Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Complete Oocyte Maturation Arrest in ART Cycles

Authors
Fatemeh Haji- Maghsoudi 1
Mohammad Ali Khalili 2
Abbas Aflatoonian 3
1 Department of Anatomy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Infertility Research and Clinical Center, Shahid Sadoughi Medical Sciences University, Isfahan, Iran
3 Department of Obstet . and Gynecol . of Shahid Sadughi Medical Science of Yazd, Yazd, Iran
Abstract
Introduction: In assisted reproductive techniques (ART), ovarian hyperstimulation drugs are used to retrieve several mature oocytes. International studies report that complete absence of MII oocytes known as “complete oocyte maturation arrest (COMA)” is a very rare phenomenon. The main objective of this retrospective study was to evaluate the ART cycles with COMA along with results from the subsequent treatment cycles. Materials and Methods: A total of 38 cases with COMA were evaluated for age of patients, ovulation induction protocols, and number of follicles and oocytes (GV & MI). Three different protocols of short, long and HMG/HCG were administered on patients. Also, type of infertility was divided into male, female and unexplained. Results: The results showed that out of 38 cases, 17 and 7 of the couples were respectively retu-rned for the subsequent treatment cycles. The mean of age for men and women was 34.2+3.3 and 29.4+3.1, respectively.Also, the majority were diagnosed with female factor infertility (22 cases). 21 women were under 35 years old and the rest were between ages of 35-41. In second and third treatment cycles, the mean number of immature oocyte (GV+MI) was 3.13+1.5 and 2.9+0.96, respecttively. In addition mean number of MII oocytes were increased from 0 in first to 2.06+1.3 in second and 2.02+0.7 in third cycles. HMG/HCG protocol was in direct relation with the lowest rate of immature egg retrieval. The results also showed that older women (>35) had the highest rate of immature oocytes. Conclusion: the results indicate that the prevalence of COMA is very high in our patients which could be related to the women’s age. However, the COMA was reduced in patients who were re-turned for the second or third times for ART treatments. This may show that extrinsic factors related to the ovulation induction protocol and Induction drugs such as the type, manufacturing company, purchasing, and preservation could be the main cause in COMA taking place in some of our cases.
Keywords
Assisted Reproductive Techniques
Immature oocyte
Infertility
Oocyte maturation arrest
Ovarian stimulation
Byskov A.G., Anderson C.Y., Leonardsen L. Role of meiosis activating sterols, MAS, in induced oocyte maturation. Mol Cell Endocrinol.2002;87:189-96.
Kubota Y., Takisawa H. Block to DNA replication in meiotic maturation: a unified view for a robust arrest of cell cycle in oocytes and smotic cells. Biossays. 2003;25:313-6.
Van Steirteghem A.C., Nagy Z., Joris H., Liv J., Staessens C., Smits J. High fertilization and implanta-tion after intracytoplasmic sperm injection. Hum Rep-rod.1993;8:1061-6.
Rudak E., Dor J., Kimchi M., Goldman B., Levran D., Mashiach S. Anomalies of human oocytes from infer-tile women undergoing treatment by in vitro fertiliza-tion. Fertil Steril.1990;54:292-6.
Hartshorne G., Montgomery S., Klenzeris L. A case of failed oocyte maturation in vivo and in vitro. Fertil Fertil Steril.1999;71:567-70.
Harrison K.L., Sherrin D.A., Keeping J.D. Repeated oocyte maturation block. J Assisted Reprod Genet. 2000;17:231-3.
Levran D., Ferhi J., Nahum H., Glezerman M., Weissman A. Maturation arrest of human oocytes as a cause of infertility. Hum Reprod.2002;17: 1604-9.
Detwiler M.R., Reuben M., Lix, Rogers E., Lin R. Two zinc finger proteins, OMA-1 and OMA2, are redund-antly required for oocyte maturation in C elegans. Dev cell.2001;1: 187-99.
Hartshorne G., Montagomery S., Klentzeris L. A case of failed oocyte maturation in vivo and in vitro. Fertil Steril.1999;71:567-70.
Kotsuji F., Kubo M., Tominaga T. Effect of interaction between granulosa and thecal cells on meiotic arrest in bovine oocytes. J Reprod Fertil.1994;100:151-6.
Zhang X., Zerafa A., Wong J., Armstrong D.T., Khamsi F. Human menopausal gonadotropin during in vitro maturation of human oocytes retrieved from small follicles enhanced in vitro fertilization and cleavage rats. Fertil Steril.1993;59:850-3.
Dandekar P.V., Martin M.C., Glass R.H. Maturation of immature oocytes by coculture with granulosa cells. Fertil Steril.1991;55:95-9.
Janssenwillen C., Nagy Z.P., Van Steirtegham A. Maturation of human cumulus-free germinal vesicle stage oocytes to MII by culture with monolayer vero cells. Hum Reprod.1995;10:375-8.
Farhi J., Nahum H., Zakut H., Levran D. Incubation with sperm enhances in vitro maturation of the oocyte from the germinal vesicle to the M2 stage. Fertil Steril.1997;68;318-22.
Journal of Reproduction & Infertility
Volume 6, Issue 2
Spring 2005
Pages 163-170