ABSTRACT
Background: In vitro maturation [IVM] is an artificial reproductive technology in which immature oocytes are harvested from the ovaries and subsequently will be matured in vitro. IVM does not require ovarian hyperstimulation [OH] and thus the risk of ovarian hyperstimulation syndrome [OHSS] is avoided. In this study, we assessed the live birth rate per initiated IVM cycle in women eligible for in vitro fertilization/intracytoplasmic sperm injection [IVF/ ICSI] and at risk for OHSS. Furthermore, we followed women who were not pregnant after IVM and committed to a conventional IVF/ICSI procedure
Materials and Methods: In this multicenter prospective cohort study, we started 76 IVM cycles using recombinant follicle stimulating hormone [rFSH] priming in 68 patients. There were 66 oocyte retrievals, in which a total of 628 oocytes were collected. We incubated the immature oocytes for 24-48 hours and fertilized those that reached metaphase II by ICSI
Results: Three hundred eighty six [61% oocytes] achieved metaphase II. The fertilization rate was 55%. We performed 59 embryo transfers [1.9 embryos per transfer] in 56 women, including 3 frozen embryo transfers. There were four ongoing pregnancies [5.3% per initiated cycle] leading to the birth of a healthy child at term. None of the patients developed OHSS. The ongoing pregnancy rate of the first conventional IVF/ICSI cycle after an unsuccessful IVM cycle was 44%, which was unexpectedly high
Conclusion: We concluded that IVM led to live births but with low effectiveness in our study. Earlier reported IVM success rates are higher which can be caused by a more extended experience in these centers with the intricate laboratory process. However, a possible selection bias in these studies cannot be ruled out. Furthermore, IVM might have a beneficial effect on further IVF/ICSI treatments due to its "ovarian drilling" effect
ABSTRACT
Background: Standardization of the semen analysis may improve reproducibility. We assessed variability between laboratories in semen analyses and evaluated whether a transformation using Z scores and regression statistics was able to reduce this variability
Materials and Methods: We performed a retrospective cohort study. We calculated between-laboratory coefficients of variation [CVB] for sperm concentration and for morphology. Subsequently, we standardized the semen analysis results by calculating laboratory specific Z scores, and by using regression. We used analysis of variance for four semen parameters to assess systematic differences between laboratories before and after the transformations, both in the circulation samples and in the samples obtained in the prospective cohort study in the Netherlands between January 2002 and February 2004
Results: The mean CVB was 7% for sperm concentration [range 3 to 13%] and 32% for sperm morphology [range 18 to 51%]. The differences between the laboratories were statistically significant for all semen parameters [all P<0.001]. Standardization using Z scores did not reduce the differences in semen analysis results between the laboratories [all P<0.001]
Conclusion: There exists large between-laboratory variability for sperm morphology and small, but statistically significant, between-laboratory variation for sperm concentration. Standardization using Z scores does not eliminate between-laboratory variability