Abstract
Here we investigate whether the presence of germinal vesicle-stage oocytes (GV− oocytes) reflects poor oocyte developmental competence (or quality). This was a prospective, non-randomised, cohort pilot-study involving 60 patients undergoing in vitro fertilization/ intracytoplasmic sperm injection for whom complete pregnancy outcome data were available. Patients in whom GV− oocytes were retrieved (GV+) at transvaginal oocyte retrieval (TVOR) were compared with those from whom no GVs were retrieved (GV−). We found that GV+ (n = 29) and GV− (n = 31) patients were similarly aged (35.4 vs. 36.4 years; p = 0.446). GV+ patients had a mean of 2.41 ± 2.03 GVs and comparable yields of MII oocytes to GV− patients (11 ± 6.88 vs. 8.26 ± 4.84; p = 0.077). Compared with GV− patients, GV+ patients had markedly lower implantation rates (11.8% vs. 30.2%; p = 0.022) as well as oocyte utilisation rates for clinical pregnancy (2.3% vs. 6.8%; p = 0.018) and live-birth (1.9% vs. 5.7%; p = 0.029). DNA damage levels measured using γH2AX immunostaining were not different in oocytes from women <36 years versus those ≥36 years (p = 0.606). Thus, patients who have GV− stage oocytes at TVOR exhibit poor oocyte quality reflected in reduced per-oocyte pregnancy success rates and uniformly high levels of oocyte DNA damage.
Highlights
Oocytes ovulated by women in their late 400 s would have been arrested in primordial follicles for a staggering 4–5 decades
Following hCG trigger during stimulated in vitro fertilization (IVF) cycles, typically around 70–85% of oocytes obtained at transvaginal oocyte retrieval (TVOR) are mature (MII-arrested) eggs with the other 15–30% being at MI- and GV− stages [7,8,9,10]
Our data based on clinical pregnancy outcomes and oocyte DNA damage levels suggest that the occurrence of GV− stage oocytes may be a surrogate marker for poor oocyte quality
Summary
Subramanian 1 , Jessica Greaney 1 , Chris Roling 2 , Jacqui Irving 2 and Hayden A. Reproductive Endocrinology & Infertility Clinic, Royal Brisbane & Women’s Hospital, Brisbane 4029, Queensland, Australia. Received: 21 November 2019; Accepted: 13 January 2020; Published: 16 January 2020
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