In Vitro Maturation of Unstimulated Immature Oocyte for the Treatment of Infertility Women

Abstract

To evaluate the efficacy of in vitro maturation (IVM) of unstimulated immature oocytes for the treatment of infertility women Prospective observational study Fifty-four cycles of IVM in 40 infertility patients including 26 women with obstinate polycystic ovary syndrome (PCOS), 14 patients with the failed history of assisted reproductive technology (ART) were carried out, 7 cycles were cancelled and the cancel rate was 13%.Transvaginal ultrasound-guided oocyte collection was performed on menstrual cycle day 9∼12 without pretreatment of gonadotropins. The oocytes were cultured in vitro using maturation medium, which consisted of TCM 199 medium supplemented with 20% fetal bovine serum, 0.075IU/mlFSH and 0.1IU/mlHCG. After 24∼48 hrs of culture, the metaphase II stage oocytes were inseminated by intracytoplasmic sperm injection (ICSI). Embryo transfer was performed 2 or 3 days after ICSI. Laser assisted hatching was done before embryo transfer. A total of 857 immature oocytes were obtained with the mean numbers of 18.2 per cycle. and 632 oocytes developed at MII stage (73.7%). A total of 476 oocytes were fertilized by ICSI (75.3%), with a cleavage rate of 91.2%.Embryo transfer was performed in 47 cycles and the mean number of embryos transferred were 4.3 per cycle (range: 2∼6). The mean thickness of endometrial on the day of embryo transfer was 8.9mm. Ninteen clinical pregnancies were obtained, giving a pregnancy rate of 19/54(35.2%) per puncture cycle and 19/47(40.2%) per transfer cycle. IVM of unstimulated immature oocytes for the treatment of women with various causes of infertility especially with obstinate PCOS is a effective alternative method. The clinical pregnancy rate of 40.2% was similar to conventional IVF treatment in our unit.