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The effect of immature oocytes quantity on the rates of oocytes maturity and morphology, fertilization, and embryo development in ICSI cycles

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The goal was to evaluate the role of the number of retrieved immature oocytes on mature oocyte counts and morphology, and also the rates of fertilization and embryo development in ICSI cycles.


101 ICSI cycles were included in this prospective evaluation. Patients were divided into 2 groups of A (≤ 2 immature oocytes) and B (> 2 immature oocytes). In sub-analysis, the impacts of the number of GV and MI oocytes were assessed on the rates of fertilization and embryo development. Also, correlations between the numbers of immature and mature oocytes, as well as maternal age between two groups were analyzed. Assessments of oocyte morphology, fertilization, embryo quality and development were done accordingly.


There was no correlation between the immature oocytes quantity with the number of mature ones. There were insignificant differences for embryo development between two groups, but fertilization rate was higher in group A (P = 0.03). In sub-analysis, insignificant differences were observed between two groups of ≤ and >2 GV and MI oocytes for rates of fertilization and embryo development. Also, the rates of clinical pregnancy and delivery were insignificant between groups. The rate of morphologically abnormal oocytes had no significant difference between two groups, except for wide perivitelline space (PVS) which was higher in group A (P = 0.03). There was no significant difference for maternal age between two groups.


In cases with few retrieved immature oocytes, rates of fertilization and incidence of wide PVS may increase, although immature oocytes may not have any negative impacts on early embryo development, or the rates on number of mature oocytes.

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Intracytoplasmic sperm injection


Assisted reproductive technology


Controlled ovarian hyperstimulation


Germinal vesicle


Metaphase I


In-vitro maturation


Gonadotropin releasing hormone


Recombinant follicle stimulating hormone


Human chorionic gonadotropin




International unit






Obstetric and gynecology


World health organization


Two pronuclei


Standard error


Odds ratio


Confidence interval


Perivitteline space


Metaphase II


Anti-Mullerian hormone


Polar body


Zona pellucida


Smooth endoplasmic reticulum cluster


Not significant


  1. Baerwald AR, Adams GP, Pierson RA. Ovarian antral folliculogenesis during the human menstrual cycle: a review. Hum Reprod Update. 2012;18(1):73–91.

    Article  PubMed  Google Scholar 

  2. Balaban B, Urman B. Effect of oocyte morphology on embryo development and implantation. Reprod Biomed Online. 2006;12(5):608–15.

    Article  PubMed  Google Scholar 

  3. Blake M, Garrisi J, Tomkin G, Cohen J. Sperm deposition site during ICSI affects fertilization and development. Fertil Steril. 2000;73(1):31–7.

    Article  PubMed  CAS  Google Scholar 

  4. Child TJ, Sylvestre C, Pirwany I, Tan SL. Basal serum levels of FSH and estradiol in ovulatory and anovulatory women undergoing treatment by in-vitro maturation of immature oocytes. Hum Reprod. 2002;17(8):1997–2002.

    Article  PubMed  CAS  Google Scholar 

  5. de Cassia SFR, de Almeida Ferreira Braga DP, Semiao-Francisco L, Madaschi C, Iaconelli Jr A, Borges Jr E. Metaphase II human oocyte morphology: contributing factors and effects on fertilization potential and embryo developmental ability in ICSI cycles. Fertil Steril. 2010;94(3):1115–7.

    Article  Google Scholar 

  6. Durlinger A, Visser JA, Themmen A. Regulation of ovarian function: the role of anti-Mullerian hormone. Reproduction. 2002;124(5):601–9.

    Article  PubMed  CAS  Google Scholar 

  7. Esfandiari N, Javed MH, Gotlieb L, Casper RF. Complete failed fertilization after intracytoplasmic sperm injection–analysis of 10 years' data. Int J Fertil Womens Med. 2005;50(4):187–92.

    PubMed  Google Scholar 

  8. Gougeon A. Human ovarian follicular development: from activation of resting follicles to preovulatory maturation. Ann Endocrinol (Paris). 2010;71(3):132–43.

    Article  CAS  Google Scholar 

  9. Halvaei I, Khalili MA, Soleimani M, Razi MH. Does maternal age have any effect on the rates of fertilization and embryo development in ICSI cycles? Iranian J Reprod Med. 2011;9 Suppl 1:49.

    Google Scholar 

  10. Halvaei I, Khalili MA, Soleimani M, Razi MH. Evaluating the role of first polar body morphology on rates of fertilization and embryo development in ICSI cycles. Int J Fertil Steril. 2011;5(2):110–5.

    Google Scholar 

  11. Hill GA, Freeman M, Bastias MC, Rogers BJ, Herbert CM, Osteen KG, Wentz AC. The influence of oocyte maturity and embryo quality on pregnancy rate in a program for in vitro fertilization-embryo transfer. Fertil Steril. 1989;52(5):801–6.

    PubMed  CAS  Google Scholar 

  12. Hsu M, Mayer J, Aronshon M, Lanzendorf S, Muasher S, Kolm P, Oehninger S. Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection: impact of cleavage status, morphology grade, and number of embryos transferred. Fertil Steril. 1999;72(4):679–85.

    Article  PubMed  CAS  Google Scholar 

  13. Jayaprakasan K, Deb S, Batcha M, Hopkisson J, Johnson I, Campbell B, Raine-Fenning N. The cohort of antral follicles measuring 2–6 mm reflects the quantitative status of ovarian reserve as assessed by serum levels of anti-Müllerian hormone and response to controlled ovarian stimulation. Fertil Steril. 2010;94(5):1775–81.

    Article  PubMed  CAS  Google Scholar 

  14. Jee BC, Ku SY, Suh CS, Kim KC, Lee WD, Kim SH. Serum anti-Müllerian hormone and inhibin B levels at ovulation triggering day can predict the number of immature oocytes retrieved in in vitro fertilization cycles. J Korean Med Sci. 2008;23(4):657–61.

    Article  PubMed  Google Scholar 

  15. Khalili MA, Mir-Rokni F, Kalantar SM. Application of vitality tests on asthenozoospermic semen from infertile men. Iran Biomed J. 1999;3:77–81.

    Google Scholar 

  16. Khalili MA, Mojibian M, Sultan AM. Role of oocyte morphology on fertilization and embryo formation in assisted reproductive techniques. Middle East Fertil Soc J. 2005;10(1):72–7.

    Google Scholar 

  17. Kim BK, Lee SC, Kim KJ, Han CH, Kim JH. In vitro maturation, fertilization, and development of human germinal vesicle oocytes collected from stimulated cycles. Fertil Steril. 2000;74(6):1153–8.

    Article  PubMed  CAS  Google Scholar 

  18. Kok JD, Looman CWN, Weima SM, te Velde ER. A high number of oocytes obtained after ovarian hyperstimulation for in vitro fertilization or intracytoplasmic sperm injection is not associated with decreased pregnancy outcome. Fertil Steril. 2006;85(4):918–24.

    Article  PubMed  Google Scholar 

  19. Lin YH, Hwang JL. In vitro maturation of human oocytes. Taiwan J Obstet Gynecol. 2006;45(2):95–9.

    Article  PubMed  Google Scholar 

  20. McAvey B, Zapantis A, Jindal SK, Lieman HJ, Polotsky AJ. How many eggs are needed to produce an assisted reproductive technology baby: is more always better? Fertil Steril. 2011;96(2):332–5.

    Article  PubMed  Google Scholar 

  21. Melie N, Adeniyi O, Igbineweka O, Ajayi R. Predictive value of the number of oocytes retrieved at ultrasound-directed follicular aspiration with regard to fertilization rates and pregnancy outcome in intracytoplasmic sperm injection treatment cycles. Fertil Steril. 2003;80(6):1376–9.

    Article  PubMed  Google Scholar 

  22. Miao Y, Ma S, Liu X, Miao D, Chang Z, Luo M, Tan J. Fate of the first polar bodies in mouse oocytes. Mol Reprod Dev. 2004;69(1):66–76.

    Article  PubMed  CAS  Google Scholar 

  23. Motta PM, Nottola SA, Micara G, Familiari G. Ultrastructure of human unfertilized oocytes and polyspermic embryos in an IVF–ET program a. Ann N Y Acad Sci. 1988;541(1):367–83.

    Article  PubMed  CAS  Google Scholar 

  24. Nazari S, Khalili MA, Esmaielzadeh F, Mohsenzadeh M. Maturation capacity, morphology and morphometric assessment of human immature oocytes after vitrification and in-vitro maturation. Iranian J Reprod Med. 2011;9(3):209–16.

    Google Scholar 

  25. Palermo GD, Cohen J, Rosenwaks Z. Intracytoplasmic sperm injection: a powerful tool to overcome fertilization failure. Fertil Steril. 1996;65(5):899–908.

    PubMed  CAS  Google Scholar 

  26. Rienzi L, Ubaldi F, Anniballo R, Cerulo G, Greco E. Preincubation of human oocytes may improve fertilization and embryo quality after intracytoplasmic sperm injection. Hum Reprod. 1998;13(4):1014–9.

    Article  PubMed  CAS  Google Scholar 

  27. Serhal PFRD, Kinis A, Marchant S, Davies M, Khadum IM. Oocyte morphology predicts outcome of intracytoplasmic sperm injection. Hum Reprod. 1997;12:1267–70.

    Article  PubMed  CAS  Google Scholar 

  28. Shen S, Khabani A, Klein N, Battaglia D. Statistical analysis of factors affecting fertilization rates and clinical outcome associated with intracytoplasmic sperm injection. Fertil Steril. 2003;79(2):355–60.

    Article  PubMed  Google Scholar 

  29. Strassburger D, Friedler S, Raziel A, Schachter M, Kasterstein E, Ron-El R. Very low sperm count affects the result of intracytoplasmic sperm injection. J Assist Reprod Genet. 2000;17(8):431–6.

    Article  PubMed  CAS  Google Scholar 

  30. Svalander P, Forsberg A, Jakobsson A, Wikland M. Factors of importance for the establishment of a successful program of intracytoplasmic sperm injection treatment for male infertility. Fertil Steril. 1995;63(4):828–37.

    PubMed  CAS  Google Scholar 

  31. Tan SL, Child TJ, Gulekli B. In vitro maturation and fertilization of oocytes from unstimulated ovaries: predicting the number of immature oocytes retrieved by early follicular phase ultrasonography. Am J Obstet Gynecol. 2002;186(4):684–9.

    Article  PubMed  Google Scholar 

  32. Van Steirteghem AC, Liu J, Joris H, Nagy Z, Janssenswillen C, Tournaye H, Derde MP, Van Assche E, Devroey P. Higher success rate by intracytoplasmic sperm injection than by subzonal insemination. Report of a second series of 300 consecutive treatment cycles. Hum Reprod. 1993;8(7):1055–60.

    PubMed  Google Scholar 

  33. WHO (2010) WHO laboratory manual for the Examination and processing of human semen. 5 edn. Cambridge University Press.

  34. Wittemer C, Ohl J, Bettahar-Lebugle K, Viville S, Nisand I. A quantitative and morphological analysis of oocytes collected during 438 IVF cycles. J Assist Reprod Genet. 2000;17(1):44–50.

    Article  PubMed  CAS  Google Scholar 

  35. Xia P. lntracytoplasmic sperm injection: correlation of oocyte grade based on polar body, perivitelline space and cytoplasmic inclusion with fertilization rate and embryo quality. Hum Reprod. 1997;2:1750–5.

    Article  Google Scholar 

  36. Xing X, Zhao H, Li M, Sun M, Li Y, Chen ZJ (2011) Morphologically abnormal oocytes not capable of fertilization despite repeated strategies. Fertility and Sterility 95 (7):2435 e2435-2437

    Google Scholar 

  37. Yoldemir T, Fraser I. The effect of retrieved oocyte count on pregnancy outcomes in an assisted reproduction program. Arch Gynecol Obstet. 2010;281(3):551–6.

    Article  PubMed  Google Scholar 

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The authors appreciate Ms. Farimah Shamsi for her help in consulting for statistical analysis and Ms. Leila Motamedzadeh for her laboratory skill during the study.

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Correspondence to Mohammad Ali Khalili.

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In cases with less than two retrieved immature oocytes fertilization rate may increase in cohort oocytes but has no effect on early embryo development. Also there is no correlation between the number of immature and mature oocytes in each cycle.

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Halvaei, I., Ali Khalili, M., Razi, M.H. et al. The effect of immature oocytes quantity on the rates of oocytes maturity and morphology, fertilization, and embryo development in ICSI cycles. J Assist Reprod Genet 29, 803–810 (2012).

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