). Embryos were cultured in vitro for 3 or 5 days before replacement. Assisted hatching was performed on a day 5 blastocyst stage embryo. Embryo and uterine synchrony were potentially enhanced by luteinization of the dominant follicle at the time of immature oocyte recovery. Mature oocyte and embryo production from immature oocyte recovery were similar to the previous IVF results of the patients. A blastocyst stage embryo, produced as a result of in-vitro maturation, ICSI, in-vitro culture and assisted hatching, resulted in the birth of a healthy baby girl at 39 weeks of gestation.
Evidence Based Womenʼs Health Journal, 2015
The aim of this study was to evaluate the role of the percentage of retrieved immature oocytes on intracytoplasmic sperm injection (ICSI) outcomes. Patients and methods A total of 100 ICSI cycles were included in this prospective evaluation. Patients were divided into two groups. Group A included patients with the percentage of mature (M2) oocytes more than 50%, and group B included patients with the percentage of mature oocytes (M2) less than 50% of the total retrieved oocytes. The impacts of the percentages of GV and MI oocytes were assessed on the rates of fertilization, implantation, embryo grading, and pregnancy rate. Results Implantation rate appeared to be significantly high; the implantation rate in group A was 33.2%, versus 17.8% in group B (P = 0.036). Fertilization rate also appeared to be significant; it was 71.63% for group A and 48.58% for group B (P = 0.049). There was statistical difference between group A and group B as regards embryo grading (D3). A positive b-human chorionic gonadotropin test followed by fetal heart beat detection occurred in 46% of group A and in 34% of group B patients. It was statistically significant (P = 0.049). Conclusion Our data demonstrated that the percentage of immature oocytes may be useful in the prognosis of ICSI outcome. If the percentage of immature oocytes is higher than 50%, the fertilization was significantly lower.
Successful birth following transfer of frozen–thawed embryos produced from in-vitro matured oocytes
Reproductive BioMedicine Online, 2010
She is Medical Director of the Gurgan Clinic Women Health, Infertility and IVF Center, Ankara, Turkey where she works on both clinical and research aspects in the IVF Unit. She is involved in research projects related to infertility and IVF and has published many international and national studies. She has participated in the organization of many international and national meetings.
The successful use of pronuclear embryo transfers the day following oocyte retrieval
1998
A retrospective analysis of results from 114 initiated in-vitro fertilization cycles utilizing pronuclear embryo transfer is presented. Patients were unselected for age or infertility criteria, constituted a continuous series and were grouped according to response to stimulation (Group 1, ideal; Group 2, suboptimal) or ovarian reserve (Group 3, poor). At 16-18 h post-insemination, embryos were scored for alignment of pronuclei and nucleoli and the appearance of the cytoplasm, generating an embryo score (ES). Transfers were performed 24-26 h post-insemination using two to six embryos with the highest ES. A corrected score was calculated (total score/number of embryos; CS). A total of 114 initiated cycles resulted in 97 oocyte retrievals with 38 clinical pregnancies (39%; 15% implantation). Pregnancy rates were significantly different between the three groups; 37 pregnancies in Group 1 (55% clinical pregnancy; 20% implantation), none in Group 2 and one in Group 3 (6%; 2% implantation: P Ͻ 0.001). The ES of transferred embryos correlated with groups. There was a strong correlation between CS and implantation and delivery rates. CS Ͼ15 resulted in a 28% implantation; 65% delivery rate. CS Ͻ14 resulted in four pregnancies, one delivered. The data show that oocyte quality and pronuclear embryo morphology are related to implantation and that pronuclear embryos can be successfully selected for embryo transfer.
Human Reproduction, 1996
A cohort comprising a total of 447 oocyte aspirations due to male factors (« = 258) or to previous fertilization failure by IVF in the presence of normal sperm parameters (n = 189) was studied. We found a significantly reduced implantation and pregnancy rate per transfer in the group with previously failed IVF attempts compared to the male factor group (P < 0.001). No differences were found in age, number of oocytes retrieved, number of embryos transferred or quality of embryos scored at the time of transfer. However, the fertilization and cleavage rates were found to be reduced in the group with previous failed IVF cycles. It is therefore concluded that previous fertilization failure despite normal sperm parameters in an IVF cycle may not be alleviated by the intracytoplasmic sperm injection (ICSI) procedure. These patients might suffer from oocyte defects as well.
Reproductive BioMedicine Online, 2004
Although, it is well known that pre-incubation of oocytes prior to conventional IVF improves fertilization and pregnancy rates, there are conflicting results regarding the effect of pre-incubation time in ICSI. This study evaluated the role of pre-incubation of oocytes on outcome in intracytoplasmic sperm injection (ICSI) cycles. A total of 1260 patients undergoing their first ICSI cycles were evaluated retrospectively. In patients undergoing ICSI during the year 2000 (Group I, n = 670), oocytes were injected immediately after retrieval, whereas in patients undergoing ICSI during 2001 (Group II, n = 590), oocytes were incubated for 2-4 h prior to injection. The mean age of patients was 33.9 +/- 5.04 years and 34.1 +/- 5.06 years in groups I and II, respectively. The number of oocytes with a first polar body (MII) and fertilization and cleavage rates were higher, and embryo quality was significantly better in group II. In contrast, the total numbers of oocytes without a first polar body (MI), those where germinal vesicle breakdown had not occurred (GV), and empty zona oocytes were higher in group I. No difference was found in the number of embryos transferred or implantation or clinical pregnancy rates. This study demonstrated that pre-incubation of oocytes prior to ICSI is associated with improved maturation of oocytes, fertilization and embryo quality.
Fertility and Sterility, 1997
Objective: To report a normal pregnancy and the delivery of a healthy child after the combination of in vitro maturation of germinal-vesicle stage oocytes and intracytoplasmic sperm injection (ICSI) in a patient. Setting: Procedures were performed in a tertiary IVF center coupled with an institutional research environment. Main Outcome Measures: Maturation rate of immature oocytes after in vitro maturation and intactness, fertilization, and developmental rates of oocytes after microinjection. Results: Nine of 14 germinal-vesicle stage oocytes matured to the metaphase II stage after 30 hours of in vitro culture (64%). Seven of eight injected and intact oocytes fertilized normally (78%) and five ofthem cleavlld with <20% fragmentation (71%). Four embryos were transferred and a singleton pregnancy was obtained that ended in the delivery of a healthy child. Conclusion: In vitro maturation of immature oocytes together with ICSI can result in normal fertilization, embryo development, pregnancy, and the delivery of healthy child.