[In vitro maturation of oocytes: a novel method of treatment of patients with polycystic ovarian syndrome undergoing in vitro fertilization].

BACKGROUND

In vitro maturation of oocytes (IVM) was developed to make in vitro fertilization (IVF) safer and simpler mainly for women with poLycystic ovarian syndrome (PCOS). The major benefits of IVM treatment include avoidance of hormone administration and risk of ovarian hyperstimulation syndrome (OHSS).

OBJECTIVE

Results of IVM from our unit in patients with PCOS.

METHODS

In this study 85 PCOS patients underwent 102 IVF cycles of IVM and were treated with one of the following protocols: (1) Priming with 150 units of recombinant FSH for 3 days, from the 3rd day of menses, following follicle development up to 10-12 mm. (2) Administration of 17beta estradiol (estrofem) on second day of menses, followed by ultrasound endometrial measurement up to > or =6 mm. thickness. Oocytes were collected 38 hours post recombinant human chorionic gonadotropin (rhCG) administration. Luteal phase support was achieved by estrofem and progesterone. Oocytes were matured either 6-30 hours (protocol 1) or 24-48 hours (protocol 2) in IVM medium and fertilized by intracytoplasmatic sperm injection (ICSI). Mean number of immature oocytes collected, maturation, fertilization, cleavage and pregnancy rates were assessed.

RESULTS

Total number of retrieved oocytes was 1224 (mean 12 +/- 6.2 per cycle); 820 (64.9%) underwent maturation after 6-48 hours of culture while 128 of them (15.6%) after 6 hours and 20.2% of transferred embryos originated from those oocytes. FertiLization rate was 47.2%. Pregnancy and implantation rates were 28.4% and 11.25% respectively.

CONCLUSIONS

IVM appears to be a simpler and tolerable treatment method in patients with PCOS undergoing IVF treatment. Favorable results were obtained.