Developmental capacity of in vitro-matured human oocytes retrieved from polycystic ovary syndrome ovaries containing no follicles larger than 6 mm

Capsule:
Contrary to earlier belief, immature oocytes retrieved from small antral follicles with a diameter of

Authors:
Luis Guzman, M.Sc., Carolina Ortega-Hrepich, M.D., Firas K. Albuz, Ph.D., Greta Verheyen, Ph.D., Paul Devroey, M.D., Ph.D., Johan Smitz, M.D., Ph.D., Michel De Vos, M.D., Ph.D.

Volume 98, Issue 2 , Pages 503-507.e2, August 2012

Abstract:

Objective:
To test the developmental competence of oocytes in a nonhCG-triggered in vitro maturation (IVM) system when oocyte-cumulus complexes (OCC) are retrieved from antral follicles with a diameter of

Design:
Prospective cohort study.

Setting:
Tertiary university-based referral center.

Patient(s):
From January 2010 to September 2011, 121 patients with polycystic ovaries/polycystic ovary syndrome underwent 239 IVM cycles in total. In 58 of these cycles (44 patients), all antral follicles had a diameter of

Intervention(s):
NonhCG-triggered IVM of oocytes, fresh or vitrified/warmed embryo transfer (ET).

Main Outcome Measure(s):
Oocyte diameter, maturation rate, fertilization rate, embryo development and morphology, implantation rate, clinical pregnancy rate, ongoing pregnancy rate.

Result(s):
Oocyte retrieval yielded 16.7 OCC/cycle, and 50.8% of oocytes completed IVM. The mean oocyte diameter increased from 108.8 ± 4.3 μm to 111.9 ± 4.1 μm after IVM. Mean fertilization rate was 63.7%, and 45.4% of 2-pronuclei oocytes developed into a morphologically good-quality embryo on day 3 after intracytoplasmic sperm injection. Fresh ET resulted in two ongoing pregnancies (2/37; 5.4%). Deferred vitrified-warmed ET led to an ongoing pregnancy rate of 34.6% (9/24). Three healthy babies were born and eight pregnancies were still ongoing.

Conclusion(s):
Oocytes retrieved from follicles with a diameter of

  • I agree that this does provide a safer stimulation for our PCOS patients. I would be curious to know if there is a significant difference in either patient characteristics or cycle parameters between the fresh ETs and vitrified-warmed ETs and if this center has similar finding in their IVM cycles outside of this study population.

  • jessie.dorais

    This is a very promising study. The authors should be commended for their efforts in characterizing the efficacy of a safer stimulation protocol for an at risk population of patients. They have demonstrated a very promising pregnancy rate for the vitrified-warmed embryo transfers in this study population. It will be interesting for F and S readers to comment on if and how this study will affect their IVF practices.

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