ObjectiveTo evaluate the influence of ovarian follicular dominance on the outcome of
oocyte in-vitro maturation.MethodsThis retrospective cohort study included 21 patients with polycystic ovaries
or polycystic ovary syndrome (Rotterdam criteria, 2004) subjected to 24
in-vitro maturation (IVM) cycles between October 2015
and January 2017. Patients undergoing IVM received minimal gonadotropin
stimulation starting on day 2 or 3 of the cycle; ovum pick-up typically
occurred on days 6 to 8. No hCG-trigger shot was given. Following 30h of
IVM, mature oocytes were inseminated by ICSI and the resulting embryos
cultured up to the blastocyst stage.ResultsOvarian follicular dominance was observed in nine of the 24 IVM cycles.
Oocyte IVM yielded an overall maturation rate of 69.3±23.8%, and no
difference was observed when the groups with or without a dominant follicle
were assessed independently. The rates of fertilization and usable
blastocysts per fertilized oocyte, mature oocyte (Metaphase II) or
cumulus-oocyte-complex were nearly three times higher (28.7±22.5%) in
the group without ovarian follicular dominance. No differences were found in
the clinical pregnancy rates attained by the individuals with or without a
dominant follicle after 21 vitrified-warmed blastocyst transfer cycles.ConclusionOccurrence of ovarian follicular dominance during hormonal stimulation for
in-vitro maturation negatively impacted embryological
outcomes. Strategies devised to limit the appearance of ovarian follicular
dominance must be further explored.