Oocyte maturation defect in women undergoing IVF: contributing factors and effects on mature sibling oocyte outcomes.

IF 3.2 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-01-09 DOI:10.1007/s10815-024-03353-w

Marga Esbert, Andrés Reig, Agustín Ballestros, Emre Seli

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引用次数: 0

Abstract

Purpose: This study aimed to identify demographic and clinical factors associated with low maturation rates and to investigate if the rate of immature oocytes impacts the outcomes of mature sibling oocytes.

Methods: Women undergoing their first IVF-ICSI cycle between 2018 and 2022 at a fertility clinic were included. Cycles were classified into five groups according to the proportion of Metaphase II stage oocytes (MII): Null (0% MII, n = 46), Poor (1-25% MII, n = 44), Low (26-50% MII, n = 453), Acceptable (51-75% MII, n = 1641), and Optimal (76-100% MII, n = 2642). Demographic characteristics and clinical outcomes were compared between the five groups. In patients with a Null/Poor maturation rate, subsequent cycle outcomes were also evaluated.

Results: A total of 4826 cycles were included in the study; 69,909 oocytes were recovered, and 53,065 were MIIs (75.9%). The Null group was older, had lower levels of anti-Müllerian hormone (AMH), needed more gonadotropins and days of stimulation, had higher follicle stimulating hormone (FSH) levels on day 3, and had less follicles > 15 mm on the day of trigger. When the outcomes of mature oocytes were compared, fertilization, usable blastocyst, aneuploidy, and life birth rates were comparable among groups. A binary logistic regression model using number of oocytes, paternal age, and trigger type with live birth rate endpoint found no differences between the categories and the base line Poor category. When patients whose maturation rate was Null/Poor, 42 (47.0%) carried out a second cycle; the maturation rate increased (56.9 ± 31.5 vs. 11.6 ± 11.2%, P < 0.0001).

Conclusion: Our data suggest that poor responders are more likely to have low rates of oocyte maturation. The proportion of immature oocytes does not impact the outcomes of mature sibling oocytes. In patients with Null/Poor maturation in their first cycle, the subsequent cycle is often associated with improved maturation rates.

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接受体外受精的女性的卵母细胞成熟缺陷：影响成熟兄弟姐妹卵母细胞结果的因素和影响。

目的：本研究旨在确定与低成熟率相关的人口统计学和临床因素，并探讨未成熟卵母细胞率是否影响成熟兄弟姐妹卵母细胞的结果。方法：纳入2018年至2022年在生育诊所接受第一次IVF-ICSI周期的妇女。根据中期II期卵母细胞（MII）的比例将周期分为五组：零（0% MII, n = 46）、差（1-25% MII, n = 44）、低（26-50% MII, n = 453）、可接受（51-75% MII, n = 1641）和最佳（76-100% MII, n = 2642）。比较五组患者的人口学特征和临床结果。在成熟率为零/差的患者中，随后的周期结果也被评估。结果：共纳入4826个周期；检出卵母细胞69,909个，MIIs 53,065个（75.9%）。Null组年龄较大，抗勒氏激素（AMH）水平较低，需要更多促性腺激素和刺激天数，第3天卵泡刺激素（FSH）水平较高，触发当天卵泡直径小于15 mm。当比较成熟卵母细胞的结果时，受精、可用囊胚、非整倍体和生命出生率在组间是可比的。使用卵母细胞数量、父亲年龄和触发类型与活产率端点的二元逻辑回归模型发现，类别与基线贫穷类别之间没有差异。当成熟率为Null/Poor时，42例（47.0%）进行了第二周期；结论：反应不良者卵母细胞成熟率较低的可能性较大。未成熟卵母细胞的比例不影响成熟兄弟姐妹卵母细胞的结果。在第一个周期中成熟不良的患者，随后的周期通常与成熟率的提高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.