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Could fertility clinics offer a sizable improvement of live birth rates by maturing post-GVBD oocytes in vitro?

  • Assisted Reproduction Technologies
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Abstract

Purpose

The objective of this study is to analyze the potential of immature, denuded, post-GVBD (germinal vesicle breakdown) oocytes (including prometaphase I, metaphase I, and prometaphase II stages) to result live birth after in vitro maturation. Furthermore, we compared two culture media to identify which of them provides better reproductive outcomes when used for in vitro maturation.

Methods

We performed a retrospective cohort study including 4022 IVF-ICSI (in vitro fertilization-intracytoplasmic sperm injection) cycles between 2011 and 2015. A total of 4450 immature post-GVBD oocytes from 1442 cycles were cultured in vitro; of these, 2364 oocytes reached MII (metaphase II) stage (IVMC oocytes, in vitro meiotic completion) and were fertilized. Overall, 3933 embryo transfers were performed: 3579 were embryos derived from MII oocytes (ET-MII); 264 were embryos derived from MII + IVMC oocytes (ET-MIX), and 90 embryos from IVMC oocytes (ET-IVMC). In total, 399 IVMC embryos were transferred.

Results

Maturation rate for immature post-GVBD oocytes was 54.1%. G-2™PLUS (Vitrolife) medium provided significantly higher maturation rate (p < 0.001) than G-IVF™PLUS (Vitrolife) (65.7% vs. 42.5%, p < 0.001). Embryos in ET-IVMC in cleavage stage had an average morphological score of 6.8/10 (7.7 in ET-MII; p < 0.001). Regarding reproductive outcomes, ET-IVMC gave 11.1% biochemical pregnancy rate, 10.0% clinical pregnancy rate, 7.8% ongoing pregnancy rate, and 5.6% live birth rate.

Conclusions

Embryos arising from IVMC oocytes resulted in a live birth rate of 5.6%. We suggest that in vitro maturation of denuded immature post-GVBD oocytes should be performed at the very least when few MII are collected, and likely in all patients, as they provide acceptable maturation and fertilization rates, and a sizeable increase in live birth.

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Acknowledgments

The authors wish to thank Sarai Brazal for her support with the database and Anna Ferrer-Vaquer for critical review of the manuscript.

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Authors and Affiliations

  1. Clínica EUGIN, Travessera de les Corts 322, 08029, Barcelona, Spain

    N. Martin-Palomino Olid, D. García, A. Rodríguez & Rita Vassena

Authors
  1. N. Martin-Palomino Olid
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  2. D. García
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  3. A. Rodríguez
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  4. Rita Vassena
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Contributions

N.M.: involved in study design, data analysis, and manuscript preparation. D.G.: involved in study design, data analysis, statistical analysis, and manuscript preparation. R.V. and A.R.: involved in study design, implementation, supervision, expert knowledge, and manuscript preparation.

Corresponding author

Correspondence to Rita Vassena.

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Ethical approval for performing this study was obtained from the institutional Ethics Committee for Clinical Research.

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The authors declare that they have no conflict of interest.

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Martin-Palomino Olid, N., García, D., Rodríguez, A. et al. Could fertility clinics offer a sizable improvement of live birth rates by maturing post-GVBD oocytes in vitro?. J Assist Reprod Genet 36, 1927–1934 (2019). https://doi.org/10.1007/s10815-019-01540-8

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  • DOI: https://doi.org/10.1007/s10815-019-01540-8

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