Abstract
Purpose: To determine the correlation between the follicular sizes and oocyte recovery, metaphase II oocyte recovery, fertilization rate and good embryo quality from mature and immature oocytes in an intracytoplasmic sperm injection (ICSI) program.
Methods: 991 follicles obtained from 72 ICSI cycles were classified into three groups according to their diameters as measured by transvaginal ultrasound including group A (<10 mm), group B (10–14 mm), and group C (>14 mm). All obtained oocytes were classified according to their nuclear maturation: germinal vesicle (GV), metaphase I (MI) and metaphase II (MII). Mature oocytes underwent ICSI while immature oocytes were further cultured until maturity before ICSI was performed. The rates of fertilization and good quality embryos at day 3 were evaluated.
Results: A progressive and significant increase in the rates of oocyte recovery and MII oocyte recovery were observed from group A follicles compared to the other groups (p < 0.001). The fertilization rate of mature and in vitro matured oocytes, as well as the rate of good quality embryos showed a tendency to increase from group A to group C follicles, but not significantly. The corresponding fertilization rates were 78 and 55.3% (p < 0.001) for mature and in vitro matured oocytes, respectively.
Conclusion: Collection of oocytes from small follicles, especially with a mean diameter less than 10 mm, and in vitro maturation of immature oocytes before fertilization may allow the total number of good quality and transferable embryos to be increased.
Keywords: Follicular sizes, in vitro maturation, metaphase II oocyte, oocyte recovery
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References
- 1.Wittmaack FM, Tureck RW, Kreger DO, Mastroianni L, Jr, Blasco L, Lessey BA. Effect of follicular size on oocyte retrieval, fertilization, cleavage and embryo quality in in vitro fertilization cycles: A 6-years data collection. Fertil Steril. 1994;62:1205–1210. doi: 10.1016/s0015-0282(16)57186-6. [DOI] [PubMed] [Google Scholar]
- 2.Ectors FJ, Vanderzwalmen P, Hoeck JV, Nijs M, Verhaegen G, Delvigne A, Schoysman R, Leroy F. Relationship of human follicular diameter with oocyte fertilization and development after in-vitro fertilization or intracytoplasmic sperm injection. Hum Reprod. 1997;12:2002–2005. doi: 10.1093/humrep/12.9.2002. [DOI] [PubMed] [Google Scholar]
- 3.Tsuji K, Sowa M, Nakano R. Relationship between human oocyte maturation and different follicular sizes. Biol Reprod. 1985;32:413–417. doi: 10.1095/biolreprod32.2.413. [DOI] [PubMed] [Google Scholar]
- 4.Scott RT, Hofmann GE, Muasher SJ, Acosta AA, Kreiner DK, Rosenwaks Z. Correlation of follicular diameter with oocyte recovery and maturity at the time of transvaginal follicular aspiration. J In Vitro Fertil Embryo Transfer. 1989;6:73–75. doi: 10.1007/BF01130729. [DOI] [PubMed] [Google Scholar]
- 5.Dubey AK, Wang HA, Duffy P, Penzias AS. The correlation between follicular measurements, oocyte morphology, and fertilization rates in an in vitro fertilization program. Fertil Steril. 1995;64:787–790. doi: 10.1016/s0015-0282(16)57855-8. [DOI] [PubMed] [Google Scholar]
- 6.Van Steirteghem AC, Liu J, Joris H, Nagy ZP, Cecile J, Tournaye H, Derde MP, Van Assche E, Devroey P. Higher success rate by intracytoplasmic sperm injection than subzonal insemination. A report of a second series of 300 consecutive treatment cycles. Hum Reprod. 1993;8:1055–1060. doi: 10.1093/oxfordjournals.humrep.a138191. [DOI] [PubMed] [Google Scholar]
- 7.Yovich J, Grudzinskas G. The Management of Infertility: A Manual of Gamete Handling Procedures. Oxford: Heinemann Medical; 1990. [Google Scholar]
- 8.Blackledge DG, Thomas WP, Turner SR, Richardson PA, Matson PL, Yovich JL. Transvaginal ultrasonically-guided oocyte pick-up. Med J Aust. 1986;145:300. doi: 10.5694/j.1326-5377.1986.tb101136.x. [DOI] [PubMed] [Google Scholar]
- 9.Vanderhyden BC, Telfer EE, Eppig JJ. Mouse oocytes promote proliferation of granulosa cells from preantral and antral follicles in vitro. Biol Reprod. 1992;46:1196–1204. doi: 10.1095/biolreprod46.6.1196. [DOI] [PubMed] [Google Scholar]
- 10.Suchanek E, Simunic V, Juretic D, Grizelj V. Follicular fluid contents of hyaluronic acid, follicle-stimulating hormone and steroids relative to the success of in vitro fertilization of human oocytes. Fertil Steril. 1994;62:347–352. doi: 10.1016/s0015-0282(16)56890-3. [DOI] [PubMed] [Google Scholar]
- 11.Oktay K, Briggs D, Gosden RG. Ontogeny of follicle stimulating hormone receptor gene expression in isolated human ovarian follicle. J Clin Endocrinol Metab. 1997;82:3748–3751. doi: 10.1210/jcem.82.11.4346. [DOI] [PubMed] [Google Scholar]
- 12.Minegishi T, Tano M, Igarashi M, Rokukawa S, Abe Y, Ibuki Y, Miyamoto K. Expression of follicle-stimulating hormone receptor in human ovary. Eur J Clin Invest. 1997;27:469–474. doi: 10.1046/j.1365-2362.1997.1350682.x. [DOI] [PubMed] [Google Scholar]
- 13.Russel JB. Immature oocyte retrieval combined with in vitro oocyte maturation. Hum Reprod. 1998;13(Suppl):63–70. doi: 10.1093/humrep/13.suppl_3.63. [DOI] [PubMed] [Google Scholar]
- 14.Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril. 1994;62:353–362. doi: 10.1016/s0015-0282(16)56891-5. [DOI] [PubMed] [Google Scholar]
- 15.Cha KY, Han SY, Chung HM, Choi DH, Lim JM, Lee WS, Ko JJ, Yoon TK. Pregnancies and deliveries after in vitro maturation culture followed by in vitro fertilization and embryo transfer without stimulation in women with polycystic ovary syndrome. Fertil Steril. 2000;73:978–983. doi: 10.1016/s0015-0282(00)00422-2. [DOI] [PubMed] [Google Scholar]
- 16.Miller KF, Goldberg JM, Falcone T. Follicular size and implantation of embryos from in vitro fertilization. Obstet Gynecol. 1996;88:583–586. doi: 10.1016/0029-7844(96)00241-4. [DOI] [PubMed] [Google Scholar]
- 17.Bergh C, Broden H, Lundin K, Hamberger L. Comparision of fertilization, cleavage and pregnancy rates of oocytes from large and small follicles. Hum Reprod. 1998;13:1912–1915. doi: 10.1093/humrep/13.7.1912. [DOI] [PubMed] [Google Scholar]
- 18.Nogueira D, Staessen C, Vande Velde H, Van Steirteghem A. Nuclear status and cytogenetics of embryos derived from in vitro-matured oocytes. Fertil Steril. 2000;74:295–298. doi: 10.1016/s0015-0282(00)00642-7. [DOI] [PubMed] [Google Scholar]
- 19.Ludwig M, Finas DF, Al-Hasani S, Diedrich K, Ortmann O. Oocyte quality and treatment outcome in intracytoplasmic sperm injection cycles of polycystic ovarian syndrome patients. Hum Reprod. 1999;14:354–358. doi: 10.1093/humrep/14.2.354. [DOI] [PubMed] [Google Scholar]
- 20.Nagy ZP, Loccufier A, Cecile J, Devroey P, Liu J, Van Steirteghem A. Pregnancy and birth after intracytoplasmic sperm injection of in vitro matured germinal vesicle stage oocyte: Case report. Fertil Steril. 1996;65:1047–1050. doi: 10.1016/s0015-0282(16)58285-5. [DOI] [PubMed] [Google Scholar]
- 21.Trounson A, Anderiesz C, Jones GM, Kausche A, Lolatgis N, Wood C. Oocyte maturation. Hum Reprod. 1998;13(Suppl):52–62. doi: 10.1093/humrep/13.suppl_3.52. [DOI] [PubMed] [Google Scholar]
- 22.Morgan PM, Warikoo PK, Bavister BD. In vitro maturation of ovarian oocytes from unstimulated rhesus monkeys: Assessment of cytoplasmic maturity by embryonic development after in vitro fertilization. Biol Reprod. 1991;45:89–93. doi: 10.1095/biolreprod45.1.89. [DOI] [PubMed] [Google Scholar]
- 23.Barnes FL, Crombie A, Gardner DK, Kausche A, Lacham-Kaplan O, Suikkari AM, Tiglias J, Wood C, Trounson AO. Blastocyst development and birth after in vitro maturation of human primary oocytes, intracytoplasmic sperm injection and assisted hatching. Hum Reprod. 1995;10:101–105. doi: 10.1093/oxfordjournals.humrep.a135896. [DOI] [PubMed] [Google Scholar]
- 24.Trounson AO, Bongso A, Szell A. Maturation of human and bovine primary oocytes in vitro for fertilization and embryo production. Singapore J Obstet Gynecol. 1996;27:78–84. [Google Scholar]
- 25.Fulka J, First NL, Moor RM. Nuclear and cytoplasmic determinants involved in the regulation of mammalian oocyte maturation. Mol Hum Reprod. 1998;4:41–49. doi: 10.1093/molehr/4.1.41. [DOI] [PubMed] [Google Scholar]
- 26.Mikkelsen AL, Smith S, Lindenberg S. Impact of oestradiol and inhibin A concentrations on pregnancy rate in in-vitro oocyte maturation. Hum Reprod. 2000;15:1685–1690. doi: 10.1093/humrep/15.8.1685. [DOI] [PubMed] [Google Scholar]