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J Assist Reprod Genet. 2018 May;35(5):841-849. doi: 10.1007/s10815-018-1155-z. Epub 2018 Mar 14.

The effect of short-term exposure of cumulus-oocyte complexes to in vitro maturation medium on yield of mature oocytes and usable embryos in stimulated cycles.

Author information

1
Department of Obstetrics & Gynecology, Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
2
Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
3
Department of Obstetrics & Gynecology, Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. cracowsky@bwh.harvard.edu.

Abstract

PURPOSE:

We examined whether short-term exposure to in vitro maturation (IVM) medium of cumulus-oocyte complexes (COCs) from a stimulated cycle increases the yield of metaphase II (MII) oocytes and usable embryos.

METHODS:

Retrospective review of two consecutive autologous IVF/ICSI cycles per patient between 2007 and 2015 in which cycle 1 did not result in live birth. Patients with short-term exposure of COCs to IVM medium (3-5 h before standard insemination or ICSI) in cycle 2 (treated) were matched 1:4 on %MI and %MII to patients without use of IVM in cycle 2 (untreated). The proportions of mature oocytes, two pronucleate (2PN) zygotes, number of usable embryos, and clinical outcomes were compared between groups with regression modeling.

RESULTS:

The treated (n = 43) and untreated (n = 163) groups had similar demographic characteristics and similarly high proportions of immature oocytes (48.2 vs. 41.3%, respectively) in cycle 1. There were no significant differences between the treated and untreated groups in the change in %MII (48.1 to 68.9% vs. 50.5 to 72.5%, respectively) or mean number of usable embryos (2.2 to 3.4 vs. 2.0 to 3.3, respectively) from cycle 1 to cycle 2.

CONCLUSIONS:

These findings suggest that short-term IVM incubation of COCs may not provide any additional benefit in patients with a prior unsuccessful cycle notable for a high proportion of immature oocytes. Further randomized studies are warranted to determine whether there is a subset of patients who may have improved clinical outcomes with this "rescue IVM" intervention.

KEYWORDS:

IVF; In vitro maturation; Maturity; Oocytes

PMID:
29536383
PMCID:
PMC5984893
[Available on 2019-05-01]
DOI:
10.1007/s10815-018-1155-z
[Indexed for MEDLINE]

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