Advertisement

In vitro maturation and fertilization of oocytes from unstimulated ovaries: Predicting the number of immature oocytes retrieved by early follicular phase ultrasonography

      Abstract

      Objective: To select women who will benefit most from in vitro maturation (IVM) of oocytes treatment, this study was undertaken to examine the ability of a transvaginal ultrasonography to predict the number of immature oocytes collected from unstimulated ovaries. Study design: The relationship between the number of immature oocytes retrieved and the pregnancy rate was assessed in 189 IVM treatment cycles. In 96 consecutive cycles, an early follicular phase transvaginal ultrasonographic measurement of the antral follicle count (AFC), ovarian volume, and peak ovarian stromal blood flow velocity (Vmax) was performed, and the results were correlated with the number of immature oocytes. Results: The clinical pregnancy rate increased significantly with the number of oocytes retrieved (P = .02) and was 26.8% (15/56) in those with >10 immature oocytes. The AFC, ovarian volume, and ovarian stromal Vmax were all predictive of the number of oocytes retrieved, but when the other factors were controlled by multiple regression analysis the AFC was the only significant predictor (P < .001). Conclusions: Pregnancy rates after IVM correlate with the number of immature oocytes retrieved. This is best predicted by an ultrasonographic assessment of the AFC. ( Am J Obstet Gynecol 2002;186:684-9.)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tan SL
        • Steer C
        • Royston P
        • Rizk P
        • Mason BA
        • Campbell S
        Conception rates and in-vitro fertilisation.
        Lancet. 1990; 335: 299
        • Tan SL
        • Royston P
        • Campbell S
        • Jacobs HS
        • Betts J
        • Mason B
        • et al.
        Cumulative conception and livebirth rates after in-vitro fertilisation.
        Lancet. 1992; 339: 1390-1394
        • Engmann L
        • Maconochie N
        • Bekir JS
        • Jacobs HS
        • Tan SL
        Cumulative probability of clinical pregnancy and live birth after a multiple cycle IVF package: a more realistic assessment of overall and age-specific success rates?.
        Br J Obstet Gynaecol. 1999; 106: 165-170
        • Chian RC
        • Gulekli B
        • Buckett WM
        • Tan SL
        Priming with human chorionic gonadotropin before retrieval of immature oocytes in women with infertility due to the polycystic ovary syndrome.
        N Engl J Med. 1999; 341: 1624-1626
        • Chian RC
        • Buckett WM
        • Tulandi T
        • Tan SL
        Prospective randomized study of human chorionic gonadotrophin priming before immature oocyte retrieval from unstimulated women with polycystic ovarian syndrome.
        Hum Reprod. 2000; 15: 165-170
        • Cha KY
        • Han SY
        • Chung HM
        • Choi DH
        • Lim JM
        • Lee WS
        • et al.
        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
        • Whittemore AS
        The risk of ovarian cancer after treatment for infertility.
        N Engl J Med. 1994; 331: 805-806
        • Venn A
        • Watson L
        • Bruinsma F
        • Giles G
        • Healy D
        Risk of cancer after use of fertility drugs with in-vitro fertilisation.
        Lancet. 1999; 354: 1586-1590
        • 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
        • Zaidi J
        • Barber J
        • Kyei-Mensah A
        • Bekir J
        • Campbell S
        • Tan SL
        Relationship of ovarian stromal blood flow at the baseline ultrasound scan to subsequent follicular response in an in vitro fertilization program.
        Obstet Gynecol. 1996; 88: 779-784
        • Engmann L
        • Sladkevicius P
        • Agrawal R
        • Bekir JS
        • Campbell S
        • Tan SL
        Value of ovarian stromal blood flow velocity measurement after pituitary suppression in the prediction of ovarian responsiveness and outcome of in vitro fertilization treatment.
        Fertil Steril. 1999; 71: 22-29
        • Templeton A
        • Morris JK
        Reducing the risk of multiple births by transfer of two embryos after in vitro fertilization.
        N Engl J Med. 1998; 339: 573-577
        • Ng EH
        • Tang OS
        • Ho PC
        The significance of the number of antral follicles prior to stimulation in predicting ovarian responses in an IVF programme.
        Hum Reprod. 2000; 15: 1937-1942
        • Syrop CH
        • Willhoite A
        • Van Voorhis BJ
        Ovarian volume: a novel outcome predictor for assisted reproduction.
        Fertil Steril. 1995; 64: 1167-1171
        • Franks S
        Polycystic ovary syndrome.
        N Engl J Med. 1995; 333: 853-861
        • Adams J
        • Polson DW
        • Franks S.
        Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism.
        BMJ. 1986; 293: 355-359
        • Engmann L
        • Maconochie N
        • Sladkevicius P
        • Bekir J
        • Campbell S
        • Tan SL
        The outcome of in-vitro fertilization treatment in women with sonographic evidence of polycystic ovarian morphology.
        Hum Reprod. 1999; 14: 167-171
        • Zaidi J
        • Campbell S
        • Pittrof R
        • Kyei-Mensah A
        • Shaker A
        • Jacobs HS
        • et al.
        Ovarian stromal blood flow in women with polycystic ovaries-a possible new marker for diagnosis?.
        Hum Reprod. 1995; 10: 1992-1996
        • Zaidi J
        • Jurkovic D
        • Campbell S
        • Pittrof R
        • McGregor A
        • Tan SL
        Description of circadian rhythm in uterine artery blood flow during the peri-ovulatory period.
        Hum Reprod. 1995; 10: 1642-1646
        • Cobo AC
        • Requena A
        • Neuspiller F
        • Aragon SM
        • Mercader A
        • Navarro J
        • et al.
        Maturation in vitro of human oocytes from unstimulated cycles: selection of the optimal day for ovum retrieval based on follicular size.
        Hum Reprod. 1999; 14: 1864-1868
        • Russell JB
        • Knezevich KM
        • Fabian KF
        • Dickson JA
        Unstimulated immature oocyte retrieval: early versus midfollicular endometrial priming.
        Fertil Steril. 1997; 67: 616-620
        • Wynn P
        • Picton HM
        • Krapez JA
        • Rutherford AJ
        • Balen AH
        • Gosden RG
        Pretreatment with follicle stimulating hormone promotes the numbers of human oocytes reaching metaphase II by in-vitro maturation.
        Hum Reprod. 1998; 13: 3132-3138
        • Mikkelsen AL
        • Smith SD
        • Lindenberg S
        In-vitro maturation of human oocytes from regularly menstruating women may be successful without follicle stimulating hormone priming.
        Hum Reprod. 1999; 14: 1847-1851