Relationship between follicular size and developmental capacity of oocytes under controlled ovarian hyperstimulation in assisted reproductive technologies

Tamura, Isao; Kawamoto-Jozaki, Mai; Fujimura, Taishi; Doi-Tanaka, Yumiko; Takagi, Hajime; Shirafuta, Yuichiro; Mihara, Yumiko; Tanaka, Toshiaki; Tamura, Hiroshi

doi:10.1002/rmb2.12382

Cited by 10 publications

(9 citation statements)

References 32 publications

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“…In our follicle models, the Polygon and Inverted-trapezoid models had the highest CLBR in comparison with the other models, and the proportion of mature oocytes in these models was higher than that in the other models. This is consistent with a study suggesting that the proportion of MII oocytes was signi cantly lower in small follicles (<13 mm) than in large follicles (≥16 mm), but with no difference in fertilization [29]. Previous studies have also reported lower oocyte recovery, reduced MII oocyte rates, and normal fertilization rates in small follicles [3,30,31].…”

Section: Discussionsupporting

confidence: 91%

“…The highest number of viable embryos in the Polygon model may be due to the higher proportion of mature oocytes. This is supported by previous ndings [29][30][31] that the proportion of mature oocytes is correlated with follicular size. In the Polygon model, moderate follicles (diameter 16-18 mm) accounted for the largest group, and there was less likelihood of receiving "post-mature" oocytes than in the Inverted-trapezoid model, which has 25% follicles that are too large (>20 mm).…”

Section: Discussionsupporting

confidence: 87%

“…However, that study was limited to cycles in which patients underwent ICSI and lacked data for IVF. A recent study 29 indicated that both the blastocyst formation rate and the pregnancy rate did not differ according to follicular size. These studies were focused on the outcome of only one blastocyst transfer cycle.…”

Section: Discussionmentioning

confidence: 95%

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Relation of graphical follicle models to the cumulative live birth rate in GnRH-antagonist stimulation treatment cycles

Yang

Liu

et al. 2022

Preprint

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Background: Previous studies have observed the number and size of follicles are two independent indicators of whether the oocyte is adequate and mature and are used to predict the trigger time in routine clinical practice. However, due to individualized differences, it currently relies mainly on physician experience. It is necesaary to explore an innovative, simple, and graphical model for predicting clinical results in ovary stimulation treatment and facilitating personalized protocol adjustment.Methods: This retrospective study included 8405 patients who started their first in vitro fertilization cycle with a GnRH-ant protocol including fresh and subsequent frozen-thawed cycles during 2016-2020. Using follicle size and number, we classified follicles recorded on the human chorionic gonadotropin (HCG) day by size (small, medium, large). Producing graphical models, and classified into Inverted-trapezoid (large follicles in dominant proportion), Polygon (moderate follicles in dominant proportion), Trapezoid (small follicles in dominant proportion), and Rectangle (equivalent proportions of the three size categories). The Cochran-Mantel-Haenszel (CMH) and Generalized Linear Model(GLM) were used to evaluate the difference among models about maturity, fertilization, and the number of viable embryos, as well as cumulative live birth rate(CLBR).Results: In GLM analysis, after adjusting the confounders, there are differences between models of CLBR. The CLBR of the different models was higher in the Polygon and Inverted-trapezoid model than Trapezoid and Rectangle model (42.75%, 39.56%, vs. 37.38%, 28.57%, respectively; all P<0.05). For oocytes derived from very large follicles (>20 mm), the CLBR was lower than that of patients with ≤20 mm follicles [26.10% vs. 42.10%, OR = 1.74 (95% confidence interval 1.52–2.00), P<0.01] in Inverted-trapezoid model, but there was no difference between models.And the risk of ovarian hyperstimulation syndrome (OHSS) rate of patients with ≤20 mm follicles was lower than that of patients with >20 mm follicles [8.64% vs. 17.89%, OR = 0.57 (95%CI: 0.49-0.65), P<0.01] in Inverted-trapezoid model. Patients who received an adjusted Gn dose(whether Decreased or Increased-dose protocol) showed no difference in CLBR among models (Polygon vs Inverted-trapezoid vs Trapezoid vs Rectangle model: 47.07% vs. 49.21% vs. 47.69% vs. 42.42%, P>0.05); but when patients continued with the same starting dose in Fixed-dose protocol, the CLBR of the Polygon model was higher than that of other models (40.43% vs. 34.32, 31.13% vs. 26.46%, respectively; all P value <0.05).Conclusion：Our results suggested the follicle models can demonstrate characteristics and the ovarian response of patients. In addition to the patients in very good condition who develop a Polygon model, it is better for other patients to reach the Inverted-trapezoid model with follicles >18 mm and <20 mm. Adjusting the protocol is critical to the outcome. But determining how to improve follicle models by regulating stimulation remains to be further studied.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

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Relation of graphical follicle models to the cumulative live birth rate in GnRH-antagonist stimulation treatment cycles

Yang

Liu

et al. 2022

Preprint

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“…We found that MII oocyte rate, FOI, and FORT were the most important predictor variables in predicting euploid. Previous research suggested the MII oocytes rate from large follicles is significantly higher than from small follicles [ 13 ]. MII oocyte rate rather than the number of oocytes retrieved is a more accurate predictor of implantation and clinical pregnancy in IVF cycles [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Nomogram based on clinical and laboratory characteristics of euploid embryos using the data in PGT-A: a euploid-prediction model

Liu

2022

BMC Pregnancy Childbirth

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Background The evaluation of embryo morphology may be inaccurate. A euploid prediction model is needed to provide the best and individualized counseling about embryo selection based on patients and embryo characteristics. Methods Our objective was to develop a euploid-prediction model for evaluating blastocyst embryos, based on data from a large cohort of patients undergoing pre-implantation genetic testing for aneuploidy (PGT-A). This retrospective, single-center cohort study included data from 1610 blastocysts which were performed PGT-A with known genetic outcomes. The study population was divided into the training and validation cohorts in a 3:1 ratio. The performance of the euploid-prediction model was quantified using the area under the receiver operating characteristic (ROC) curve (AUC). In addition, a nomogram was drawn to provide quantitative and convenient tools in predicting euploid. Results We developed a reliable euploid-prediction model and can directly assess the probability of euploid with the AUC (95%CI) of 0.859 (0.834,0.872) in the training cohort, and 0.852 (0.831,0.879) in the validation cohort, respectively. The euploid-prediction model showed sensitivities of 0.903 and specificities of 0.578. Conclusions The euploid-prediction model is a reliable prediction model and can directly assess the probability of euploid.

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“…Controlled ovarian hyperstimulation (COH) was performed using standard gonadotropin releasing hormone agonist (GnRHa)/follicle-stimulating hormone (FSH) protocols, as we reported previously [ 53 ]. Nasal spray GnRHa (900 μg/day) was given from the mid-luteal phase in the previous cycle to continuously suppress pituitary gonadotropin secretion until the injection of HCG (10,000 IU).…”

Section: Methodsmentioning

confidence: 99%

Effects of Melatonin on the Transcriptome of Human Granulosa Cells, Fertilization and Blastocyst Formation

Tamura

Kawamoto-Jozaki

et al. 2022

IJMS

Self Cite

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Melatonin is a promising reagent that can improve assisted reproductive technology (ART) outcomes in infertility patients. However, melatonin is not effective for all infertile patients, and it remains unclear for which patients melatonin would be effective. This study examined the effects of melatonin on ART outcomes and examined its mechanisms. Melatonin increased the fertilization rate in patients whose fertilization rates in the previous cycle were less than 50%, but not in patients whose fertilization rates were more than 50% in the previous cycle. Melatonin increased the blastocyst formation rate in patients whose embryo development rates in the previous cycle were less than 50%, but not in patients whose embryo development rates were more than 50% in the previous cycle. To clarify its mechanisms, transcriptome changes by melatonin treatment in granulosa cells (GCs) of the patients were examined by RNA-sequence. Melatonin treatment altered the transcriptomes of GCs of patients with poor ART outcomes so that they were similar to the transcriptomes of patients with good ART outcomes. The altered genes were associated with the inhibition of cell death and T-cell activity, and the activation of steroidogenesis and angiogenesis. Melatonin treatment was effective for patients with poor fertilization rates and poor embryo development rates in the previous ART cycle. Melatonin alters the GCs transcriptome and, thus, their functions, and this could improve the oocyte quality, leading to good ART outcomes.

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Relationship between follicular size and developmental capacity of oocytes under controlled ovarian hyperstimulation in assisted reproductive technologies

Cited by 10 publications

References 32 publications

Relation of graphical follicle models to the cumulative live birth rate in GnRH-antagonist stimulation treatment cycles

Relation of graphical follicle models to the cumulative live birth rate in GnRH-antagonist stimulation treatment cycles

Nomogram based on clinical and laboratory characteristics of euploid embryos using the data in PGT-A: a euploid-prediction model

Effects of Melatonin on the Transcriptome of Human Granulosa Cells, Fertilization and Blastocyst Formation

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