ISSN 1518 0557
Occurrence of ovarian follicular dominance during stimulation for IVM impacts usable blastocyst yield

2018; 22
Sergio Romero, Ricardo Pella, Francisco Escudero, Ygor Pérez, Mario García, Patricia Orihuela
JBRA Assist. Reprod. 2018; 22 (1):56-60

Received February 02, 2017
Accepted August 22, 2017
Abstract

Objective: To evaluate the influence of ovarian follicular dominance on the outcome of oocyte in-vitro maturation. Methods: This retrospective cohort study included 21 patients with polycystic ovaries or polycystic ovary syndrome (Rotterdam criteria, 2004) subjected to 24 in-vitro maturation (IVM) cycles between October 2015 and January 2017. Patients undergoing IVM received minimal gonadotropin stimulation starting on day 2 or 3 of the cycle; ovum pick-up typically occurred on days 6 to 8. No hCG-trigger shot was given. Following 30h of IVM, mature oocytes were inseminated by ICSI and the resulting embryos cultured up to the blastocyst stage. Results: Ovarian follicular dominance was observed in nine of the 24 IVM cycles. Oocyte IVM yielded an overall maturation rate of 69.3±23.8%, and no difference was observed when the groups with or without a dominant follicle were assessed independently. The rates of fertilization and usable blastocysts per fertilized oocyte, mature oocyte (Metaphase II) or cumulus-oocyte-complex were nearly three times higher (28.7±22.5%) in the group without ovarian follicular dominance. No differences were found in the clinical pregnancy rates attained by the individuals with or without a dominant follicle after 21 vitrified-warmed blastocyst transfer cycles. Conclusion: Occurrence of ovarian follicular dominance during hormonal stimulation for in-vitro maturation negatively impacted embryological outcomes. Strategies devised to limit the appearance of ovarian follicular dominance must be further explored.


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doi: 10.5935/1518-0557.20180006

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