Obstetric outcome of patients with polycystic ovary syndrome treated by maturation and fertilization and embryo transfer

Background/Purposes A common observation in oocyte in vitro maturation (IVM) cycles is poor embryo quality. However, no study was dedicated to assess zygote and early cleavage embryo quality in IVM cycles. The objective of this study is to analyze fertilization outcome, embryo development and the resulting pregnancy and births in unstimulated IVM cycles. Methods IVM oocytes were collected 36 h post hCG and matured in vitro for 28-30 h. All oocytes were inseminated by ICSI. Resulting zygotes and embryos were assessed on day-1, 2 and 3, when transfers were made. Results The overall oocyte maturation and fertilization rates were 63% and 62%, respectively. Abnormal fertilization rate was 1.7%. Ninety five and 14.6% of the 2Pn zygotes reached the 2-cell and 8 -cell stage at day-2 and day-3, respectively. Embryo quality assessment on day-3 at transfer revealed that only 9% of the embryos were of very good quality. Most embryos showed developmental delay. An average of 3.29 embryos were transferred per patient resulting in implantation and clinical gestation rates of 16% and 32%, respectively. Overall 14 healthy babies were born and there is one ongoing pregnancy. ConclusionResults show a significant rate of abnormal fertilization and poor embryo quality after IVM, which is reflected in a higher than average number of embryos being transferred. However, pregnancy, implantation and birth rates are reasonably high and allow us to consider IVM a valuable approach for the treatment of infertility in PCO or PCOS patients.

Section: Introductionmentioning

confidence: 99%

Fertilization outcome, embryo development and birth after unstimulated IVM

Bös-Mikich

Ferreira²,

Höher³

et al. 2010

“…For that reason, women with polycystic ovaries, who have several antral follicles by definition, are the best candidates for an IVM treatment [31][32][33][34][35][36][37][38].…”

Section: Discussionmentioning

confidence: 99%

“…Alternative reproductive strategies have been proposed to reduce risks and costs of in-vitro technology or merely simplify the clinical procedure. In-vitro maturation (IVM) of oocytes has been adopted in some centres to avoid ovarian stimulation in women at high risk of ovarian hyperstimulation syndrome (OHSS), such as polycystic ovary (PCO) or polycystic ovary syndrome (PCOS) patients [31][32][33][34][35][36][37][38]. In other cases, IVM has been also suggested to represent an alternative for the treatment of women with normal ovarian physiology, but suffering from tubal pathologies or with an infertile partner [39][40][41].…”

Section: Introductionmentioning

confidence: 99%

Anti-mullerian hormone as a predictive marker for the selection of women for oocyte in vitro maturation treatment

Fadini

Comi

Renzini

et al. 2011

Purpose In oocyte in-vitro maturation (IVM) treatments, the chances to achieve a pregnancy are critically dependent on the retrieval of a suitable number of oocytes. In this study, we assessed the ability of circulating levels of anti-mullerian hormone (AMH) to identify normo-ovulatory women suitable for IVM treatment on the basis of the number of retrieved oocytes. Method Serum AMH was quantified in normo-ovulatory women younger than 39 years undergoing IVM treatment. After immature oocyte retrieval and IVM, maximum 3 mature oocytes were used for treatment and all resulting embryos were transferred, as established by law. From 177 cycles, 991 oocytes were recovered. Following IVM, 484 mature oocytes were obtained (50.1%). Results The overall pregnancy rate per embryo transfer was 16.6% (25/151) and the implantation rate was 10.9% (30/ 278). Linear regression and receiver operating characteristic (ROC) analyses were applied to identify independent variables and quantify a cut-off AMH value able to identify patients suitable for IVM treatment. An AMH value of 1.28 ng/ml was identified as a threshold for the prediction of the retrieval of at least 5 oocytes, with a sensitivity of 93.4% and a specificity of 33.8%. Positive and negative predictive values were 67.6% and 75.0%, respectively. Conclusions AMH can be adopted to identify women candidate for an IVM treatment from whom a suitable number of oocytes may be retrieved. This is of crucial significance during a non-stimulated cycle, in order to prevent an insufficient oocyte collection and rescue the treatment by implementing a conventional controlled ovarian stimulation.

“…Apart from that IVM also provides a source of invaluable and scarce oocyte [5]. In patients with polycystic ovary syndrome (PCOS) IVM is offered as an important treatment strategy [4,16]. In spite of so many beneficial sides of IVM over routine IVF technique, this is still confined at experimental level in human.…”

Section: Introductionmentioning

confidence: 99%

Resveratrol treatment during goat oocytes maturation enhances developmental competence of parthenogenetic and hand-made cloned blastocysts by modulating intracellular glutathione level and embryonic gene expression

Mukherjee

Malik

Saha

et al. 2013

Purpose The aim of the present study was to determine whether supplementation of resveratrol, a stilbenoid antioxidant with therapeutic significance, influences goat (Capra hircus) oocyte maturation and subsequent embryonic development and expression of apoptosis and early embryonic development-related genes. Methods Five different concentrations of resveratrol (0.1, 0.25, 0.5, 2.0 and 5.0 μM) were used in in vitro maturation (IVM) medium. Cell tracker blue and 2′,7′-dichlorodihydrofluorescein diacetate (H 2 DCFDA) fluorescent stains were used to assay intracellular glutathione and reactive oxygen species levels in mature oocytes. Parthenogenetic activation and hand-made cloning were performed to check the developmental potential following resveratrol treatment. We used quantitative real-time PCR to analyze embryonic gene expression. Result Compared to control, no significant improvement was observed in nuclear maturation in resveratrol-treated groups and at 5.0 μM concentration maturation rate decreased significantly (P <0.05). But resveratrol treatment at the concentrations of 0.25, 0.5 μM significantly reduced intracellular ROS, and increased GSH concentrations. Oocytes treated with 0.25, 0.5 μM resveratrol when subsequently used for PA and HMC, higher extent of blastocyst yields were observed. Expression analysis of proapoptotic (Bax) gene in mature oocytes, cumulus cells, and HMC-derived blastocysts revealed lesser transcript abundances in various resveratrol-treated groups., however no change in the same was observed for antiapoptotic gene (Bcl2). Differential expression of genes associated with developmental competence and nuclear reprogramming was also observed in HMC-derived blastocysts. Conclusion Our results show that resveratrol treatment at optimum concentrations (0.25 and 0.5 μM) during IVM produced beneficial microenvironment within oocytes by increasing the intracellular GSH, decreasing ROS level and this in turn, stimulated embryonic development and regulated gene expression.