The effect of short-term exposure of cumulus-oocyte complexes to in vitro maturation medium on yield of mature oocytes and usable embryos in stimulated cycles
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We examined whether short-term exposure to in vitro maturation (IVM) medium of cumulus-oocyte complexes (COCs) from a stimulated cycle increases the yield of metaphase II (MII) oocytes and usable embryos.
Retrospective review of two consecutive autologous IVF/ICSI cycles per patient between 2007 and 2015 in which cycle 1 did not result in live birth. Patients with short-term exposure of COCs to IVM medium (3–5 h before standard insemination or ICSI) in cycle 2 (treated) were matched 1:4 on %MI and %MII to patients without use of IVM in cycle 2 (untreated). The proportions of mature oocytes, two pronucleate (2PN) zygotes, number of usable embryos, and clinical outcomes were compared between groups with regression modeling.
The treated (n = 43) and untreated (n = 163) groups had similar demographic characteristics and similarly high proportions of immature oocytes (48.2 vs. 41.3%, respectively) in cycle 1. There were no significant differences between the treated and untreated groups in the change in %MII (48.1 to 68.9% vs. 50.5 to 72.5%, respectively) or mean number of usable embryos (2.2 to 3.4 vs. 2.0 to 3.3, respectively) from cycle 1 to cycle 2.
These findings suggest that short-term IVM incubation of COCs may not provide any additional benefit in patients with a prior unsuccessful cycle notable for a high proportion of immature oocytes. Further randomized studies are warranted to determine whether there is a subset of patients who may have improved clinical outcomes with this “rescue IVM” intervention.
KeywordsIn vitro maturation Oocytes IVF Maturity
The authors acknowledge the Brigham and Women’s Hospital Embryology team for their assistance in data retrieval.
Compliance with ethical standards
This retrospective study was approved by the Partners’ Healthcare Institutional Review Board.
Conflict of interest
The authors declare that they have no conflict of interest.
- 9.Reichman D, Politch J, Ginsburg E, Racowsky C. Extended in vitro maturation of immature oocytes from stimulated cycles: an analysis of fertilization potential, embryo development, and reproductive outcomes. J Assist Reprod Genet. 2010;27:347–56. https://doi.org/10.1007/s10815-010-9416-5.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Coticchio G, Dal Canto M, Mignini Renzini M, Guglielmo MC, Brambillasca F, Turchi D, et al. Oocyte maturation: gamete-somatic cells interactions, meiotic resumption, cytoskeletal dynamics and cytoplasmic reorganization. Hum Reprod Update. 2015;21(4):427–54. https://doi.org/10.1093/humupd/dmv011.CrossRefPubMedGoogle Scholar
- 15.Strassburger D, Goldstein A, Friedler S, Raziel A, Kasterstein E, Mashevich M, et al. The cytogenetic constitution of embryos derived from immature (metaphase I) oocytes obtained after ovarian hyperstimulation. Fertil Steril. 2010;94(3):971–8. https://doi.org/10.1016/j.fertnstert.2009.04.035.CrossRefPubMedGoogle Scholar
- 17.Liu S, Li Y, Gao X, Yan J, Chen Z. Changes in the distribution of mitochondria before and after in vitro maturation of human oocytes and the effect of in vitro maturation on mitochondria distribution. Fertil Steril. 2010;93(5):1550–5. https://doi.org/10.1016/j.fertnstert.2009.03.050.CrossRefPubMedGoogle Scholar