In Vitro Maturation of Oocytes: Current Status and Controversies

Volume 4 • Issue 2 • 1000e124 JFIV Reprod Med Genet ISSN: 2375-4508 JFIV, an open access journal In vitro oocyte maturation (IVM) has carved a niche for itself in assisted reproductive technology (ART). In 1991, Cha et al. [1] reported the first collection of immature oocytes, which were matured in vitro and resulted in a live birth. Since then, IVM protocols have developed ranging from IVM without hormonal priming, to several modalities of gonadotropin primed IVM, including human chorionic gonadotropin (hCG) triggering. In polycystic ovary syndrome (PCOS) patients, there might be a benefit in administering hCG prior to oocyte retrieval [2]. Our prospective study showed improved implantation (9.6% vs 1.5%) and clinical pregnancy rates (29.9% vs 4%) after hCG priming when compared with regular cycling patients [3]. Then, we sought whether higher doses of hCG would improve metaphase-II (MII) oocyte yield by an RCT whereby patients were randomized to receive the usual 10000 IU or a higher dose of 20000 IU. The maturation, fertilization, pregnancy or implantation rates (IRs) were found to be comparable which supports the notion that there is no benefit to use the higher dose in IVM [4]. Additionally, Fadini et al. [5] reported that the combination of hCG and FSH priming, in women with regular cycles, might be superior to IVM cycles without priming. The number of mature oocytes at retrieval (20.3% vs 0%), MII oocytes after 30h culture (77.4% vs 48.4%), IRs (16.4% vs 9.2%), and clinical pregnancy rates (29.9% vs 15.3%) were found to be statistically higher with FSH priming plus hCG when compared to no priming [5]. These findings suggest that FSH and hCG might work in concert to affect oocyte maturation and fertilization potential.