title: Developmental potential of human oocytes matured in vitro followed by vitrification and activation.
abstract: BACKGROUND
  Oocyte in vitro maturation (IVM) and cryopreservation at the time of routine ovarian tissue freezing may be offered to cancer patients as an additional option for fertility preservation. This study aimed to investigate the developmental capacity of oocytes isolated from unstimulated ovaries.
  
  
  METHODS
  Immature oocytes (n = 63) from seven consenting premenopausal patients were analysed. Oocytes were collected during routine laparoscopic examination with biopsy of an ovary (cystic adnexal mass, n = 3; cervical adenocarcinoma, n = 2) or oophorectomy (sex reassignment surgery, n = 2) without previous stimulation of the ovaries. The stage of the patient's menstrual cycle was not considered. Oocytes in all visible antral follicles were aspirated from ovaries, cultured in IVM medium and vitrified at the MII stage before being kept in liquid nitrogen for at least one month. After warming, oocytes were subjected to parthenogenetic activation by chemical stimulus. Their further development was recorded at intervals of 24 hours for up to 6 days of culture.
  
  
  RESULTS
  61.9% of oocytes matured in vitro within 48 hours. The survival rate after vitrification and warming was 61.5%. A total of 75% of surviving oocytes were able to respond to artificial activation, 44.4% of the parthenotes developed to early embryonic stage. However, only 1 in 18 (5.6%) of the resulting embryos reached blastocyst stage.
  
  
  CONCLUSIONS
  Oocytes matured in vitro from unstimulated ovaries seem to have limited developmental potential after cryopreservation and artificial activation. Although the outcome of IVM for non-stimulated oocytes is poor, it is currently the only chance besides cryopreservation of ovarian tissue for women for whom ovarian stimulation is not possible due to life circumstances. Based on our preliminary results, we suggest that the use of cryopreserved ovaries for fertility preservation in women with cancer warrants further investigation.
authors.affiliation: Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich, CH-8091, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Imesch
authors.affiliation: Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich, CH-8091, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Scheiner
authors.affiliation: Division of Reproductive Endocrinology, University Hospital Zurich, Zurich, CH-8091, Switzerland.
authors.forename: Min
authors.initials: M
authors.lastname: Xie
authors.affiliation: Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich, CH-8091, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fink
authors.affiliation: Division of Reproductive Endocrinology, University Hospital Zurich, Zurich, CH-8091, Switzerland.
authors.forename: Erwin
authors.initials: E
authors.lastname: Macas
authors.affiliation: Division of Reproductive Endocrinology, University Hospital Zurich, Zurich, CH-8091, Switzerland.
authors.forename: Raghvendra
authors.initials: R
authors.lastname: Dubey
authors.affiliation: Division of Reproductive Endocrinology, University Hospital Zurich, Zurich, CH-8091, Switzerland.
authors.forename: Bruno
authors.initials: B
authors.lastname: Imthurn
keywords: Fertility preservation; In vitro maturation; Ovarian tissue; Parthenogenesis; Vitrification