Objective: Giant oocytes occur with considerable frequency in human ovaries and are implicated in triploid conceptions and development of mature ovarian teratomas. There is general belief that the majority of giant oocytes undergo atresia in the fetal and early neonatal periods, however, some appear to remain in the adult ovary, to varying degrees. The aim of the present study was to determine the incidence and cytology of giant oocytes aspirated from patients undergoing IVF.Design: A prospective analysis of giant oocytes and embryos encountered over a 3 year period in our IVF program.Materials/Methods: Over a period 3 years, we collected data on the presence or absence of giant oocytes in our IVF program. Each giant oocyte and resulting embryo was morphologically assessed. When possible, giant embryos were analysed cytogenetically by FISH.Results: Out of a total of 14,827 oocytes examined, 43 giant oocytes were found. This gave an overall incidence of 0.29%. There were no cases in which more than one giant oocyte was retrieved from the same patient. The average number of retrieved oocytes and the mean estradiol (E2) value on the day of hCG were each significantly higher in the group of patients that had giant oocytes (19.6 oocytes, E2 = 2647 pg/ml) than in the group without (9.9 oocytes, E2 = 2167 pg/ml) (p = .01; p = .01 respectively). Giant oocytes were, on average, 28% larger in diameter (mean 147 um; without the zona pellucida) than normal oocytes (115 um) and had about twice the normal volume. Two different morphological patterns were observed among giant unfertilized and fertilized oocytes. Unfertilized oocytes either contained one diploid or two haploid chromosomal sets, with one or two polar bodies respectively. Ten giant oocytes fertilized and were observed to have either 2 or 3 pronuclei, with either 2 or 4 polar bodies respectively. Six of these giant embryos were analyzed by FISH. Four of the 6 giant embryos analyzed had 2 pronuclei. All 6 of the embryos analyzed were chromosomally abnormal.Conclusions: These observations suggest that embryos resulting from fertilization of giant oocytes are unlikely to be genetically normal. Therefore, our results would suggest that giant embryos originating from either 2 or 3 pronuclear zygotes should be excluded from uterine transfers. Objective: Giant oocytes occur with considerable frequency in human ovaries and are implicated in triploid conceptions and development of mature ovarian teratomas. There is general belief that the majority of giant oocytes undergo atresia in the fetal and early neonatal periods, however, some appear to remain in the adult ovary, to varying degrees. The aim of the present study was to determine the incidence and cytology of giant oocytes aspirated from patients undergoing IVF. Design: A prospective analysis of giant oocytes and embryos encountered over a 3 year period in our IVF program. Materials/Methods: Over a period 3 years, we collected data on the presence or absence of giant oocytes in our IVF program. Each giant oocyte and resulting embryo was morphologically assessed. When possible, giant embryos were analysed cytogenetically by FISH. Results: Out of a total of 14,827 oocytes examined, 43 giant oocytes were found. This gave an overall incidence of 0.29%. There were no cases in which more than one giant oocyte was retrieved from the same patient. The average number of retrieved oocytes and the mean estradiol (E2) value on the day of hCG were each significantly higher in the group of patients that had giant oocytes (19.6 oocytes, E2 = 2647 pg/ml) than in the group without (9.9 oocytes, E2 = 2167 pg/ml) (p = .01; p = .01 respectively). Giant oocytes were, on average, 28% larger in diameter (mean 147 um; without the zona pellucida) than normal oocytes (115 um) and had about twice the normal volume. Two different morphological patterns were observed among giant unfertilized and fertilized oocytes. Unfertilized oocytes either contained one diploid or two haploid chromosomal sets, with one or two polar bodies respectively. Ten giant oocytes fertilized and were observed to have either 2 or 3 pronuclei, with either 2 or 4 polar bodies respectively. Six of these giant embryos were analyzed by FISH. Four of the 6 giant embryos analyzed had 2 pronuclei. All 6 of the embryos analyzed were chromosomally abnormal. Conclusions: These observations suggest that embryos resulting from fertilization of giant oocytes are unlikely to be genetically normal. Therefore, our results would suggest that giant embryos originating from either 2 or 3 pronuclear zygotes should be excluded from uterine transfers.
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