FACTORS AFFECTING THE IN-VITRO MATURATION OUTCOMES

Objectives : In-vitro maturation of human oocytes is becoming increasingly important in treating some aspects ol infertility. Our aim is to study the effect of concentration of recombinant follicle stimulating hormone(r-FSH) in culture media and follicle size, on oocytes maturation, fertilization, and cleavage and pregnancy rates in women with polycystic ovary syndrome.
Methods; In a randomized study of 100 women in an IVF program, 50 patients with 674 germinal vesicle oocytes were allocated to study the effect of three concentrations of r-FSH (0.0, 0.075, and 7.5 IU) supplemented in culture media on oocyte maturation, fertilization, cleavage, and pregnancy rate. The remaining 50 patients produced 500 GV and were allocated to study the effect of two follicle r sizes (8-10 and 11-13 mm) on the same parameters as above. Results; Oocyte maturation rate significantly (P < 0.05) increased from 47% at 0.0 (control) to 81 and 83% at 0.075 and 7.5 lU/ml of r-FSH concentration, respectively. Fertilization, cleavage, and clinical pregnancy rates showed a similar trend and significantly increased from 45 to 83 and 80%; from 32 to 80 and 77% and from 0 to 17 and 14% at the three r-FSH concentrations, respectively. The results however showed that increasing r-FSH concentration to more than 0.075 IU did not further improve the rates of the above parameters even when the concentration was increased 100 folds.Follicular size on the other hand showed significant (P<0.05) increase on the above parameters. Oocytes retrieved from 11-13 mm follicles showed higher rates of maturation, fertilization, cleavage, and pregnancy, than those retrieved from 8-10 mm follicles. The above parameters increased from 48 to 70%; from 54 to 76% from 64 to 68%, and from I to 22.5%, respectively.
Conclusion: The results suggested that r-FSH supplementation in the culture media with a concentration of 0.075 IU was optimum in the present study and improving GV maturation, fertilization, cleavage and pregnancy rate. The results also showed that oocytes recovered from follicles with 11-13 mm in diameter provided higher maturation rates and a better subsequent developmental competence than those retrieved from smaller follicles of 8-10 mm diameter.