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Rescue in vitro maturation (IVM) of immature oocytes in stimulated cycles in women with low functional ovarian reserve (LFOR)

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Abstract

Rescue in vitro maturation (IVM) is currently not a routine procedure in association with in vitro fertilization (IVF). We compared in a prospectively cohort study of 10 patients with normal functional ovarian reserve (NFOR) and of 25 with low functional ovarian reserve (LFOR), defined by abnormally high FSH and/or abnormally low AMH levels), IVM dynamics of immature oocytes. Following controlled ovarian hyperstimulation in IVF cycles, only immature oocytes underwent rescue IVM (for up to 48 h). Oocyte maturation dynamics, fertilization rates, embryo development, and pregnancy rates were then compared between NFOR and LFOR patients. Though proportion of MI and GV oocytes reaching MII stages within 48 h and rate of maturation of MI oocytes did not differ, in women with LFOR significantly more GV oocytes reached MII stage within 24 h (30.4 vs. 66.9 %; P = 0.013), while fertilization rates and embryo generation numbers were similar between both groups. Rescue IVM, thus, produced 1.5 additional embryos for transfer in women with LFOR and 1.6 in patients with NFOR, a highly significant difference in relative improvement in available embryo numbers for LFOR (+60.0 %) and NFOR women (+16.5 %). Rescue IVM, thus, not only demonstrates different time dynamics between women with LFOR and NFOR but also disproportionate efficacy in improving available embryo numbers for transfer in favor of LFOR patients. 1/7 patients, who reached embryo transfer with only embryos produced via rescue IVF conceived and delivered, proving that rescue IVF in women with LFOR also improves pregnancy and delivery chances. Because of the small number of embryos LFOR patients produce, every additional embryo is of considerable potential clinical significance for them, suggesting that rescue IVM in women with LFOR should become routine practice.

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Acknowledgments

This work was supported by the Foundation for Reproductive Medicine and intramural grants from the Center for Human Reproduction (CHR) – New York.

Author contributions

H.-J. Lee, D. H. Barad, V. A. Kushnir, and N. Gleicher contributed in study concept; All authors contributed in study execution; H.-J. Lee and D. H. Barad contributed in data analysis and statistical evaluation; H.-J. Lee and N. Gleicher contributed in manuscript preparation; All authors contributed in final manuscript approval.

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Authors and Affiliations

  1. The Center for Human Reproduction, 21 East 69th Street, New York, NY, 10021, USA

    Ho-Joon Lee, David H. Barad, Vitaly A. Kushnir, Aya Shohat-Tal, Emanuela Lazzaroni-Tealdi, Yan-Guang Wu & Norbert Gleicher

  2. The Foundation for Reproductive Medicine, New York, NY, USA

    David H. Barad & Norbert Gleicher

  3. Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY, USA

    David H. Barad

  4. Department of Obstetrics and Gynecology, Wake Forest University, Winston-Salem, NC, USA

    Vitaly A. Kushnir

  5. Stem Cell and Molecular Embryology Laboratory, The Rockefeller University, New York, NY, USA

    Norbert Gleicher

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  1. Ho-Joon Lee
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Correspondence to Norbert Gleicher.

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The authors report no potential conflicts in respect to the here-reported study.

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Lee, HJ., Barad, D.H., Kushnir, V.A. et al. Rescue in vitro maturation (IVM) of immature oocytes in stimulated cycles in women with low functional ovarian reserve (LFOR). Endocrine 52, 165–171 (2016). https://doi.org/10.1007/s12020-015-0744-1

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  • DOI: https://doi.org/10.1007/s12020-015-0744-1

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