Effect of gonadotrophin priming on in-vitro maturation of oocytes collected from women at risk of OHSS

This study examined the effects of human menopausal gonadotrophin (HMG) or human chorionic gonadotrophin (HCG) priming on cumulus-oocyte complex (COC) morphology, oocyte maturation and embryo development in patients undergoing in-vitro maturation (IVM) cycles. The patients were primed with nothing (group 1), low-dose HMG (group 2) or 10,000 IU HCG (group 3) before oocyte retrieval. COC with dispersed cumulus cell appearance was only observed in group 3. In addition, 11% of metaphase II stage oocytes at the time of retrieval were collected from group 3. Oocyte maturation in vitro in group 3 was faster than that in groups 1 and 2. The blastocyst development rate of residual embryos after embryo transfer in group 3 was significantly higher than that of groups 1 and 2 (P < 0.05). These results suggest that HCG priming may stimulate the COC, promote oocyte maturation, and improve developmental competence in IVM cycles.     

Effect of incubation with different concentrations and durations of FSH for in-vitro maturation of murine oocytes

The purpose of the study was to evaluate whether a lower concentration of FSH or 2-h incubation with FSH would improve the outcome of in-vitro maturation of oocytes. The immature oocytes were obtained from FVB mice, and were allocated to four groups and incubated in the maturation media for 24 h. The maturation media were supplemented with 10 mIU/ml FSH for 24 h (group 1), 10 mIU/ml FSH for 2 h (group 2), 75 mIU/ml FSH for 24 h (group 3) or 75 mIU/ml FSH for 2 h (group 4). In each group, half of the in-vitro-matured oocytes were fertilized and cultured to blastocysts and the remaining matured oocytes were analysed for growth differentiation factor (GDF)-9 and bone morphogenetic protein (BMP)-15 mRNA to assess the oocyte quality. The maturation rates and oocyte BMP-15 mRNA concentrations were similar among the four groups. The GDF-9 mRNA concentrations were similar in group 2 and group 4. The fertilization and blastocyst rates were higher in groups 2 and 4 than in groups 1 and 3. It is concluded that 2-h incubation with FSH is better than 24-h incubation in terms of the fertilization rate and blastocyst development.     

Influence of the dominant follicle on in-vitro maturation of human oocytes: a prospective non-randomized study

The present study was designed to examine the influence of timing of aspiration and the influence of a dominant follicle on maturation and fertility potential of immature oocytes aspirated in unstimulated cycles. The study included 81 regularly cycling women. In group I (n = 53), oocyte retrieval was scheduled the day after a follicle of 10 mm and an endometrium of at least 5 mm were observed. In group II (n = 28), aspiration was scheduled the day after observation of the same ultrasound criteria plus a detected increase (100%) in the level of oestradiol compared with the level on day 3. The maturation rate was significantly higher in group I compared with group II (107/184, 58.2% versus 56/124, 45.2%, P < 0.05), whereas the rates of fertilization and cleavage did not differ between the two groups. The clinical pregnancy rate per aspiration was significantly higher in group I compared with group II (9/53, 17% versus 0/28, 0%, P < 0.05). When comparing oocytes originating from the ovary with the dominant follicle (ipsilateral ovary) with oocytes originating from the ovary without a dominant follicle (contralateral ovary) an increased fertilization rate was observed in group I, and an increased maturation rate was observed in group II. When the data from the two groups were pooled, an increased maturation rate was observed in oocytes originating from the ipsilateral ovary compared with oocytes originating from the contralateral ovary. No difference was found with respect to rates of fertilization and cleavage rates when all oocytes originating from the ipsilateral ovary were compared with all oocytes originating from the contralateral ovary.     

Effects of growth factors and granulosa cell co-culture on in-vitro maturation of oocytes

The maturation medium for in-vitro oocyte maturation is usually supplemented with serum. However, supplementation with serum from pregnant women adversely affects the outcome of in-vitro maturation. The purpose of the study was to assess if growth factors or granulosa cell co-culture could overcome the adverse effects of pregnant women's serum. The basal maturation medium consisted of TCM199, 75 mIU/ml human menopausal gonadotrophin (HMG), 0.2 mmol/l pyruvate, and 10% serum. The maturation medium for control 1 contained fertile women's serum. The maturation medium for control 2 contained pregnant women's serum. The maturation media for the study groups consisted of medium for control 2, with the addition of EGF, IGF-I, activin, TGFβ or granulosa cell co-culture. Immature oocytes were obtained from FVB mice, and the experiment was repeated six times. After maturation, the oocytes were fertilized and cultured to blastocysts, and the cumulus cells were analysed for apoptosis. The maturation, fertilization and blastocyst rates of the control 2 group were significantly lower than those of control 1 group (P < 0.05). Addition of EGF, IGF-1, activin, TGFβ or granulosa cell co-culture could not improve the outcome of in-vitro maturation. Cumulus cell proliferation was inhibited by pregnant women's serum. Apoptosis of cumulus cell was not related to in-vitro oocyte maturation and subsequent embryo development.     

Comparison of in-vitro maturation cycles with and without in-vivo matured oocytes retrieved

This study compared the embryological characteristics and clinical outcome of in-vitro maturation (IVM) treatment cycles with and without in-vivo matured oocytes collected following human chorionic gonadotrophin (HCG) priming. The patients were administered 10,000 IU of HCG subcutaneously when endometrial thickness reached > or =6 mm and oocyte collection was performed 35-36 h after HCG administration. The clinical outcome and embryological aspects were analysed between IVM cycles with (group 1) and without (group 2) in-vivo matured oocytes. In group 1, three (range 1-12) in-vivo matured oocytes per patient were retrieved on average. The number of good quality embryos derived from in-vivo matured oocytes in group 1 was significantly higher than those derived from in-vitro matured oocytes in group 1 and group 2 (P < 0.05). However, there was no difference between the number of good quality embryos produced from in-vitro matured oocytes in the two groups. There were 12 clinical pregnancies (40.0%) in group 1, and seven pregnancies (23.3%) in group 2. These results suggest that IVM cycles with in-vivo matured oocytes resulted in a good clinical pregnancy rate, which could be explained by the superior quality of embryos derived from the in-vivo matured oocytes.     

孕妇血清表皮生长因子在判断胎儿成熟度中的价值

目的了解正常孕妇在妊娠各期血清中表皮生长因子（ＥＧＦ）及孕激素（Ｐ）,与羊水中ＥＧＦ、Ｐ、淀粉酶（Ａｍｓ）、肌酐（Ｃｒ）、间接胆红素（ＴＢ）的浓度变化在判断胎儿成熟度中的价值。方法用放射免疫法测定正常孕妇１８１例（早孕３５例,中孕６９例,晚孕７７例）血清及其中８７例孕妇（中孕４４例,晚孕４３例）羊水中的ＥＧＦ、Ｐ浓度变化;用生化分析仪测定此８７例孕妇羊水中Ａｍｓ、Ｃｒ、ＴＢ浓度变化。同时还对其中２３例足月分娩的新生儿的脐静脉、脐动脉血清中ＥＧＦ及Ｐ的浓度进行测定。结果孕妇血清中ＥＧＦ和Ｐ的浓度均随孕周增长而增加。羊水中ＥＧＦ浓度与羊水中Ａｍｓ、Ｃｒ浓度呈正相关。孕３２周以后,当ＥＧＦ≥４．５μｇ／Ｌ时,胎儿成熟率为７０．５９％。结论妊娠期孕妇血清中ＥＧＦ的浓度变化可用于判断胎儿成熟度     

Comparison of in-vitro outcomes from cryopreserved oocytes and sibling fresh oocytes

In Italy, the restrictive IVF law generalizes the indication for oocyte freezing for surplus oocytes in 78.5% of in-vitro assisted reproductive cycles. With a view to understanding better what the prospects for intracytoplasmic sperm injection (ICSI) on frozen-thawed oocytes might be, the consequences of freeze-thaw procedures on fertilization, cleavage rates and embryo quality obtained from frozen-thawed oocytes were studied and compared with the results obtained from sibling fresh oocytes. Eleven IVF and 29 ICSI on 76 and 169 fresh oocytes were performed and the corresponding 40 ICSI on 221 sibling frozen-thawed oocytes. There was no difference in terms of fertilization rate between fresh and sibling frozen-thawed oocytes. The cleavage rate (98.0 and 94.4% with fresh oocytes in IVF and ICSI; 77.3% with frozen-thawed oocytes in ICSI; P < 0.001) and embryo quality (grade I embryos over total embryos: 36.7 and 22.2% with fresh oocytes in IVF and ICSI; 12.1% with frozen-thawed oocytes in ICSI; respectively P < 0.001 and P < 0.05) were statistically lower after oocyte cryopreservation. The significant decrease in meiotic spindle retrieval rate before freezing (62.4%) and after thawing procedures (43.4%; P < 0.001) suggests that cryoconservation induces irreversible damage to microtubule repolymerization. The consequences of oocyte cryopreservation procedures on embryo development are reviewed.     

未成熟卵母细胞体外成熟培养治疗多囊卵巢综合征不孕患者的妊娠结局

新生儿肺炎死亡,其余至今未发现明显畸形.10例早产,占21.3%(10/47),36例足月产,占76.6%(36/47),1例过期妊娠.新生儿平均出生体重2972 g,低体重儿17例,占26.2%(17/65).结论 多囊卵巢综合征不孕患者行未成熟卵母细胞IVM培养后,虽然获得了较高的临床妊娠率,而且早期流产率、异位妊娠率、妊娠并发症发生率、围产儿死亡及新生儿缺陷的发生率等不高,但多胎妊娠、早产、低出生体重儿发生率较高.     

The levels of selected hormones in serum and ovarian cyst fluid in girls and young women]

OBJECTIVES: The aim of the study was to determinate levels of the FSH, LH and E2 in serum and ovarian cyst fluid in neoplastic tumors (7 benign, 1 of low malignant potential) and functional cysts. MATERIAL AND METHODS: We measured the concentrations of the FSH, LH and E2 at 12 girls and young women hospitalized in our teaching department using immunoenzymatic method. RESULTS: We found higher levels of gonadotropins in serum and particular in ovarian cyst fluid at neoplastic tumors in comparison with functional cysts. There were also high levels of estradiol and low of gonadotropins in functional ovarian cyst fluid. CONCLUSION: The differences of FSH, LH and E2 levels in ovarian cyst fluid in neoplastic and functional cyst have cognitive character and need more investigations.     

Evaluation of the developmental competence and chromosomal compliment of mouse oocytes derived from in-vitro growth and maturation of preantral follicles

Purpose To evaluate the developmental potential and aneuploidy rates of in-vitro versus in-vivo grown and matured mouse oocytes. Methods Mice were superovulated to obtain in-vivo matured oocytes. Mouse preantral follicles were also mechanically isolated and cultured in-vitro. In-vitro fertilization (IVF) was performed and fertilization, cleavage, and morula/blastocyst formation rates were compared between groups. Cytogenetic analysis was used to compare oocyte aneuploidy rates and aneuploidy characteristics in the developing embryos. Results In-vivo oocyte maturation resulted in higher IVF fertilization, cleavage, and morula/blastocyst formation rates versus in-vitro follicle culture (96.4% versus 78.5%, p < 0.001; 95.3% versus 77.4%, p < 0.001; 94.1% versus 76.9%, p < 0.001). Total aneuploidy rates were higher in embryos derived from in-vitro matured oocytes versus those grown in-vivo (4.0% versus 1.3%, p < 0.05). Conclusions Results indicate a reduced developmental competency of in-vitro matured oocytes. The data also highlight an increased susceptibility to meiotic errors in early stage follicles undergoing in vitro culture. Capsule Impaired developmental capacity and errors in proper chromosome segregation are observed in mouse oocytes generated from in-vitro preantral follicle culture versus those developed in-vivo.     

The estimation of L-ascorbic acid serum concentration and selected parameters of metabolism of serum lipids in pregnant women with diabetes

Diabetes during pregnancy is a pathological state causing many metabolic disorders, not only in carbohydrate metabolism. The aim of the study was to estimate the changes of lipids metabolism and changes of L-ascorbic acid serum concentration in pregnancy complicated by diabetes. In tested groups values of lipids metabolism parameters were lower in diabetic group compared to control group. The lowest mean values of concentration of total cholesterol, LDL cholesterol and triglycerides were found in gestational diabetes group, while the lowest mean value of HDL cholesterol concentration was found in pregestational diabetic group. The L-ascorbic acid mean values correlated negatively with total cholesterol concentrations, LDL cholesterol and triglycerides levels.     

The effect of the antiprogestin mifepristone (RU 486) on maturation and in-vitro fertilization of human oocytes

The effect of RU 486 (mifepristone), a potent antiprogestin, on the in-vitro fertilization of human oocytes was investigated. In 40 normal volunteer women requesting laparoscopic sterilization, follicle aspiration for oocyte recovery was attempted 34 h after the injection of 5000 i.u. human chorionic gonadotrophin (hCG). Twenty women were allocated to receive 100 mg RU 486 orally 1 h before the hCG injection, the remaining 20 women acted as controls. There was no significant difference in the cleavage rate of the oocytes after fertilization in vitro between the two groups (56% and 66% respectively). Also, the morphological characteristics of the cleaving oocytes and the concentrations of oestradiol, progesterone and androstenedione in the follicular fluid of the leading follicle did not differ significantly between the two groups. Since RU 486 was detected in substantial amounts in the follicular fluid specimens, these results suggest that progesterone is not critical for the final stages of human oocyte maturation.     

农村妇女孕期体重对妊娠结局的影响

目的:探讨农村妇女孕期体重与妊娠结局的关系,为农村孕妇的体重管理提供理论依据。方法:收集2014年2月至2015年2月禹城市人民医院产一科住院分娩的单胎妊娠农村初产妇896例,按孕前体重指数(BMI)分为孕前消瘦组(≤18.5kg/m~2)、孕前体重正常组(18.5kg/m~2BMI24kg/m~2)、超重组(24kg/m2≤BMI28kg/m~2)、肥胖组(≥28kg/m~2);按孕期体重增长分为体重增长适宜组及体重增长过度组。分析各组孕妇妊娠结局及并发症的发生情况。结果:孕前超重组与孕前体重正常组比较,孕期体重增长过度组与孕期体重增长适宜组比较,均显著增加妊娠期高血压疾病、妊娠期糖尿病、剖宫产、产后出血、巨大儿的风险,差异有统计学意义(P0.05)。结论:孕前超重与孕期体重增长过度是导致农村孕妇不良妊娠结局的危险因素,应加强孕妇的体重管理,降低妊娠不良结局发生。     

In-vitro maturation of immature oocytes for infertile women with PCOS

Immature oocyte retrieval followed by in-vitro maturation (IVM) is a promising potential treatment option, especially for women who are infertile through polycystic ovarian syndrome (PCOS). Although the pregnancy and implantation rates of IVM treatment are not as high as conventional IVF treatment, IVM treatment has many advantages for infertile women with PCOS, because this group of patients is extremely sensitive to stimulation with exogenous gonadotrophins and is at increased risk of developing ovarian hyperstimulation syndrome (OHSS). Different protocols have been used before immature oocyte retrieval, indicating that there are beneficial effects with FSH or LH priming on oocyte maturation. To date, the clinical pregnancy and implantation rates obtained from IVM treatment in infertile women with PCOS are approximately 30-35% and 10-15% respectively. Therefore, as an option, IVM treatment can be offered to women with PCOS instead of conventional IVF treatment with ovarian stimulation.     

The effect of the antiprogestin mifepristone (RU 486) on maturation and in-vitro fertilization of human oocytes

Summary. The effect of RU 486 (mifepristone), a potent antiprogestin, on the in-vitro fertilization of human oocytes was investigated. In 40 normal volunteer women requesting laparoscopic sterilization, follicle aspiration for oocyte recovery was attempted 34 h after the injection of 5000 i.u. human chorionic gonadotrophin (hCG). Twenty women were allocated to receive 100 mg RU 486 orally 1 h before the hCG injection, the remaining 20 women acted as controls. There was no significant difference in the cleavage rate of the ooctyes after fertilization in vitro between the two groups (56% and 66% respectively). Also, the morphological characteristics of the cleaving oocytes and the concentrations of oestradiol, progesterone and androstenedione in the follicular fluid of the leading follicle did not differ significantly between the two groups. Since RU 486 was detected in substantial amounts in the follicular fluid specimens, these results suggest that progesterone is not critical for the final stages of human oocyte maturation.     

A study of thyroid hormones in women suffering from vomiting in pregnancy

Twelve pregnant women hospitalized because of hyperemesis are examined on their thyroid hormone values. Pathological values of Thyroxin T4 are found in seven patients (58%). The values of Free T4 are elevated in only three patients and all the values of Tyroxin T3 are found to be within the normal range. It is concluded that the pathological values of T4 and Free T4 do not represent thyroid disease, and the mechanism of hyperemesis gravidarum is still obscure.     

First successful pregnancy following PGD for chromosome translocation on embryos generated from in-vitro matured oocytes: a case report

As far as is known, this is the first report of a successful pregnancy outcome following preimplantation genetic diagnosis for a chromosome translocation in embryos generated from in-vitro matured oocytes. A couple presented to the study clinic where the female partner was a carrier of the reciprocal chromosome translocation 46,XX,t(1;20)(p36.1;p12.2) with three consecutive pregnancy terminations due to either fetal abnormality or unbalanced translocation products detected in the conceptus. Under routine ultrasound investigation she was diagnosed with polycystic ovaries. The patient underwent an in-vitro maturation/preimplantation genetic diagnosis cycle where the immature oocytes were matured in vitro and fertilized by intracytoplasmic sperm injection. Day-3 embryos were screened for the chromosome abnormality by fluorescent in-situ hybridization. A single embryo diagnosed as chromosomally normal/balanced was transferred on day 5 and resulted in the birth of a healthy child.