Maturation Arrest of Oocytes?Case Reports

Abstract

We report three case of maturation arrest of oocyte two of which were treated with oocyte donation. A total failure of human oocytes to complete meiosis is rarely observed during assisted conception cycles. Maturation arrest of oocytes may occur at various stages of the cell cycle from germinal vesicle (GV) stage to metaphase one and two (MI and MII). Two cases that presented to us had unexplained infertility, but the third case had rheumatoid arthritis, which may result in an immune problem. In all the three couples, maturation arrest of the oocytes was noted repeatedly in all cycles of assisted reproductive technology (ART). In the first case the oocytes were arrested at both, the GV and metaphase I stage, in the second and third case arrest was noted in MI. Failure to resume meiosis in vivo may arise at one of the following three levels: iƒ¼ absent or incomplete luteinizing hormone(LH) effect iƒ¼ derangements in the signaling mechanism from the surrounding cumulus cells iƒ¼ intrinsic oocyte factors Currently no therapeutic approach would help to overcome the blocks in oocyte maturation and sustain successful in-vitro fertilization (IVF) Oocyte maturation arrest may be the cause of infertility in some couples previously classified as having unexplained infertility. The recognition of oocyte maturation arrest as a specific factor for infertility tells, how important the oocyte factor is. All the three patients were advised oocyte donation as the literature quotes very poor pregnancy rate with own oocyte. One patient conceived in the second cycle, whereas the other patient failed to conceive, despite transfer of good quality embryos.