Effect of hCG priming on embryonic development of immature oocytes collected from unstimulated women with polycystic ovarian syndrome

Reproductive Biology and Endocrinology

Jie Qiao¹  Ping Liu¹  Ying Lian¹  Xiumei Zhen¹  Lina Wang¹  Xiaoying Zheng¹ 

[1] Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China

关键词: hCG priming;    In vitro maturation;    Polycystic ovarian syndrome;   

Others  :  1150638
DOI  :  10.1186/1477-7827-10-40

 received in 2012-02-02, accepted in 2012-05-24,  发布年份 2012

【 摘 要 】

Backgroud

The effect of hCG priming on oocyte maturation and subsequently outcome in IVM cycles has remained a debated issue. A randomized controlled study was performed to investigate whether or not hCG priming prior to oocyte aspiration can improve the developmental competence of immature oocytes from unstimulated ovaries in women with polycystic ovarian syndrome (PCOS).

Methods

Eighty two patients with PCOS underwent IVM cycles. Each patient was randomly assigned to the hCG-primed (10,000 IU) or non-primed groups 36–38 hours before oocyte retrieval depending on the computerized random table. After the oocytes had in vitro matured, fertilization, culture and embryo transfer were performed.

Results

The average number of cumulus-oocyte complexes (COCs) recovered was 13.80 and 14.35 in the hCG-primed and non-primed groups, respectively (p > 0.05). The maturation rate of COCs was significantly improved in the hCG-primed group (55.43% vs. 42.29%; p < 0.05). The fertilization and cleavage rates were comparable between the groups. The hCG-primed and non-primed groups did not differ with respect to the clinical pregnancy (37.50% vs. 50.00%), live birth (22.50% vs. 30.95%), and implantation rates (32.86% vs. 32.56%). The pregnancy losses was 6 (40.00%) of 15 clinical pregnancies in the hCG-primed group, and 8 (38.10%) of 21 clinical pregnancies in the non-primed group.

Conclusions

While a significant improvement in the nuclear maturation rate of immature oocytes was observed in hCG-primed IVM cycles with PCOS patients, the use of hCG prior to oocyte retrieval did not improve the subsequent embryo developmental competence. The high rate of pregnancy loss in IVM cycles should receive more attention.

【 授权许可】

   
2012 Zheng et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Rotterdam ESHRE /ASRM - sponsored PCOS concensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long – term health risks related to polycystic ovary syndrome. Fertil Steril 2004, 81:19-22.
• [2]Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, et al.: The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009, 91:456-488.
• [3]Archer JS, Chang RJ: Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004, 18:737-754.
• [4]Trounson A, Wood C, Kausche A: In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril 1994, 62:353-362.
• [5]Chian RC, Buckett WM, Tan S-L: In-vitro maturation of human oocytes. Reprod Biomed Online 2004, 8:148-166.
• [6]Soderstrom-Anttila V, Makinen S, Tuuri T, Suikkari AM: Favourable pregnancy results with insemination of in vitro matured oocytes from unstimulated patients. Hum Reprod 2005, 20:1534-1540.
• [7]Hashimoto S, Fukuda A, Murata Y, Kikkawa M, Oku H, Kanaya H, Sonoda M, Sugihara K, Murata T, Nagata F, et al.: Effect of aspiration vacuum on the developmental competence of immature human oocytes retrieved using a 20 gauge needle. Reprod Biomed Online 2007, 14:444-449.
• [8]Cha KY, Chung HM, Lee DR, Kwon H, Chung MK, Park LS, Choi DH, Yoon TK: Obstetric outcome of patients with polycystic ovary syndrome treated by in vitro maturation and in vitro fertilization embryo transfer. Fertil Steril 2005, 83:1461-1465.
• [9]Le Du A, Kadoch IJ, Bourcigaux N, Doumerc S, Bourrier MC, Chevalier N, Fanchin R, Chian RC, Tachdjian G, Frydman R, et al.: In vitro oocyte maturation for the treatment of infertility associated with polycystic ovarian syndrome: the French experience. Hum Reprod 2005, 20:420-424.
• [10]Child TJ, Phillips SJ, Abdul-Jalil AK, Gulekli B, Tan SL: A comparison of in vitro maturation and in vitro fertilization for women with polycystic ovaries. Obstet Gynecol 2002, 100:665-670.
• [11]Child TJ, Abdul-Jalil AK, Gulekli B, Tan SL: In vitro maturation and fertilization of oocytes from unstimulated normal ovaries, polycystic ovaries, and women with polycystic ovary syndrome. Fertil Steril 2001, 76:936-942.
• [12]Filicori M, Cognigni G, Samara A, Melappioni S, Perri T, Cantelli B, Parmegiani L, Pelusi G, DeAloysio D: The use of LH activity to drive folliculogenesis: exploring uncharted territories in ovulation induction. Hum Reprod Update 2002, 8:543-557.
• [13]Chian RC, Buckett WM, Tulandi T, Tan SL: Prospective randomized study of human chorionic gonadotrophin priming before immature oocyte retrieval from unstimulated women with polycystic ovarian syndrome. Hum Reprod 2000, 15:165-170.
• [14]Chung MK, Chung HM, Lee WS, Han SY, Yoon TK, Cha KY: Applicability of a hCG priming of unstimulated PCOS patients for improving IVM/IVF-ET outcome. Fertil Steril 2000, 74:S32-S33.
• [15]Hillier SG: Current concepts of the roles of follicle stimulating hormone and luteinizing hormone in folliculogenesis. Hum Reprod 1994, 9:188-191.
• [16]Jakimiuk AJ, Weitsman SR, Navab A, Magoffin DA: Luteinizing hormone receptor, steroidogenesis acute regulatory protein, and steroidogenic enzyme messenger ribonucleic acids are overexpressed in thecal and granulosa cells from polycystic ovaries. J Clin Endocrinol Metab 2001, 86:1318-1323.
• [17]Yang SH, Son WY, Yoon SH, Ko Y, Lim JH: Correlation between in vitro maturation and expression of LH receptor in cumulus cells of the oocytes collected from PCOS patients in HCG-primed IVM cycles. Hum Reprod 2005, 20:2097-2103.
• [18]Lindeberg M, Carlstrom K, Ritvos O, Hovatta O: Gonadotrophin stimulation of non-luteinized granulose cells increases steroid production and the expression of enzymes involved in estrogen and progesterone synthesis. Hum Reprod 2007, 22:401-406.
• [19]Haouzi D, Assou S, Mahmoud K, Hedon B, De Vos J, Dewailly D, Hamamah S: LH/hCGR gene expression in human cumulus cells is linked to the expression of the extracellular matrix modifying gene TNFAIP6 and to serum estradiol levels on day of hCG. Hum Reprod 2009, 24:2868-2878.
• [20]Zheng XY, Liu P, Fan M, Zhen XM, Chen XN, Qiao J: Correlation between cumulus cell morphology and developmental potential of the immature oocytes collected from unstimulated women with polycystic ovarian syndrome. (published in Chinese). Chin J Clin Obst et Gynecol 2008, 9:267-270.
• [21]Moor RM, Dai Y, Lee C, Fulka J Jr: Oocyte maturation and embryonic failure. Hum Reprod Update 1998, 4:223-236.
• [22]Combelles CM, Cekleniak NA, Racowsky C, Albertini DF: Assessment of nuclear and cytoplasmic maturation in in-vitro matured human oocytes. Hum Reprod 2002, 17:1006-1016.
• [23]Suikkari AM, Soderstrom-Anttila V: In-vitro maturation of eggs: is it really useful? Best Pract Res Clin Obstet Gynaecol 2007, 21:145-155.
• [24]Buckett WM, Chian RC, Dean NL, Sylvestre C, Holzer HE, Tan SL: Pregnancy loss in pregnancies conceived after in vitro oocyte maturation, conventional in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril 2008, 90:546-550.
• [25]Requena A, Bronet F, Guillen A, Agudo D, Bou C, Garcia-Velasco JA: The impact of in-vitro maturation of oocytes on aneuploidy rate. Reprod Biomed Online 2009, 18:777-783.
• [26]Li Y, Feng HL, Cao YJ, Zheng GJ, Yang Y, Mullen S, Critser JK, Chen ZJ: Confocal microscopic analysis of the spindle and chromosome configurations of human oocytes matured in vitro. Fertil Steril 2006, 85:827-832.