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PubMed2000

Power Doppler endometrial evaluation as a method for the prognosis of embryo implantation in an ICSI program.

PURPOSE: The objective of the present study was to evaluate power Doppler of the endometrium as a parameter for the prognosis of embryo implantation in patients who underwent intracytoplasmic sperm injection (ICSI). METHODS: The power Doppler was performed on a transverse section at the level of the uterine fundus on the day of human chorionic gonadotropin in 185 patients who submitted to ovarian stimulation for ICSI. The endometrium was divided into four equal quadrants and classified as grade I, II, III, or IV according to the visualization of the power Doppler in the quadrants. The color Doppler signal was considered to be positive when it reached at least the basal layer of the endometrium. RESULTS: Age, number of days of stimulation, number of follicles > or = 16 mm, number of oocytes in metaphase II retrieved, and fertilization rate did not differ patients with the four different types of endometrial grades. Endometrial thickness and the pulsatility index of uterine artery also were similar for the four grades. The rate of embryo implantation also did not differ significantly (P = 0.53) among groups: grade I = 10%; grade II = 11.6%; grade III = 15.4%; grade IV = 10.5%. The pregnancy rates were grade I = 25%; grade II = 29.7%; grade III = 37.5%; grade IV = 23.8% (P = 0.44). CONCLUSIONS: Our data demonstrate that isolated evaluation of endometrial vascularization with power Doppler is not an important factor for the prediction of pregnancy in an ICSI program.

Adult↗
PubMed2006

Outcome of in vitro fertilization/intracytoplasmic sperm injection after laparoscopic cystectomy for endometriomas.

OBJECTIVE: To assess the impact of prior unilateral or bilateral endometrioma cystectomy on controlled ovarian hyperstimulation (COH) and intracytoplasmic sperm injection (ICSI) outcome. DESIGN: Retrospective case-control study. SETTING: Department of Obstetrics and Gynecology, School of Medicine, Hacettepe University, Ankara, Turkey. PATIENT(S): Fifty-seven consecutive infertile patients were enrolled who had previously undergone unilateral (n = 34) or bilateral (n = 23) laparoscopic cystectomy for endometriomas more than 3 cm in diameter and underwent ICSI. The control group consisted of 99 patients with tubal factor infertility. INTERVENTION(S): Controlled ovarian hyperstimulation and ICSI. MAIN OUTCOME MEASURE(S): Cycle cancellation rate, number of oocytes, fertilization rate, embryo quality, clinical pregnancy rate (PR), and implantation rate. RESULT(S): The mean number of oocytes, metaphase II oocytes, and two-pronucleated oocytes were significantly lower in the bilateral cystectomy group compared to the unilateral cystectomy and control groups. However, all other parameters, including fertilization rate, the mean number of embryos transferred, the mean number of grade 1 embryos transferred, the clinical PR per embryo transfer, and implantation rate, were comparable among the three groups. Within the unilateral cystectomy group, the mean number of oocyte retrieved from the operated site was significantly less than in the contralateral nonoperated site. CONCLUSION(S): Laparoscopic endometrioma cystectomy does reduce the ovarian reserve. However, diminished ovarian reserve does not translate into impaired pregnancy outcome.

Adult↗
PubMed2003

Complete down-regulation is not mandatory for good assisted reproductive treatment cycle outcomes.

OBJECTIVE: To determine the implications and predictive value of estradiol concentrations following pituitary down-regulation with gonadotrophin releasing hormone agonists in women undergoing controlled ovarian hyperstimulation for assisted reproductive technology. STUDY DESIGN: A total of 277 patients undergoing ovarian hyperstimulation for intracytoplasmic sperm injection (ICSI) were enrolled into the study and the patients were divided into four groups according to estradiol levels on the initial day of stimulation of which group-A consisted of the patients who had < or =25 pg/ml (n=90), group-B with levels between 26 and 50 pg/ml (n=104), group-C with levels between 51 and 75 pg/ml (n=67) and group-D with levels > or =76-90 pg/ml (n=16) and the results were compared. The primary outcome measures included ovarian response and the clinical pregnancy rates. RESULTS: The clinical pregnancy rates in groups-A, B, C and D were 33.3% (30/90), 26.0% (27/104), 35.8% (24/67), and 25.0% (4/16), respectively, and there was no statistically significant difference (P=0.482). The mean number of oocytes retrieved in groups were (9.7+/-5.8, 10.3+/-6.5, 11.0+/-6.8, and 12.1+/-6.6), respectively (P=0.453) and the fertilization rates in groups-A, B, C and D were found to be similar (75, 80, 73 and 79%, respectively; P=0.658). CONCLUSION: Complete and deep desensitization obviously seems not to be mandatory for successful stimulation in assisted reproductive technology cycles.

Adult↗
PubMed2003

Effects of vaginal progesterone administration starting on the day of oocyte retrieval on pregnancy rates.

PURPOSE: Vaginal progesterone administration starting on the day of oocyte retrieval induced a decrease in uterine contraction frequency on the day of embryo transfer (ET) as compared with preovulatory values. Uterine relaxation before ET is likely to improve outcome by avoiding displacement of the embryo from the uterine cavity (Fanchin, Righini, de Ziegler, Oliviennes, Ledée, Frydman: Fertil Steril 2001;75:1136-1140). The objective of the present study was to determine whether the early use of vaginal progesterone on the day of oocyte retrieval may alter the embryo implantation and pregnancy rates. METHODS: A total of 103 patients were submitted for ovarian stimulation with GnRH-a and recombinant FSH (Puregon, Organon) for the application of invasive assisted reproduction techniques (ICSI). The patients were divided into two groups in a prospective and randomized manner: Group A (n = 51) where application of vaginal progesterone started (Utrogestan, Besins International) at the dose of 400 mg from the evening of the day of oocyte retrieval, and Group B (n = 52) started to apply vaginal progesterone at the same dose but from the evening of embryo transfer (2nd day). RESULTS: The age of Group A patients (34.2 +/- 4.6) was similar (p = 0.50) to that of Group B patients (34.8 +/- 4.9). The number of oocytes retrieved and at metaphase II from Group A patients (10.6 +/- 6.9 and 7.8 +/- 6.0; respectively) did not differ significantly (p = 0.84 and p = 0.49, respectively) from the number of oocytes retrieved and metaphase II from Group B patients (10 +/- 5.6 and 6.7 +/- 4.7, respectively). Also, there was no difference (p = 0.48) in number of embryos transferred to Group A patients (2.7 +/- 0.8) versus Group B patients (2.7 +/- 0.9). Embryo implantation and pregnancy rates for Group A patients (12.6 and 27.4%, respectively) were equal (p = 0.98 and p = 1.0, respectively) to those for Group B patients (13.4 and 28.8%, respectively). CONCLUSION: Vaginal progesterone at the dose of 400 mg started on the day of oocyte retrieval did not increase implantation or pregnancy rates when compared to the same dose started on the day of embryo transfer.

Administration, Intravaginal↗
PubMed2006

[Use of biochemical markers to predict the outcome of pregnancies conceived by in vitro fertilization].

BACKGROUND: Pregnancies obtained after in vitro fertilization and embryo transfer are at increased risk for an adverse outcome compared with women who conceive naturally. Multiple gestations also occur more frequently after in vitro fertilization. Therefore, there is a need for markers that accurately detect the establishment of pregnancy and predict its outcome as early as possible, allowing for modification of monitoring and treatment if required. Ultrasound examination is part of the routine follow-up after in vitro fertilization, but a gestational sac is not reliably visible until 33-37 days after ovulation induction. As a result, there is an ongoing effort to find endocrine markers that can earlier detect the establishment of pregnancy and forecast its outcome. OBJECTIVE: The authors' aim was to assess the predictive value of the following potential serum markers, measured in the second week after embryo transfer in samples collected prospectively during the past ten years at the Division of Assisted Reproduction of their department: total beta-hCG (theoretical post-embryo transfer day 11 values, calculated from levels in two samples collected with a difference of two days, based on the mathematical model describing its exponential increase in early pregnancy), inhibin A, and CA-125. METHODS: Data of patients undergoing IVF or intracytoplasmic sperm injection and embryo transfer between 1995 and 2001 were analyzed. Establishment of pregnancy was assessed by measuring total beta-hCG concentrations in two serum samples collected between 8 and 16 days after ET with a difference of two days. Measurement of inhibin A and CA-125 levels was performed in the same samples. Logistic regression analyses were used to study the association of these serum markers and the number of retrieved oocytes and transferred embryos with pregnancy outcome. Receiver-operating characteristic (ROC) curves were constructed to identify optimal cutoff levels for outcomes and to assess overall predictive accuracy. RESULTS AND CONCLUSIONS: (1) Day 11 total beta-hCG can be used to compare hCG levels in samples from different sampling days and to predict early pregnancy losses and multiple ongoing pregnancies with high sensitivity and specificity. (2) Inhibin A concentrations are more accurate than day 11 hCG levels for predicting preclinical abortion after IVF but they have no advantage in forecasting ongoing or multiple ongoing pregnancies. (3) Prognostic accuracy of CA-125 measurements for the prediction of pregnancy as well as its outcome is inferior to that achieved with inhibin A.

Abortion, Spontaneous↗
PubMed1997

Enhancement of fertilization by piperine in hamsters.

The effect of piperine on the fertilization of eggs with sperm was investigated in female hamsters. They were intragastrically treated with piperine at doses of 50 and 100 mg/kg BW from day 1 through day 4 of the oestrous cycle. During piperine treatment, these females were superovulated and artificially inseminated (AI) with spermatozoa from untreated male hamsters at 12 h after hCG injection. The fertilization and growth of embryos were examined at various times after AI. In control hamsters, the percent fertilization increased with time, from 27.4 +/- 3.3% at 9 h after AI to 75.3 +/- 9.6 at 24 h after AI. Administration of piperine to the superovulated animals markedly enhanced the percent fertilization at 9 h after AI. It was increased to 85.4 +/- 4.1 and 82.8 +/- 4.8% by piperine at doses of 50 and 100 mg/kg BW, respectively. However, examination of the embryos retrieved 48 h after AI revealed no differences in the stage of embryonic development among different groups of animals. The possibility that this effect was due to the direct action of vanillic acid, a major piperine metabolite, was tested in vitro. Direct exposure of spermatozoa to vanillic acid at doses 25-100 mg% did not significantly affect their motility, percent acrosome reaction or fertilizing ability. This suggests that the enhancement of fertilization by piperine treatment was not related to the secretion of vanillic acid into the oviduct.

Alkaloids↗
PubMed1996

High incidence of triploidy in in-vitro fertilized oocytes from a patient with a previous history of recurrent gestational trophoblastic disease.

The patient described has a history of recurrent gestational trophoblastic disease following spontaneous conception. She subsequently underwent two cycles of in-vitro fertilization (IVF) for management of infertility related to tubal obstruction. IVF of the oocytes retrieved showed a significantly high incidence of abnormal fertilization resulting in the development of triploid embryos. This report explores the possible association of an oocyte defect predisposing to abnormal fertilization, resulting in a high incidence of triploid embryos. Since the development of partial hydatidiform moles is related to the origin of triploidy, this phenomenon is suggested to explain the occurrence of recurrent trophoblastic disease in this patient. We propose the use of intracytoplasmic sperm injection (ICSI) as a therapeutic option to minimize the incidence of triploidy in future IVF cycles; donor oocyte IVF would be another alternative.

Adult↗
PubMed1999

Elevated serum progesterone level on the day of human chorionic gonadotropin administration does not adversely affect implantation rates after intracytoplasmic sperm injection and embryo transfer.

OBJECTIVE: To evaluate the association between serum P levels on the day of hCG administration and the outcome of intracytoplasmic sperm injection (ICSI). DESIGN: Retrospective case study. SETTING: Assisted reproduction unit of a tertiary care private hospital. PATIENT(S): Nine hundred eleven ICSI cycles that proceeded to ET were studied. INTERVENTION(S): The decision to administer hCG was based on serum E2 levels and follicle size. Serum P was measured from frozen sera obtained on the day of hCG administration. Cycles were stratified according to serum P levels of <0.9 ng/mL (n = 298) or > or =0.9 ng/mL (n = 613). This cutoff level was selected because it yielded the highest sensitivity and specificity according to a receiver operator characteristic curve. MAIN OUTCOME MEASURE(S): Implantation and clinical pregnancy rates. RESULT(S): In cycles with high serum P levels, more oocytes were retrieved and more embryos were available for transfer. Clinical pregnancy rates per ET in the low and high P groups were 36.9% and 45.4%, respectively (P<.05). The implantation rate per embryo was similar in the two groups (14.9% and 16.4%, respectively, in cycles with P levels <0.9 vs > or =0.9 ng/mL). Abortion rates were 22.7 and 25.8%, respectively (P>.05). CONCLUSION(S): Our data showed no adverse effect of high serum P levels on the day of hCG administration on implantation rates after ICSI and ET.

Adult↗
PubMed2002

Basal serum levels of FSH and estradiol in ovulatory and anovulatory women undergoing treatment by in-vitro maturation of immature oocytes.

BACKGROUND: The study aim was to establish whether basal serum levels of FSH and estradiol are predictive of outcome in women undergoing treatment by in-vitro maturation (IVM) of immature oocytes. METHODS: Data were obtained from 123 unstimulated IVM cycles. Serum was taken between cycle days 2-4 for analysis. Patients received 10 000 IU of HCG 36 h before immature oocyte recovery that was performed between cycle days 9-14. IVM was performed and mature oocytes fertilized by ICSI, followed 2-3 days later by embryo transfer. Outcome measures included the number of immature oocytes retrieved, and the rates of oocyte maturation, fertilization, cleavage and pregnancy. RESULTS: A median (range) of 8 (0-36) immature oocytes was retrieved per patient. Oocyte maturation, fertilization, cleavage and pregnancy rates were 83, 76, 93 and 17.9% respectively. Serum FSH levels and the presence of polycystic ovary were significant independent predictors of the number of immature oocytes retrieved, whilst patient age and basal estradiol level were not. A basal serum estradiol level >100 pmol/l was associated with a significantly higher pregnancy rate (26 versus 11% for estradiol <100 pmol/l; P = 0.032). CONCLUSIONS: Measurement of basal serum levels of FSH and estradiol are useful in predicting the number of immature oocytes retrieved and the pregnancy rate in women undergoing unstimulated IVM treatment.

Adult↗
PubMed1991

In vivo delivery of estradiol from ceramic drug delivery devices.

Ceramic drug delivery systems (CDS) are capable of delivering a wide variety of chemicals and/or biologicals directly into the systemic circulation in a continuous manner over long intervals with minimum risk to the recipient. The objectives of the present study were: (i) to determine the capability of tricalcium phosphate (TCP) capsules to deliver estradiol (E) in a sustained manner into the circulation of intact adult male rats, and (ii) to investigate the physiological responses associated with the presence of constant levels of estradiol in adult male rats. Microcrystals, particle size of less than 38 um, of TCP powder were prepared using standard procedures. TCP capsules with an outer diameter of 0.8 cm and an inner diameter of 0.4 cm were prepared by compressing calcined materials in a cylindrical dye at a compression load of 700 Kg. The ceramic capsules had a final density of 1.82 +/- 0.03 gm/cm3. A total of 54 adult male rats were divided into three groups of 18. Each rat in group I was implanted intraperitoneally with 2 CDS, one TCP capsule impregnated with polylactic acid (PLA) and the second nonimpregnated TCP capsule. Each capsule contained 40 mg of E. Animals in group II were implanted with two similar capsules without E (shams) and group III animals which served as intact controls were not fitted with CDS. Eight rats from each group were euthanized 2, 4, or 6 months following CDS implantation. Ceramic capsules were retrieved from the euthanized animals and the amount of E left within the ceramic was determined.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

Clinical usefulness of basal FSH as a prognostic factor in patients undergoing intracytoplasmic sperm injection.

OBJECTIVE: To determine if basal serum follicle stimulating hormone (FSH) level could be a prognostic factor of the clinical outcome in intracytoplasmic sperm injection (ICSI) cycles in the couples with male factor infertility. MATERIALS AND METHODS: From December 1995 to March 1998, total 118 patients underwent in vitro fertilization and embryo transfer (IVF-ET) with ICSI due to male factor infertility were included in this study. Patients were allocated to the low basal FSH group (< 8.5 mIU/ml) and the high basal FSH group (> or = 8.5 mIU/ml). The basal levels of FSH were measured in the 3rd day of menstrual cycle preceding ovarian stimulation cycle in total IVF cycles by immunoradiometric assay (IRMA). Statistical analysis was performed using Student's t-test, Fisher's exact test, and chi 2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose of exogeneous gonadotropin required in the high basal FSH group was significantly higher than that in the low basal FSH group. The numbers of retrieved oocytes and oocytes with grade I, II were significantly higher in the low basal FSH group. The clinical pregnancy rate per cycle in the low basal FSH group (16.2%) was significantly higher than that in the high basal FSH group (4.0%). CONCLUSION: These results suggested that the basal serum FSH levels could be predictive of pregnancy outcome and the results of controlled ovarian hyperstimulation (COH) in ICSI cycles.

Adult↗
PubMed1996

Mimicking the high levels of activity of a large in-vitro fertilization unit leads to early success at the commencement of an in-vitro fertilization and embryo transfer programme.

Infertile couples seeking treatment will endeavour to obtain the highest standards of care at a conveniently located centre. The success rated of a centre would also be an important concern. The busier in-vitro fertilization (IVF) units (> 400 cycles per year) have substantially higher pregnancy rates than those carrying out < 300 cycles per year. We report our experiences at the IVF centre, Maternity Hospital, Kuwait of mimicking the high level of activity of a large IVF unit. Infertile couples were treated in groups of 30-35 every 4-6 weeks. Patients in each group had menstrual cycles synchronized to their luteal phase using progestogens. Thereafter they were down-regulated with gonadotrophin-releasing hormone agonist (long protocol). Oocyte retrieval and embryology activities were concentrated and completed in 7-10 days in each group. This episodic high level of activity was aimed at mimicking that of a busy large IVF centre, although continuous in the latter. The overall results in terms of fertilization cleavage, implantation and clinical pregnancy rates were similar to those obtained in large IVF units. The clinical pregnancy rate per cycle was 25.8-39.1% in IVF and 46.1% in intracytoplasmic sperm injection.

Adult↗
PubMed2006

Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial.

OBJECTIVE: To evaluate the effect of acupuncture on reproductive outcome in patients treated with IVF/intracytoplasmic sperm injection (ICSI). One group of patients received acupuncture on the day of ET, another group on ET day and again 2 days later (i.e., closer to implantation day), and both groups were compared with a control group that did not receive acupuncture. DESIGN: Prospective, randomized trial. SETTING: Private fertility center. PATIENT(S): During the study period all patients receiving IVF or ICSI treatment were offered participation in the study. On the day of oocyte retrieval, patients were randomly allocated (with sealed envelopes) to receive acupuncture on the day of ET (ACU 1 group, n = 95), on that day and again 2 days later (ACU 2 group, n = 91), or no acupuncture (control group, n = 87). INTERVENTION(S): Acupuncture was performed immediately before and after ET (ACU 1 and 2 groups), with each session lasting 25 minutes; and one 25-minute session was performed 2 days later in the ACU 2 group. MAIN OUTCOME MEASURE(S): Clinical pregnancy and ongoing pregnancy rates in the three groups. RESULT(S): Clinical and ongoing pregnancy rates were significantly higher in the ACU 1 group as compared with controls (37 of 95 [39%] vs. 21 of 87 [26%] and 34 of 95 [36%] vs. 19 of 87 [22%]). The clinical and ongoing pregnancy rates in the ACU 2 group (36% and 26%) were higher than in controls, but the difference did not reach statistical difference. CONCLUSION(S): Acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI, compared with no acupuncture. Repeating acupuncture on ET day +2 provided no additional beneficial effect.

Acupuncture Therapy↗
PubMed2003

Comparison between cytokine concentration in follicular fluid of poor and high responder patients and their influence of ICSI-outcome.

OBJECTIVE: The aim of this study was to compare the cytokine concentration in follicular fluid (FF) of low and high responder intracytoplasmic sperm injection (ICSI) patients and to find out the impact of these cytokines in FF on ICSI outcome. DESIGN: The levels of insulin-like growth factor (IGF)-I, IL-6, IL-8, epidermal growth factor (EGF), platelet-derived growth factor (PDGF), granulocyte-macrophage-colony stimulating factor (GM-CSF) were measured from low and high responder ICSI patients, the results were compared between the two groups and their influence on ICSI outcome was analysed. MATERIAL AND METHODS: A total of 49 low (G.I) and 34 high (G.II) responder patients were enrolled in this study. FF was collected at the time of oocyte retrieval and measured either by enzyme-linked immunosorbent assay (IL-6, IL8, EGF, PDGF, GM-CSF) or radio immuno assay (IGF-I). RESULTS: The concentration of IL-6 (pg/mL), IL-8 (pg/mL), IGF-I (ng/mL), PDGF (pg/mL), EGF (pg/mL), GM-CSF (pg/mL) in G.I was 6.0 +/- 4.3, 288.1 +/- 139.2, 0.416 +/- 0.089, 249.8 +/- 150.1, 9.12 +/- 5.5 and 1.45 +/- 2.10 and the corresponding value in G.II was 7.4 +/- 4.8, 208.6 +/- 64.0, 0.431 +/- 0.094, 387.6 +/- 36.0, 8.9 +/- 5.4 and 1.8 +/- 3.3, respectively. Only the PDGF concentration showed a significant (P = 0.007) difference between the two groups. Besides, negative correlations were found between PDGF and fertilization rate (r = -0.287; P = 0.046) of G.I. The mean number of retrieved (6.4 +/- 2.3 versus. 15.7 +/- 5.4) and fertilized (3.6 +/- 1.6 versus 7.0 +/- 4.5) oocytes differ significantly (P = 0.001) between the two groups. The fertilization rate was significantly higher in G.I than in G.II (60.9 +/- 25.1 versus 43.4 +/- 20.7%). CONCLUSION: There was no significant difference between IGF-I, IL-6, IL-8, EGF and GM-CSF concentrations of low and high responder patients. Besides, PDGF was significantly (P = 0.007) higher in high responder compared with low responder patients. Moreover, in poor responder patients, a negative correlation was found between PDGF and fertilization rate. However, the cytokine levels in FF of the patients undergoing controlled ovarian hyperstimulation for ICSI could not be used as a marker of oocyte fertilization and implantation potential.

Adult↗
PubMed2004

First polar body morphology before ICSI is not related to embryo quality or pregnancy rate.

BACKGROUND: The aim of this study was to analyse the relationship between the first polar body (1st PB) morphology and the fertilization rate, cleavage rate, embryo quality, pregnancy and implantation rate. METHODS: This was a retrospective study on 167 consecutive cycles undergoing assisted reproduction with ICSI. The 1st PB morphology was evaluated at the moment of ICSI in the 596 injected oocytes and it was coded as intact or fragmented. The fertilization rate, cleavage rate, embryo quality (three grades), pregnancy rate, implantation rate and the time elapsed between oocyte retrieval and ICSI were evaluated. The 1st PB morphology was checked twice (denudation and ICSI) in a random sample of 180 oocytes in order to verify the effect of the in vitro culture. RESULTS: No significant relationship was found between the 1st PB morphology and the fertilization rate (P=0.703), cleavage rate (P=0.055), embryo quality (P=0.673), pregnancy rate (P=0.201) and implantation rate (P=0.511). A significant positive relationship (P=0.006) was found between the frequency of the 1st PB fragmentation and the time elapsed between denudation and ICSI. The pregnancy rate was significantly higher (P=0.008) when oocytes were injected between 5 and 7 h after retrieval rather than earlier or later. CONCLUSIONS: Our data suggest that the embryo quality, pregnancy rate and implantation rate are not related to the 1st PB fragmentation. The time which elapses between the oocyte retrieval and ICSI should be maintained at approximately 6 h in order to obtain optimal results.

Cleavage Stage, Ovum↗
PubMed1999

Oocyte quality and treatment outcome in intracytoplasmic sperm injection cycles of polycystic ovarian syndrome patients.

Patients with polycystic ovarian syndrome (PCOS) have higher miscarriage rates. It is postulated that this is caused by a lower rate of mature oocytes, and a lower quality of embryos. Retrospectively we analysed 51 intracytoplasmic sperm injection (ICSI) cycles of 31 PCOS patients. These data were compared to age-matched controls (105 cycles) during the same period. All patients of both groups received gonadotrophin-releasing hormone (GnRH) agonists prior to gonadotrophin treatment. The rate of metaphase II oocytes (MII) was not different. However, the mean absolute number of normally fertilized oocytes was significantly higher in PCOS patients (5.00 versus 3.56, P < 0.01), due to a higher number of oocytes retrieved. More embryos were transferred by cycle in the PCOS group (2.69 versus 2.17, P < 0.05), with a higher cumulative embryo score. The overall and multiple pregnancy rate showed no differences and the clinical abortion rate was lower (21 versus 41.67%, P < 0.05) in the controls. Our findings demonstrate that negative factors unconnected to oocyte morphology must be present in PCOS patients. It is possible that only cytoplasmic, not nuclear, maturity is influenced in these patients.

Adult↗
PubMed1985

Fertilization in vitro of cumulus-enclosed mouse oocytes: effect of timing of the ovulatory HCG injection.

Human chorionic gonadotropin (HCG) may be injected to time ovulation and plan oocyte retrieval for clinical in vitro fertilization (IVF). Neither clinical nor experimental data on effects of subtle alterations in timing of the HCG injection on oocyte fertilizability in vitro were available. We induced follicular development in immature hybrid mice with an injection (4 IU) of pregnant mare serum gonadotropin (PMSG). In the first series of experiments, HCG was given 42, 46 or 50 hours later. We collected cumulus-enclosed, oviducal oocytes for IVF using capacitated mouse sperm 13 hours after the last HCG injection. The fertilization incidence (mean, three experiments) fell as the PMSG-HCG interval was reduced (50 hours, 64%; 46 hours, 40%; 42 hours 24%), but this could be explained by a corresponding increase in spontaneous oocyte activation caused by prolonging the HCG-oocyte collection interval. In the second series of experiments, the latter was fixed at 13 hours; the PMSG interval was altered by staggering the initial PMSG injection. No spontaneous activation occurred, but oocytes collected after "early" HCG injection still showed significantly lower fertilization incidences (42 hours, 36%; 46 hours, 46%) compared with the 50-hour injection (66%). The possible clinical implication of this finding is discussed.

Animals↗
PubMed2003

Pregnancies and births achieved from in vitro matured oocytes retrieved from poor responders undergoing stimulation in in vitro fertilization cycles.

OBJECTIVE: To describe pregnancies that resulted from in vitro matured oocytes derived from stimulated IVF cycles before cancellation owing to poor response of gonadotropins. DESIGN: Case report. University hospital. PATIENT(S): Eight patients who underwent in vitro maturation.Immature oocyte retrieval, in vitro maturation of immature oocytes, fertilization, and ET. Luteal support with progesterone and plvyeron was given. MAIN OUTCOME MEASURE(S): Pregnancy and live birth. RESULT(S): Three pregnancies (two live births and another ongoing) were achieved after immature oocyte retrieval, in vitro maturation, fertilization with ICSI, and ET. CONCLUSION(S): Immature oocyte retrieval from poor responders during stimulation, followed by in vitro maturation, may be an alternative before the cycle is canceled.

Adult↗