In vitro maturation (IVM) of human oocytes is an attractive alternative to conventional assisted reproductive technology (ART) treatment, as it involves no or minimal ovarian stimulation. Currently, commercialized media specifically designed for IVM are often used. These media are expensive, have limited shelf life, and must be ordered in advance. If standard culture media can be used in place of the specialized IVM media, it would simplify management and make IVM more feasible and more widely employed in ART centers around the world, especially in developing countries where resources are scarce. This study was, therefore, conducted to test the hypothesis that blastocyst medium was as good as commercial IVM medium to support maturation and developmental competence of human immature oocytes as previously shown in the mouse system. Immature oocytes were obtained by needle aspiration from 89 pregnant women during cesarean deliveries between April 2012 and February 2013. Sibling oocytes were allocated to Sage IVM media (512 oocytes) or blastocyst medium (520 oocytes) and assessed for maturation 36 hours later. Mature oocytes were inseminated by intracytoplasmic sperm injection and cultured up to 144 hours. There was no difference in maturation rate (65.0% vs 68.7%; P ¼ .218) or fertilization rate (66.9% vs 66.4%; P ¼ .872) of oocytes matured in vitro in both media. There was also no difference in the formation of good-quality blastocysts (46.6% vs 45.9%; P ¼ .889) in the 2 groups. Further study should be done to ascertain implantation and pregnancy potential of these embryos.
ObjectiveThe aim of this study was to compare the rate of maturation, fertilization, and embryo development of in vitro-matured human oocytes derived from pregnant and non-pregnant women.MethodsImmature oocytes were obtained by needle aspiration from 49 pregnant women (group 1) who underwent a cesarean section at term and 77 non-pregnant women (group 2) who underwent a gynecological operation during the same period (8 months). Healthy immature oocytes (530 in group 1 and 539 in group 2) were cultured and assessed for maturation 36 hours later. Mature oocytes were inseminated by intracytoplasmic sperm injection and cultured up to 144 hours.ResultsThe percentage of degenerated oocytes was significantly higher (12.1% vs. 6.3%; p<0.001) in group 1 than in group 2. There was no significant difference in the maturation rate (66.8% vs. 68.1%; p=0.698), fertilization rate (66.7% vs. 67.6%; p=0.857), or the rate of formation of good-quality blastocysts (46.2% vs. 47.2%; p=0.898) in oocytes obtained from pregnant and non-pregnant women.ConclusionThe developmental competence of immature oocytes did not differ between pregnant and non-pregnant women.
Abstracts Analysis of transabdominal ultrasonic findings of 167 patients presented with clinical suspicion of extrauterine pregnancies (EUP), all with measurable serum HCG, has been undertaken. Patients were divided into two main groups, namely those with demonstrable typical intrauterine gestational sac (46.7%), and those without (53.3%). This later group of patients, i.e., without intrauterine sac, was further subdivided into four other groups depending on whether or not they have adnexal mass and/or fluid in cul‐de‐sac. In this first subgroup of patients (21 cases), without any demonstrable mass or fluid, a positive predictive value (PPV) for EUP of only 28.6% was obtained. With ultrasound showing fluid but no mass, the PPV was 55.6%, while those with both mass and fluid, the PPV as high as 95.7% was possible. Characterization of the adnexal mass or cul‐de‐sac findings among those with empty uterus may further improve PPV. The results of this study indicates that ultrasonic examination can help to provide a more correct diagnosis in the investigation of EUP. EUP can be easily excluded, in the great majority of cases, with sonographic visualization of intrauterine pregnancy. In the case of empty uterus with no mass nor fluid, patients should be closely followed up with HCG titer and ultrasonic examination. For those with empty uterus with fluid, culdocentesis may be indicated; whereas in the case of empty uterus with mass, laparoscopy should be considered as additional investigative procedures.
Aim: To investigate the developmental competence of human embryos that originated from in vitro matured oocytes retrieved during cesarean section. Methods: Immature oocytes were collected from 95 pregnant women, who underwent cesarean section at Buddhachinaraj Hospital Medical School and consented to participate in the study. Retrieved oocytes were cultured in blastocyst medium supplemented with 75 IU/L of human menopausal gonadotropin. Oocyte maturation was assessed at 30 and 48 h after culture. In vitro matured oocytes were inseminated by intracytoplasmic sperm injection and cultured up to 144 h. The fertilization, cleavage and blastocyst formation rates were observed. Results: Maturation rate of oocytes after 30 h of culture was 67.9% compared with 13.1% at 48 h (P < 0.0001). Insemination of oocytes in both groups resulted in similar fertilization, cleavage and blastocyst formation rates. Conclusion: A large proportion of oocytes retrieved at the time of cesarean section exhibited the capacity to undergo maturation in vitro. They can be fertilized and developed into good-quality blastocyst stage.
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