In-vitro maturation (IVM) was performed in 350 cycles for 262 unstimulated patients diagnosed with polycystic ovary syndrome who were primed with human chorionic gonadotrophin (HCG) before oocyte retrieval. In order to improve nuclear and cytoplasmic maturation, growth hormone was added to the maturation medium. Oocytes were recovered in 94.8% of the cycles, with a mean number of nine cumulus-oocyte complexes retrieved. Within 28 h, 62% of the oocytes reached the metaphase II (MII) stage, and 17.6% were MII after a further 20 h in culture. An ongoing pregnancy rate of 15.2% was obtained, but with a high miscarriage rate, 28% of the total with a positive betaHCG test assessed after embryo transfer. Cytogenetic and DNA fragmentation analysis of the embryos was not fundamentally different from what is classically observed in routine IVF. This observation implies that the results are not necessarily due to compromised oocyte quality after IVM, and that endometrial receptivity should also be considered, especially in IVM cycles where the follicular phase is dramatically shortened.

Background MicroRNAs (miRNAs) are small RNA molecules that modulate post-transcriptional gene regulation. They are often used as promising non-invasive biomarkers for the early diagnosis of cancer. However, their roles in assisted reproduction are still unknown. Methods This prospective study was designed to evaluate the expression profiles of seven extracellular miRNAs (miR-7-5p, miR-202-5p, miR-378-3p, miR-224, miR-320a, miR-212-3p, and miR-21-5p) in human follicular fluid (FF) to explore the outcomes of in vitro fertilization (IVF). Of 255 women, 145 were without polycystic ovary syndrome (PCOS), and their ovarian assets were normal (NOR), while 110 were with normo-androgenic PCOS. Results The combination of six FF miRNAs expression profile discriminated between PCOS and NOR women with a sensitivity of 79.2% and a specificity of 87.32% (AUC = 0.881 [0.61; 0.92], p = 0.001). MiR-202-5p significantly had a lower abundance level, and miR-378-3p had a high abundance level in pooled FF samples from patients treated with human menopausal gonadotropin (hMG) than those treated with recombinant follicle-stimulating hormone (rFSH) (p < 0.001). Our results showed that miRNA-320a was significantly different in top-quality embryos versus non-top-quality embryos on day 3 in NOR patients with a sensitivity of 80% and specificity of 71%, (AUC = [0.753 (0.651; 0.855)], p = 0.001). For clinical pregnancy outcome prediction, FF miRNA-21 exhibited high sensitivity (74.8%) and specificity (83.7%) with the AUC value of 0.774 (0.682; 0.865). Conclusion Conclusively, our results provide evidence that miR-7-5p, miR-378-3p, miR-224, miR-212-3p were a differentially high expression in normo-androgenic PCOS patients than NOR patients. While miRNA-320a was significantly different in top-quality embryos versus non-top-quality embryos on day 3 (p = 0.001). The expression level of FF miR-212-3p was significantly related to the probability of embryos to develop into a high-quality blastocyst in patients with normal ovarian reserve.

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This retrospective case control study was executed to compare the efficacy of short and long acting Gonadotropin releasing hormone agonist (GnRH-a) on pregnancy outcome. A total of 540 cycles with a history of male factor were identified from 2013 to 2016. The patients were separated into two groups: long acting protocol (LAP) group consisting of 310 cycles which were induced by a combination of GnRH-a incorporated with Follicular stimulating hormone (FSH) and Human menopausal gonadotropin (hMG), while short acting protocol (SAP) group or flare up regimen comprises of 230 cycles introduced by a combination of GnRH-a along with FSH and hMG. Patients are divided into subsequent age groups ≤ 30, 31–35, 36–40 and > 40 years. In comparison with the SAP group, the duration of ovarian stimulation, calculated dose of GnRH-a, number of retrieved mature oocytes, good quality embryos for implantation and persistent pregnancies were all significantly found to be high (p < 0.05) in the LAP group as compared to the SAP group. The clinical pregnancy rates were comparatively high in the LAP group (33.12%; P = 0.001) than in the SAP group (28.23%). The findings of our study revealed that irrespective of patient’s age, the long acting protocol was more reliable and fertile with reference to number of mature oocytes retrieved, time period for stimulation, total dose of GnRH-a during controlled ovarian hyperstimulation, high quality embryos, fertilization and cleavage rate as well as pregnancy outcome.