Recovery and Maturation of Immature Oocytes in Patients at Risk for Ovarian Hyperstimulation Syndrome
Purpose: Our purpose was to examine the rate of immature oocyte recovery and their potential for in vitro maturation from canceled human menopausal gonadotropin cycles due to the risk of having ovarian hyperstimulation syndrome develop.
Methods: Patients underwent ultrasound-guided immature oocyte pickup. The number of oocytes recovered from these patients was recorded, and then cultured in vitro. Cumulus expansion and the stage of nuclear maturation were observed after 24 and 48 hr, respectively.
Results: Seventeen patients underwent 20 immature oocyte recoveries. A total of 162 oocytes (8.1 oocytes/patient) was obtained. All of the oocytes were enclosed in dense layers of cumulus cells. Among them, 78.4% showed cumulus expansion after 24 hr and 66% completed meiotic maturation to metaphase II after 48 hr in culture. There was only one immature oocyte pickup in which no oocytes were recovered (95% recovery rate). None of the patients had ovarian hyperstimulation syndrome develop.
Conclusions: Immature oocytes can be recovered from canceled human menopausal gonadotmpin cycles in patients who are at potential risk for severe hyperstimulation syndrome. These oocytes can be matured in vitro and can be used for clinical and research purposes as well.
Unable to display preview. Download preview PDF.
- 1.Zeleznik AJ: Dynamic of primate follicular growth. A physiological perspective. In The Ovary, EY Adashi, PCK Leung (eds). New York, Raven Press, 1993, pp 41–55Google Scholar
- 2.Edwards RG, Brody SA: Principles and Practice of Assisted Human Reproduction. Philadelphia, Saunders, 1995Google Scholar
- 3.Wassarman PM: The mammalian ovum. In The Physiology of Reproduction, E Knobil, J Neill (eds). New York Raven Press, 1988, pp 69–112Google Scholar
- 4.Edwards RG: Maturation in vitro of mouse, sheep, cow, pig, rhesus monkey and human ovarian oocytes. Nature 1965;208:349–351Google Scholar
- 5.Fukuda Y, Ichikawa M, Naito K, Toyoda Y: Birth of normal calves resulting from bovine oocytes matured, fertilized and cultured with cumulus cells in vitro up to blastocyst stage. Biol Reprod 1990;42:114–119Google Scholar
- 6.Yoshida M, Mizoguchi Y, Ishigaki K, Kojima T, Nagai T: Birth of piglets derived from in vitro fertilization of pig oocytes matured in vitro. Theriogenolgy 1993;39:1303–1311Google Scholar
- 7.Cha KY, Koo JJ, Ko JJ, Choi DH, Han SY, Yoon TK: Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril 1991;55:109–113Google Scholar
- 8.Trounson A, Wood C, Kausche A: In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril 1994;62:353–362Google Scholar
- 9.Barnes FL, Crombie A, Gardner DK, Kausche A, Lacham-Kaplan O, Suikkari AM, Tiglias J, Wood C, Trounson AO: Blastocyst development and birth after in vitro maturation of human primary oocytes, intracytoplasmic sperm injection and assisted hatching. Hum Reprod 1995;10:3243–3247Google Scholar
- 10.Russell JB, Knezevich KM, Fabian KF, Dickson JA: Unstimulated immature oocyte retrieval: Early vs. mid follicular endometrial priming. Fertil Steril 1997;67:616–620Google Scholar
- 11.Jaroudi KA, Hollanders JMG, Sieck UV, Roca GL, Elnour AM, Coskun S: Pregnancy after transfer of embryos which were generated from in vitro-matured oocytes. Hum Reprod 1997;12:857–859Google Scholar
- 12.Prins G, Wagner C, Weidel L, Gianfortoni J, Marut E, Scommegna A: Gonadotropins augment maturation and fertilization of human immature oocyte cultured in vitro. Fertil Steril 1987;47:1035–1037Google Scholar
- 13.Zhang X, Zerafa AJW, Armstrong DT, Khamsi F: Human menopausal gonadotropin during in vitro maturation of human oocytes retrieved from small follicles enhances in vitro fertilization and cleavage rates. Fertil Steril 1993;59:850–853Google Scholar
- 14.Dandekar PV, Martin MC, Glass RH: Maturation of immatures oocytes by coculture with granulosa cells. Fertil Steril 1991;55:95–99Google Scholar
- 15.Lindenberg S: Factors regulating in vitro maturation of oocytes. Oral presentation at ESHRE'97, Edinburg, UK, 22–25 June 1997Google Scholar
- 16.Asch RH, Li H, Yovich JL, Katayama KP, Balmaceda JP, Rojas FJ, Stone SC: Failed oocyte retrieval after lack of human chorionic gonadotropin administration in assisted reproductive technology. Fertil Steril 1992;58:361–365Google Scholar
- 17.Shoham Z, Jacobs HS, Insler V: Luteinizing hormone: its role mechanism of action and detrimental effects when secreted during the follicular phase. Fertil Steril 1993;59:1153–1161Google Scholar
- 18.Zegers-Hochschild F, Fernadez E, Mackenna A, Fabres C, Altieri E, Lopez T: The empty follicle syndrome: A pharmaceutical industry syndrome. Hum Reprod 1995;9:2262–2265Google Scholar
- 19.Pincus G, Enzmann EV: The comparative behavior of mammalian eggs in vivo and in vitro. I. The activation of ovarian eggs. J Exp Med 1935;62:655–675Google Scholar
- 20.Edwards RG, Bavister BD, Steptoe PC: Early stages of fertilization in vitro of human oocytes matured in vitro. Nature 1969;221:632–635Google Scholar
- 21.Bomsel-Helmreich O, Huyen LVN, Durand-Gasselin I, Salat-Baroux J, Antoine JM: Mature and immature oocytes in large and medium follicles after clomiphene citrate and human menopausal gonadotropin stimulation without human chorionic gonadotropin. Fertil Steril 1987;48:596–604Google Scholar
- 22.Barnes FL, Kausche A, Tiglias J, Wood C, Wilton L, Trounson AO: Production of embryos from in vitro-matured primary human oocytes. Fertil Steril 1996;65:1151–1156Google Scholar
- 23.Gomez E, Tarin JJ, Pellicer A: Oocyte maturation in humans: The role of gonadotropins and growth factors. Fertil Steril 1993;60:40–46Google Scholar
- 24.Wynn P, Krapez J, Picton HM, Rutherford AJ, Gosden RG: Randomization study of oocytes matured in vitro after collection from unstimulated or mildly stimulated patients. Hum Reprod 1997;12 (abstract book 1):13Google Scholar