The Developmental Competence of Oocytes Retrieved from The Leading Follicle in Controlled Ovarian Stimulated Cycles (original) (raw)
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A quantitative assessment of follicle size on oocyte developmental competence
Fertility and Sterility, 2008
Objective: To quantitatively assess the impact of follicle size on oocyte maturation, fertilization, and embryo quality. Design: Prospective study. Setting: Academic medical center. Patient(s): Couples undergoing ovarian stimulation and in vitro fertilization (IVF). Intervention(s): A total of 235 cycles were monitored prospectively, and 2934 oocytes were collected from five groups of follicle size. Repeated measures multivariate analyses were used to compare the smaller follicle sizes with the lead follicle. Main Outcome Measure(s): Oocyte maturation, fertilization, and embryo quality. Result(s): Compared with the lead follicular group (>18 mm), the odds of a mature oocyte from a 16 to 18 mm size follicle were 37% and declined progressively with each size. The odds of fertilization of oocytes from follicles 16 to 18 mm in size was 28% less than the lead group and decreased with each size. The rate of polyspermy with conventional insemination was increased for the smaller follicular groups (adjusted odds ratio ¼ 2.37). Follicle size did not predict embryo cell number, but embryos from smaller follicles had a statistically significantly higher fragmentation compared with the lead group. Conclusion(s): The lead follicular group was most likely to have a mature oocyte that was capable of fertilization and best suited for development into a high-quality embryo. The smaller follicles were capable of producing metaphase II oocytes that could fertilize, but at rates approaching only 60% that of the lead follicular group. (Fertil Steril Ò 2008;90:684-90.
Human …, 1998
As a consequence of multiple follicular growth during ovarian stimulation for in-vitro fertilization (IVF), follicles of varying sizes often yield oocytes that vary in maturity and morphology of the oocyte-cumulus-corona complex. The objective of this prospective study was to explore the relationship between follicular fluid aspirate volume and the oocyte's developmental potential in an IVF treatment cycle. In total 9933 follicles were studied from 400 patients who underwent 535 consecutive IVF treatment cycles at St James's University Hospital, Leeds, UK, between February 1995 and February 1996. The volume of each individual follicle aspirated was recorded and related to the probability of obtaining an oocyte, its fertilizing capacity, the cleavage rate and the quality of embryos derived. We found no statistically significant difference in oocyte recovery rates between follicles with an aspirate volume ഛ1 ml and follicles with a volume Ͼ1 ml. Although oocytes obtained from follicles with an aspirate volume ഛ1 ml showed a significantly lower fertilization rate, they went on to cleave at the same rate as oocytes obtained from larger follicles and resulted in embryos of comparable quality. Furthermore, there was no statistically significant difference in the implantation, clinical pregnancy or live birth rates per cycle between embryos derived from follicles with an aspirate volume ഛ1 ml and those derived from follicles with an aspirate volume Ͼ1 ml. We conclude that follicular size and the oocyte's developmental potential in the stimulated ovary are not closely related and can be independent. This is in contrast to the Graafian follicle and the preovulatory oocyte in the natural cycle.
Human Reproduction, 1999
The potential use of immature oocytes for in-vitro fertilization (IVF) requires the conditions for successful maturation to be defined. This study focused on the day of oocyte retrieval. The selection of a dominant follicle may induce endocrine changes in the remaining cohort that may be detrimental to their subsequent fertilization and embryonic development. Natural cycles in volunteer donors were followed by measurement of serum oestradiol and by vaginal ultrasound, starting on day 3 of the cycle. Cycles were randomly allocated to one of two groups: group 1 (n ⍧ 10), in which follicles were aspirated before the leading follicle was 10 mm in diameter; and group 2 (n ⍧ 9), in which follicles were aspirated when a dominant follicle was clearly visible with diameter >10 mm. Oocytes were cultured in vitro to metaphase II (MII) stage, donated, and inseminated by intracytoplasmic sperm injection (ICSI) with husband's spermatozoa. Those that became fertilized within 24 h were further co-cultured in autologous endometrial epithelial cells up to the blastocyst stage, and cryopreserved. There was a significantly (P < 0.05) increased rate of oocyte retrieval in group 1 (70.8% of aspirated follicles) compared with group 2 (50.5%). Maturation to MII and fertilization were similar between the groups. However, development to blastocyst stage was significantly (P < 0.05) higher in group 1 embryos (56.5%) compared with group 2 (35.7%). There was a positive correlation (r 2 ⍧ 0.1978) between the appearance of the cumulus cells and the ability to develop to blastocyst stage when both parameters were analysed in group 1, whereas no such correlation was found in group 2. In conclusion, our data suggest the importance of retrieving immature oocytes before follicular selection, and define the conditions for the first stage in the use of immature oocytes. Further stages must be defined before this technique can be used clinically.
Human Reproduction, 2019
STUDY QUESTION Is there is an association between follicle size and the quality of oocytes retrieved from them as judged by ability to achieve the blastocyst stage, blastocyst grades and blastocyst ploidy? SUMMARY ANSWER Although follicle size is a valuable predictor of oocyte maturity and is a significant predictor of the ability of a fertilized oocyte to become a quality blastocyst, the ploidy of each quality blastocyst is not related to the size of the follicle from which its oocyte was retrieved. WHAT IS KNOWN ALREADY It is unclear whether the oocytes within larger follicles are the best oocytes of the cohort. Although there have been studies examining follicle size in relation to embryo quality, there has been no study relating the incidence of euploidy in embryos to follicle size. STUDY DESIGN, SIZE, DURATION The purpose of this study was to examine follicle sizes and the oocytes from those follicles (and the embryos that result from those oocytes) to see if there is an associ...
Journal of Assisted Reproduction and Genetics, 2011
Purpose To examine the fertilization and developmental potential of sibling mature oocytes collected from different follicle sizes on day of retrieval in in vitro maturation (IVM) cycles. Methods Two hundred thirty eight hCG-primed IVM cycles were performed in 213 patients with polycystic ovaries. If sibling mature oocytes were retrieved on day of collection, they were divided into two groups, Group 1 (n= 78): M-II oocytes obtained from follicles size 10-14 mm; Group 2 (n=192): M-II oocytes obtained from follicles size <10 mm. Results Of the 238 cycles, 63 cycles had more than one M-II oocytes retrieved (total M-II oocytes=270) both from Groups 1 and 2. There were no significant differences between the two groups for oocyte diameter (117.2 mm vs. 116.9 mm), fertilization (79.5% vs. 72.4%) and good quality embryo on day 3 (66.1% vs. 56.8%).
Fertility and Sterility, 2019
assess variability of mean cycle FF AMH concentrations between IVF cycles for each woman and between participants. Mean cycle FF AMH concentrations were then divided into tertiles (T1-T3), and Kruskal-Wallis and x 2-tests were applied as appropriate to explore associations of demographic and reproductive characteristics across tertiles. RESULTS: The mean FF AMH concentration was 1.20 ng/ml (range¼0 to 24.0 ng/ml). There was high correlation between follicles within each IVF cycle (Spearman r¼0.78 to 0.86), and ICC indicated low within-woman variability of mean cycle FF AMH concentrations [0.87 (95% CI 0.81 to 0.92)].Compared to women in T1 of FF AMH concentrations (0.2 ng/mL), on average women in T3 (2.3 ng/mL) were younger (mean age in T3¼33.5 vs. T1¼36.0 years, p¼0.04), leaner [mean body mass index (BMI) in T3¼22.4 vs. T1 24.5 kg/m 2 , p¼0.04], had higher serum AMH concentrations (mean in T3¼0.6 vs. T1¼0.1 ng/mL, p¼0.0001), and lower day-3 follicular stimulating hormone (FSH) levels (mean T3¼6.4 vs. T1¼ 7.0 IU/L, p ¼ 0.03). Although most diagnoses were similar across tertiles of FF AMH concentrations, as expected, women in T3 were more often diagnosed with ovulatory disorders compared to women in T1 (T3¼17% vs. T1¼4%, p¼0.30). Smoking, education, and peak estradiol levels were not significantly associated with pre-ovulatory FF AMH concentrations. CONCLUSIONS: We observed that pre-ovulatory FF AMH concentrations are highly correlated within an IVF cycle and that within-woman variability is low across cycles, suggesting that a dominant follicle's AMH concentration may reflect a woman's overall FF AMH concentration. Furthermore, mean cycle FF AMH concentrations were associated with other markers of ovarian reserve, suggesting a possible role in predicting future reproductive outcomes.
Oocyte diameter as a predictor of fertilization and embryo quality in assisted reproduction cycles
Fertility and Sterility, 2010
Objective: To assess the impact of the mean oocyte diameter (MOD) on occurrence of fertilization and embryo quality in assisted reproduction cycles. Design: Prospective observational study. Setting: Sector of Human Reproduction of the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo (HCFMRP-USP). Patient(s): Thirty-five women undergoing intracytoplasmic sperm injection (ICSI) at the University Hospital of Ribeirão Preto from May to October 2007. Intervention(s): MOD assessment. Main Outcome Measure(s): Occurrence of fertilization and qualitative embryo classification on 2nd and 3rd day after ICSI.
Follicular fluid markers of oocyte developmental potential
Human Reproduction, 2002
BACKGROUND: Concentrations of certain substances in follicular fluid (FF) are related to fertilization outcome and early post-fertilization development. The study aim was to identify FF markers with which to predict embryo implantation potential. METHODS: Concentrations of selected hormones, cytokines and growth factors in individual FF samples obtained during assisted reproduction treatment were related with treatment outcomes. RESULTS: Mean concentrations of LH, growth hormone (GH), prolactin (PRL), 17β-estradiol (E2) and insulin-like growth factor (IGF)-I were higher, and that of interleukin-1 (IL-1) was lower, in treatment attempts leading to a clinical pregnancy as compared with those in which no pregnancy was established. Concentrations of FSH, progesterone, tumour necrosis factor-α and IGF-II were similar in successful and unsuccessful attempts. In successful attempts, LH and GH levels were higher in those follicles from which oocytes giving rise to transferred embryos (i.e. embryos with best morphology and fastest cleavage rate) originated, as compared with other follicles from which a mature oocyte was recovered but was cryopreserved for later use. CONCLUSIONS: FF levels of LH, GH, PRL, E2, IGF-I and IL-1 may serve to analyse cases of repeated assisted reproduction failures and to assess effects of modifications of the ovarian stimulation protocol.