title: In vivo maturation of oocytes by extending the interval between human chorionic gonadotropin administration and oocyte retrieval.
abstract: OBJECTIVE
  To find whether the percentage of mature oocytes can be increased in the following ICSI cycle, in a selected group of patients with >or=47% immature oocytes, with the prolongation of hCG-to-oocyte retrieval interval.
  
  
  METHODS
  Randomized study.
  
  
  METHODS
  In vitro fertilization unit in a medical center in Israel.
  
  
  METHODS
  From January 2003 to June 2005, in 72 of 2,650 intracytoplasmic sperm injection cycles (2.8%), >or=47% of the total aspirated oocytes were immature (group A). In the following treatment cycle, with similar controlled ovarian hyperstimulation, hCG was planned to be injected in the same interval (group B) as well as 3-4 hours earlier (group C). In fact, the hCG-to-oocyte retrieval interval in group C was statistically significantly longer (38.6 +/- 1.2 hours) compared with that in group B (35.3 +/- 0.7 hours).
  
  
  METHODS
  The clinical characteristics of the patients, ovarian stimulation, hormonal profile, and the intracytoplasmic sperm injection outcome of the various groups were assessed.
  
  
  METHODS
  The number and maturity of the aspirated oocytes.
  
  
  RESULTS
  The mean number of ampules needed for stimulation, treatment duration, serum E(2), and P level on the hCG day were similar in the various groups. Escaped ovulation did not occur in any of the patients. A larger number of aspirated oocytes, a statistically significantly larger percentage of mature oocytes (72%), and a statistically significantly lower percentage of metaphase I (12%), germinal vesicle (18%), and degenerated oocytes (8%) were found in group C compared with group A (50%; 16%, 21%, and 13%, respectively). Similar morphological distribution of the aspirated oocytes was observed among groups B and C. Clinical implantation and pregnancy rates were higher in group C compared with group B.
  
  
  CONCLUSIONS
  In a selected group of patients with >or=47% immature oocytes per retrieval, a larger cohort of mature oocytes can be recruited by extending the hCG- to-oocyte retrieval interval in a subsequent cycle. This improved outcome directly affects the quality of embryos available for transfer and thus increases pregnancy rate.
authors.affiliation: Infertility and IVF Unit, Assaf Harofeh Medical Center, Tel Aviv University, Zerifin, Israel. araziel@012.net.il
authors.forename: Arieh
authors.initials: A
authors.lastname: Raziel
authors.forename: Morey
authors.initials: M
authors.lastname: Schachter
authors.forename: Deborah
authors.initials: D
authors.lastname: Strassburger
authors.forename: Esti
authors.initials: E
authors.lastname: Kasterstein
authors.forename: Raphael
authors.initials: R
authors.lastname: Ron-El
authors.forename: Shevach
authors.initials: S
authors.lastname: Friedler
mesh_terms: D000328:Adult; D018929:Cell Culture Techniques / Q000379:methods*; D049109:Cell Proliferation / Q000187:drug effects; D002469:Cell Separation; D002478:Cells, Cultured; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D009865:Oocytes / Q000166:cytology / Q000187:drug effects* / Q000254:growth & development*; D010062:Ovulation Induction / Q000379:methods*; D013997:Time Factors
chemical_list: D006063:Chorionic Gonadotropin