title: Prolonging oocyte in vitro culture and handling time does not compensate for a shorter interval from human chorionic gonadotropin administration to oocyte pickup.
abstract: OBJECTIVE
  To assess the impact of oocyte aspiration, denudation, and sperm injection timing in relation to oocyte hCG exposure time on intracytoplasmic sperm injection (ICSI) outcome.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  A total of 614 consecutive ICSI cycles were performed in 421 patients aged <38 years with at least three aspirated oocytes and no more than three previous treatments.
  
  
  METHODS
  Gonadotropin-releasing hormone agonist or GnRH antagonist suppression; oocyte pickup (OPU)-hCG interval more/less than 36 hours; OPU-denudation interval more/less than 2 hours; denudation-ICSI interval more/less than 1 hour.
  
  
  METHODS
  Fertilization, embryo transfer, and pregnancy rates.
  
  
  RESULTS
  Late OPU was associated with more available embryos than early OPU and significantly higher rates of fertilization (66.0% ± 22.8% vs. 61.8% ± 24.3%), ET (99.5% vs. 96.2%), and pregnancy (47.2% vs. 35.4%). This advantage was more pronounced in GnRH agonist cycles. The length of incubation before or after denudation had no effect, regardless of OPU timing. On logistic stepwise regression, OPU timing was the only significant independent predictor of pregnancy (odds ratio 1.6, 95% confidence interval 1.17-2.29).
  
  
  CONCLUSIONS
  The timing of OPU has a predominant effect on ICSI success, especially in GnRH agonist cycles. Delaying oocyte denudation or sperm injection does not compensate for insufficient postpriming exposure to the follicular environment.
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Garor
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: yoelsh1@clalit.org.il.
authors.forename: Yoel
authors.initials: Y
authors.lastname: Shufaro
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Naomi
authors.initials: N
authors.lastname: Kotler
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dania
authors.initials: D
authors.lastname: Shefer
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Natalia
authors.initials: N
authors.lastname: Krasilnikov
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Ben-Haroush
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Pinkas
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Fisch
authors.affiliation: Infertility and IVF Unit, Beilinson's Women Hospital, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Onit
authors.initials: O
authors.lastname: Sapir
mesh_terms: D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology / Q000628:therapy*; D054315:Oocyte Retrieval / Q000379:methods*; D009865:Oocytes / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012102:Reproductive Control Agents / Q000008:administration & dosage; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D012102:Reproductive Control Agents
keywords: In vitro fertilization; hCG; in vitro maturation; in vivo maturation