RESUMO
OBJECTIVE: To evaluate whether metaphase I (MI) oocytes completing maturation in vitro to metaphase II ("MI-MII oocytes") have similar developmental competence as the sibling metaphase II (MII) oocytes that reached maturity in vivo. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): A total of 1,124 intracytoplasmic sperm injection (ICSI) cycles from 800 patients at a single academic center between April 2016 and December 2020 with at least 1 MII oocyte immediately after retrieval and at least 1 sibling "MI-MII oocyte" that was retrieved as MI and matured to MII in culture before ICSI were included in the study. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): A total of 7,865 MII and 2,369 sibling MI-MII oocytes retrieved from the same individuals were compared for the fertilization and blastocyst formation rates. For patients who underwent single euploid blastocyst transfers (n = 406), the clinical pregnancy, spontaneous pregnancy loss, and live birth rates were compared between the 2 groups. RESULT(S): The fertilization rate was significantly higher in MII oocytes than in delayed matured MI-MII oocytes (75.9% vs. 56.1%). Similarly, the blastocyst formation rate was higher in embryos derived from MII oocytes than in those from MI-MII oocytes (53.8% vs. 23.9%). The percentage of euploid embryos derived from MII oocytes was significantly higher than that of those from MI-MII oocytes (49.2% vs. 34.7%). Paired comparison of sibling oocytes within the same cycle showed higher developmental competence of the MII oocytes than that of MI-MII oocytes. However, the pregnancy, spontaneous pregnancy loss, and live birth rates after a single euploid blastocyst transfer showed no statistically significant difference between the 2 groups (MII vs. MI-MII group, 65.7% vs. 74.1%, 6.4% vs. 5.0%, and 61.5% vs. 70.0%, respectively). CONCLUSION(S): Compared with oocytes that matured in vivo and were retrieved as MII, the oocytes that were retrieved as MI and matured to MII in vitro before ICSI showed lower developmental competence, including lower fertilization, blastocyst formation, and euploidy rates. However, euploid blastocysts from either cohort resulted in similar live birth rates, indicating that the MI oocytes with delayed maturation can still be useful even though the overall developmental competence was lower than that of their in vivo matured counterparts.
Assuntos
Aborto Espontâneo , Gravidez , Feminino , Humanos , Masculino , Estudos Retrospectivos , Metáfase , Sêmen , Oócitos , Fertilização in vitroRESUMO
Objetivo: comparar la calidad embrionaria y describir las tasas de implantación, embarazo y aborto en las técnicas de fertilización in vitro (FIV) y el cultivo intravaginal de ovocitos. Materiales y métodos: cohortes históricas de pacientes con tratamiento de fertilización in vitro y el cultivo intravaginal de ovocitos en el Centro Colombiano de Fertilidad y Esterilidad (Cecolfes) durante el año 2010. Se incluyeron 137 pacientes aspiradas dentro de los cuatro grupos de estudio: Grupo 1, FIV/Incubadora; Grupo 2, FIV/INVO; Grupo 3, ICSI/INVO, y Grupo 4, ICSI/Incubadora. Se midió el peso de la paciente, el número de ovocitos recuperados y óvulos maduros (MII), la tasa de implantación y la tasa de embarazo y aborto en cada uno de los grupos. Se realizó análisis mediante la prueba de Kruskal-Wallis; la calidad embrionaria fue evaluada con un análisis de covarianza multivariado (MANOVA). Resultados: se observó diferencia significativa en la calidad embrionaria entre las dos técnicas FIV e INVO (p = 0,0388). En la técnica INVO se presentaron mayores tasas de división embrionaria (μ = 7,35/INVO frente a 6,64/Incubadora) y menor fragmentación (μ = 4,67/INVO frente a 4,59/ Incubadora). En cuanto a la tasa de implantación, embarazo y aborto se obtuvieron más altos porcentajes en los grupos INVO. Conclusión: la técnica INVO se asoció a mejor calidad embrionaria. Las tasas de implantación, embarazo y bajas tasas de aborto son semejantes a las descritas en la técnica FIV.
Objective: Comparing embryo quality and describing implantation, pregnancy and abortion rates regarding in vitro fertilization (IVF) and intravaginal oocyte culture (INVO) techniques. Materials and methods: The study involved historical cohorts of patients undergoing IVF and INVO treatment in the Colombian Fertility and Sterility Centre (Centro Colombiano de Fertilidad y Esterilidad Cecolfes) during 2010. It involved 137 aspirated patients, covering four study groups: Group 1 IVF/incubator, Group 2 IVF/INVO, Group 3 ICSI/INVO and Group 4 ICSI/incubator. The patients weight, the number of ovocytes retrieved, mature ovules (M2), implantation rate, pregnancy and abortion rates were measured in each group. The Kruskal-Wallis test was used for statistical analysis; embryo quality was evaluated by multivariate covariance analysis (MANOVA). Results: A significant difference was observed regarding embryo quality between IVF and INVO (p = 0.0388), the INVO technique having higher embryo cleavage rates (μ = 7.35/INVO cf 6.64/ incubator) and lower embryo fragmentation (μ = 4.67/INVO cf 4.59/incubator). INVO groups also had higher percentages concerning their implantation, pregnancy and abortion rates. Conclusion: The INVO technique led to obtaining better quality embryos; implantation, pregnancy and abortion rates were similar to those described for the IVF technique.
