Insufficient Cumulus Expansion and Poor Oocyte Retrieval in Endometriosis-Related Infertile Women

Author(s):  
Yaoxue Yin ◽  
Yundong Mao ◽  
Anthony Liu ◽  
Li Shu ◽  
Chun Yuan ◽  
...  
2019 ◽  
Vol 9 (1) ◽  
Author(s):  
S. Teramoto ◽  
H. Osada ◽  
M. Shozu

Abstract Ovulation consists of a follicle’s rupture and subsequent oocyte extrusion, although there is a paucity of evidence regarding whether every follicle’s rupture is associated with extrusion of its oocyte. We examined this issue in a large-scale window-of-opportunity study by attempting aspiration of single dominant follicles that were found to have ruptured before a scheduled oocyte retrieval during in vitro fertilisation and embryo transfer treatment of infertile women. We were able to aspirate 587 of 1,071 ultrasonographically confirmed post-rupture dominant follicles from 1,071 women (i.e. one dominant follicle per woman) and retrieved 225 oocytes (oocyte recovery ratio: 43.4% of aspirated follicles), which yielded 28 live births (live birth ratio: 11.0% of retrieved oocytes). Interestingly, the live birth ratio for post-rupture dominant follicles was not statistically different from that achieved using regular pre-rupture aspiration of dominant follicles (1,085/8,977, 12.1%). These findings suggest that oocyte extrusion frequently does not occur after follicle rupture in infertile women undergoing in vitro fertilisation treatment, although the oocyte retained in the follicle can remain competent for use during that treatment.


2009 ◽  
Vol 21 (9) ◽  
pp. 33
Author(s):  
T. S. Hussein ◽  
A. N. Filby ◽  
R. B. Gilchrist ◽  
M. Lane

Interactions between the oocyte and its companion somatic cells are crucial to establish and maintain a highly specialized microenvironment required for oocyte viability. Specifically, cumulus cell expansion in the mouse is reliant on oocyte-secreted factors (OSF). Little is know about factors secreted by the human oocyte and how they may interact with cumulus cells. Therefore, the aim of this study was to establish whether human cumulus oocyte complexes (COC) produce OSF that induces cumulus expansion. COC of patients undergoing routine clinical IVF were cultured individually for 6h following oocyte retrieval. The human oocyte conditioned medium (HOCM) was collected. The bioactivity of OSF in the HOCM was assessed using an established assay of cumulus expansion of mouse oocytectomized complexes (OOX). Cumulus expansion was assessed blinded using the scoring system; 1 (no expansion) to 4 (maximally expanded) and gene expression was assessed by real time RT-PCR. Culture of OOX in control media with or without FSH did not induce expansion. Similarly, OOX cultured in HOCM without FSH did not expand. However, culture of OOX in HOCM with FSH significantly induced expansion (2.4±0.1 compared with control 1.1±0.04, P<0.05). Furthermore, this expansion was not different to OOX co-cultured with human (2.9±0.1) or mouse (2.6±0.1) denuded oocytes. Cumulus/OOX gene expression of hyaluronan synthase-2 and cyclooxygenase-2 was significantly up-regulated 4-5 fold when OOX were cultured in HOCM compared to control (P<0.05). Interestingly, different patients produced HOCM which resulted in different levels of expansion (range from 1.5-3.7). This study has established that human COC secrete paracrine factor(s) that enable cumulus expansion. This expansion was dependent on the presence of FSH. The identity of these factor(s) are currently unknown however it appears that COC from different patients produce differing levels of these cumulus expansion enabling factor(s).


2021 ◽  
Author(s):  
Yasutaka Murata ◽  
Fumika Oda ◽  
Miki Shirai ◽  
Nanako Sato ◽  
Atsuko Sugita ◽  
...  

Abstract Purpose To assess if consecutive oocyte retrieval (OR) of more than three times could be an effective method to obtain competent embryos becoming babies. Methods To maximize the chances of pregnancy for refractory infertile women, we designed a new treatment course, “Squeeze and freeze.” In this method, ovarian stimulation was initiated whenever the antral follicle was visible using ultrasound, regardless of the menstrual cycle stage for 3 months, aiming to retrieve all possible oocytes and collecting the maximum number of competent embryos for subsequent transfer. Eighty-eight patients underwent 101 treatment courses, in which retrievals at an average of 4.8 times were performed for 3 months. The clinical results and obstetric outcomes were retrospectively reviewed. Results The ratio of matured oocytes, 2PN embryos, available embryos, fair blastocysts per oocyte, and number of available embryos or fair blastocysts per retrieval did not differ between the two initial and later attempts. Similarly, no significant differences were observed in these parameters between the follicular- and luteal-phase retrievals. After subsequent embryo transfer, 62 patients achieved clinical pregnancy, 49 had an ongoing pregnancy, 47 delivered healthy babies, and 8 conceived a second baby. Conclusion Periodic consecutive OR is an efficient infertility treatment for refractory women. In this method, as many oocytes as possible are obtained from a patient in a limited period at the earliest stage of their life. More than three consecutive ORs, including luteal-phase ORs, could obtain competent embryos efficiently, increasing the chances of childbearing.


MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 5-20
Author(s):  
Vu Ho ◽  
Toan Pham ◽  
Tuong Ho ◽  
Lan Vuong

IVF carries a considerable physical, emotional and financial burden. Therefore, it would be useful to be able to predict the likelihood of success for each couple. The aim of this retrospective cohort study was to develop a prediction model to estimate the probability of a live birth at 12 months after one completed IVF cycle (all fresh and frozen embryo transfers from the same oocyte retrieval). We analyzed data collected from 2600 women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) at a single center in Vietnam between April 2014 and December 2015. All patients received gonadotropin-releasing hormone (GnRH) antagonist stimulation, followed by fresh and/or frozen embryo transfer (FET) on Day 3. Using Cox regression analysis, five predictive factors were identified: female age, total dose of recombinant follicle stimulating hormone used, type of trigger, fresh or FET during the first transfer, and number of subsequent FET after the first transfer. The area under the receiver operating characteristics curve for the final model was 0.63 (95% confidence interval [CI] 0.60‒0.65) and 0.60 (95% CI 0.57‒0.63) for the validation cohort. There was no significant difference between the predicted and observed probabilities of live birth (Hosmer-Lemeshow test, p > 0.05). The model developed had similar discrimination to existing models and could be implemented in clinical practice.


10.32947/357 ◽  
2018 ◽  
Vol 18 (1) ◽  
pp. 1-10

Thirty three infertile women were divided into two groups according to their BMI (21 obese and 12 overweight) there age ranges between (16-41) years, with their husbands twenty one infertile men and twelve fertile men and their ages range between (23-46) years. In the present study we observed that several indicators affect the fertility such as BMI in infertile obese women which was 34.65 kg/m2. That is higher than that of overweight infertile women that recorded 24.87 kg/m2. obese housewives scored the highest percentage (85.71%) compared with the overweight group (25%), In addition the obese age group between 30-41 years scored (66.67%) compared with the overweight group whose members’ age 16-29.9 years scored 75%. However, drinking cola (soft drink) percentage in obese infertile women was (85.71%) and the tea consumption was higher in overweight group (66.67%). The hormones FSH and LH decrease in obese women but serum prolactin hormone increased twice about 29.27 ng/ml in comparison with overweight group. Testosterone hormone decreased in obese women but Leptin in obese women (19.52 μg/L) was higher than that of overweight women (11.03 μg/L). Infertile unemployed men got the highest percentage of 66.67%. Besides, the smoker infertile men were higher in percentage (80.95%) compared with fertile men 41.67%. The elevated LH, FSH and prolactin values are significantly high (p<0.01) (7.895 mlU/ml, 9.89 mlU/ml and 13.33 ng/ml) respectively, but the testosterone was significantly low (3.91 ng/dl) in comparison with fertile men(21.76ng/dl). Whileleptin significantly increased in infertile men more than the fertile ones. These changes in hormones have a great correlation with semen characteristics as the abnormalities in sperms increased to (64.52) and the percentage of rapid, progressive and non -progressive motility decreased, but the immotile motility was highly significant (65.71) in infertile men. As a result this indicates that the reason of infertility is shared between the wife and husband.


2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.


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