Advertisement

Factors inducing decreased oocyte maturation rate: a retrospective analysis of 20,939 ICSI cycles

  • Yihua Lin
  • Puyu Yang
  • Yanrong Chen
  • Jinliang Zhu
  • Xinyu Zhang
  • Caihong MaEmail author
Gynecologic Endocrinology and Reproductive Medicine
  • 23 Downloads

Abstract

Purpose

Decreased oocyte maturation rate (OMR) is associated with worse clinical outcomes in IVF/ICSI cycles. The clinical features inducing decreased OMR remain unknown. The study is designed to explore the factors influencing the incidence of decreased OMR and its effects on clinical outcomes.

Methods

This is a retrospective case–control study analyzing data from 20,939 ICSI cycles in a reproductive center of university affiliated hospital from January 2015 to December 2017. Patients with a decreased OMR (< 30%) were characterized as Group A and those with an OMR ≥ 30% constituted Group B. Candidate factors of decreased OMR and clinical outcomes were compared between the two groups.

Results

There were 1.3% cycles with an OMR < 30% and 22.16% of all oocytes retrieved (12.87 per cycle in average) were immature. Primary infertility, longer duration of infertility, larger BMI, more previous assisted reproductive times, less oocytes retrieved were risk factors for decreased OMR. Compared with long agonist protocol, patients received antagonist protocol for COH had a higher incidence of decreased OMR. The fertilization rate and subsequent embryo development of oocytes in Group A were worse than Group B. Implantation rate and clinical pregnancy rate were both lower in Group A than Group B.

Conclusion

Primary infertility, duration of infertility, BMI, previous assisted reproductive times, number of oocytes retrieved and COH protocol were found to be factors inducing decreased OMR. Patients with decreased OMR had worse clinical outcomes.

Keywords

Oocyte maturation ICSI Risk factor Pregnancy 

Notes

Acknowledgements

The authors thank the staff of the Reproductive Medicine Center of Peking University Third Hospital for their invaluable help in data collection. This work was supported by National Natural Science of Foundation of China (81170618) and Key Clinical Program of Peking University Third Hospital (BYSY2015002).

Author contribution

CM: project development, manuscript review. YL: data management, data analysis, manuscript writing. PY: data collection, data analysis, manuscript writing. YC: data collection, manuscript editing. JZ: project development. XZ: data analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Greaney J, Wei Z, Homer H (2017) Regulation of chromosome segregation in oocytes and the cellular basis for female meiotic errors. Hum Reprod Update.  https://doi.org/10.1093/humupd/dmx035 CrossRefPubMedGoogle Scholar
  2. 2.
    Lonergan P, Fair T (2016) Maturation of oocytes in vitro. Annu Rev Anim Biosci 4:255–268.  https://doi.org/10.1146/annurev-animal-022114-110822 CrossRefPubMedGoogle Scholar
  3. 3.
    Muasher SJ, Abdallah RT, Hubayter ZR (2006) Optimal stimulation protocols for in vitro fertilization. Fertil Steril 86(2):267–273.  https://doi.org/10.1016/j.fertnstert.2005.09.067 CrossRefPubMedGoogle Scholar
  4. 4.
    Sousa M, Cunha M, Silva J, Oliveira E, Pinho MJ, Almeida C, Sa R, da Silva JT, Oliveira C, Barros A (2016) Ultrastructural and cytogenetic analyses of mature human oocyte dysmorphisms with respect to clinical outcomes. J Assist Reprod Genet 33(8):1041–1057.  https://doi.org/10.1007/s10815-016-0739-8 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Beall S, Brenner C, Segars J (2010) Oocyte maturation failure: a syndrome of bad eggs. Fertil Steril 94(7):2507–2513.  https://doi.org/10.1016/j.fertnstert.2010.02.037 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Halvaei I, Ali Khalili M, Razi MH, Nottola SA (2012) The effect of immature oocytes quantity on the rates of oocytes maturity and morphology, fertilization, and embryo development in ICSI cycles. J Assist Reprod Genet 29(8):803–810.  https://doi.org/10.1007/s10815-012-9799-6 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Bar-Ami S, Zlotkin E, Brandes JM, Itskovitz-Eldor J (1994) Failure of meiotic competence in human oocytes. Biol Reprod 50(5):1100–1107CrossRefGoogle Scholar
  8. 8.
    Bergere M, Lombroso R, Gombault M, Wainer R, Selva J (2001) An idiopathic infertility with oocytes metaphase I maturation block: case report. Hum Reprod (Oxf, Engl) 16(10):2136–2138CrossRefGoogle Scholar
  9. 9.
    Levran D, Farhi J, Nahum H, Glezerman M, Weissman A (2002) Maturation arrest of human oocytes as a cause of infertility: case report. Hum Reprod (Oxf, Engl) 17(6):1604–1609CrossRefGoogle Scholar
  10. 10.
    Hourvitz A, Maman E, Brengauz M, Machtinger R, Dor J (2010) In vitro maturation for patients with repeated in vitro fertilization failure due to “oocyte maturation abnormalities”. Fertil Steril 94(2):496–501.  https://doi.org/10.1016/j.fertnstert.2009.03.040 CrossRefPubMedGoogle Scholar
  11. 11.
    Gulekli B, Olgan S, Aydiner F (2011) In vitro oocyte maturation from unstimulated cycles: does it offer a realistic chance to overcome the problem of repeated oocyte maturation arrest in IVF? Arch Gynecol Obstet 283(Suppl 1):133–134.  https://doi.org/10.1007/s00404-010-1826-1 CrossRefPubMedGoogle Scholar
  12. 12.
    Griffin D, Feinn R, Engmann L, Nulsen J, Budinetz T, Benadiva C (2014) Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates. Fertil Steril 102(2):405–409.  https://doi.org/10.1016/j.fertnstert.2014.04.028 CrossRefPubMedGoogle Scholar
  13. 13.
    Avrech OM, Goldman GA, Rufas O, Stein A, Amit S, Yoles I, Pinkas H, Fisch B (1997) Treatment variables in relation to oocyte maturation: lessons from a clinical micromanipulation-assisted in vitro fertilization program. J Assist Reprod Genet 14(6):337–342CrossRefGoogle Scholar
  14. 14.
    Sachs AR, Politch JA, Jackson KV, Racowsky C, Hornstein MD, Ginsburg ES (2000) Factors associated with the formation of triploid zygotes after intracytoplasmic sperm injection. Fertil Steril 73(6):1109–1114CrossRefGoogle Scholar
  15. 15.
    Humaidan P, Bredkjaer HE, Bungum L, Bungum M, Grondahl ML, Westergaard L, Andersen CY (2005) GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. Hum Reprod (Oxf, Engl) 20(5):1213–1220.  https://doi.org/10.1093/humrep/deh765 CrossRefGoogle Scholar
  16. 16.
    Dahan MH, Tan SL, Chung J, Son WY (2016) Clinical definition paper on in vitro maturation of human oocytes. Hum Reprod (Oxf, Engl) 31(7):1383–1386.  https://doi.org/10.1093/humrep/dew109 CrossRefGoogle Scholar
  17. 17.
    Nogueira D, Sadeu JC, Montagut J (2012) In vitro oocyte maturation: current status. Semin Reprod Med 30(3):199–213.  https://doi.org/10.1055/s-0032-1311522 CrossRefPubMedGoogle Scholar
  18. 18.
    Son WY, Chung JT, Chian RC, Herrero B, Demirtas E, Elizur S, Gidoni Y, Sylvestre C, Dean N, Tan SL (2008) A 38 h interval between hCG priming and oocyte retrieval increases in vivo and in vitro oocyte maturation rate in programmed IVM cycles. Hum Reprod (Oxf, Engl) 23(9):2010–2016.  https://doi.org/10.1093/humrep/den210 CrossRefGoogle Scholar
  19. 19.
    Zilberberg E, Haas J, Dar S, Kedem A, Machtinger R, Orvieto R (2015) Co-administration of GnRH-agonist and hCG, for final oocyte maturation (double trigger), in patients with low proportion of mature oocytes. Gynecol Endocrinol 31(2):145–147.  https://doi.org/10.3109/09513590.2014.978850 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Center for Reproductive Medicine, Department of Obstetrics and GynecologyPeking University Third HospitalBeijingPeople’s Republic of China
  2. 2.National Clinical Research Center for Obstetrics and GynecologyBeijingChina
  3. 3.Key Laboratory of Assisted Reproduction, Ministry of EducationBeijingChina
  4. 4.Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive TechnologyBeijingChina

Personalised recommendations