Luteinizing hormone-releasing hormone as an ovulation trigger in regularly ovulating women: problems in assessment of efficacy.
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Maturation and/or in vitro fertilisation of human oocytes was carried out on 70 oocytes recovered from 56 young women who had normal periods and were having laparoscopy for tubal sterility. Five oocytes were recovered in the pre-ovulatory phase of spontaneous cycles by the use of ultrasound determination of follicular growth and the presence of an LH peak estimated from urine levels. 65 oocytes were obtained by puncture of follicules that had been stimulated using HMG/HCG 32-36 hours after HCG had been injected. 66 per cent of these eggs showed signs of degeneration before culture. The immature oocytes which were cultured for 42-46 hours at 36 degrees C with or without gonadotrophins underwent meoisis in 80 per cent of cases and 41 per cent expelled their first polar body. None of these oocytes could be fertilised in vitro, whereas 50 per cent of the oocytes that were recovered in metaphase II and fertilised in vitro had reached the stage of pronuclei 20 hours later. Ultrastructural and cytogenic studies will be carried out to ascertain the quality of these eggs before any attempt is made to reimplant.
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