[Oocyte quality as a predictive marker for assessment of IVF/ICSI procedure outcome].

The technology of in vitro fertilization consists mainly of pick up, selection and insemination of oocytes, embryo culture and their transfer into recipient's womb. Before any further manipulation of oocytes their quality has to be accurately evaluated as it has direct impact on the monospermic fertilization, early development, establishment and maintenance of pregnancy. Criteria applied for oocyte quality assessment are subdivided into morphological, cellular and molecular. Morphological ones include the structure of oocyte: cumulus-oocyte complex, cytoplasm, firstpolarbody, perivitelline space, zona pellucida, and meiotic spindle. Morphological alterations may be related to the particular patient and the treatment cycle characteristics, to affect most or all oocytes in the cohort. The aim of the resent review is by summarizing available data from literature to investigate if non-invasive observation of any morphological feature or group of features of MII phase human oocytes has strong predictive value for further development and the in vitro procedure outcome.

[In vitro maturation--a potential approach of infertility treatment of patients with PCOS].

Polycystic ovary syndrome (PCOS) affects about 15-20% of women of reproductive age. This is a heterogeneous condition characterized by a combination of menstrual cycle disturbances, hyperandrogenism and polycystic ovaries. A significant percent of these women comes to the necessity of assisted reproduction procedure. During the conventional procedure of in vitro fertilization (IVF) the patients are being exposed to a controlled ovarian hyperstimulation (COH) with gonadothropine hormones with the purpose of ensuring collection of numerous mature oocytes for fertilization and respectively obtaining numerous embryos for selection and embryotransfer. The supraphysiological doses of exogenous gonadothropines used for COH often lead to an excessive ovarian response, characterized by the development of numerous follicles of different size and different quality, aspiration of immature oocytes and higher risk of severe ovarian hyperstimulation syndrome (OHSS) in women with PCOS. The retrieval of immature oocytes from unstimulated ovaries followed by in vitro maturation (IVM) procedure appears a potential therapy which eliminates aforenamed risks and respectively is highly beneficial for application to women with PCOS.

[Endocrinology of in vitro maturation of oocytes].

In-vitro maturation (IVM) of oocytes is an alternative to conventional in-vitro fertilization (IVF) treatment. Significant progress has been made to improve pregnancy and implantation rates from in-vitro matured oocytes. However oocyte maturation in vitro is profoundly affected by culture conditions. Most IVM protocols supplement gonadotropins--folicle stimulating hormone (FSH) and luteinizing hormone (LH) into a culture medium for oocyte maturation. The addition of these hormones, as well as some growth factors is based on their physiological role in oocyte maturation in vivo. However, it is possible, they not to play the same role in promoting oocyte maturation in vitro. The aim of this survey is to examine the hormones and growth factors, which participate in oocyte maturation in vivo and to summarize briefly the available information about the effect they have on the in vitro maturation. The researches on effects of these endocrine factors on oocyte maturation and subsequent fertilization, as well as on early embryonal development proceed.