Ri-Cheng Chian

Obstetric outcomes following vitrification of in vitro and in vivo matured oocytes

OBJECTIVEnTo evaluate obstetric outcomes with oocyte vitrification after ovarian stimulation (OS) and in vitro maturation (IVM) of immature oocytes.nnnDESIGNnA prospective trial from October 2003 to April 2007.nnnSETTINGnUniversity-based medical center.nnnPATIENT(S)nOS group: 38 patients undergoing intrauterine insemination who overresponded to OS. IVM group: 20 patients who had previous unsuccessful intrauterine insemination.nnnINTERVENTION(S)nMature oocyte retrieval following OS. Immature oocyte retrieval and IVM. Oocyte vitrification, thawing, insemination, and transfer of the resulting embryos.nnnMAIN OUTCOME MEASURE(S)nLive-birth rates and obstetric outcomes.nnnRESULT(S)nThe OS group was superior to the IVM group in terms of oocyte survival (81.4 +/- 22.6% vs. 67.5 +/- 26.1%), fertilization rate (75.6 +/- 22.5% vs. 64.2 +/- 19.9%), and cumulative embryo score (38.4 +/- 22.3 vs. 20.0 +/- 13.8). However, the differences in the implantation rate per embryo (19.1 +/- 25.8% vs. 9.6 +/- 24.1%), clinical pregnancy rate per cycle started (44.7%, vs. 20.0%), and live-birth rate per cycle started (39.5% vs. 20.0%) were not statistically significant. Twenty healthy babies were born in the OS group and four in the IVM group.nnnCONCLUSION(S)nPregnancies achieved with vitrification of oocytes after OS and IVM treatments do not appear to be associated with adverse pregnancy outcomes. Vitrification of IVM oocytes represents a novel option for fertility preservation.

Live birth after vitrification of in vitro matured human oocytes

OBJECTIVEnTo report the first healthy live birth from immature oocytes retrieved in a natural menstrual cycle, followed by in vitro maturation (IVM) and cryopreservation of the oocytes by vitrification.nnnDESIGNnCase report.nnnSETTINGnUniversity-based tertiary medical center.nnnPATIENT(S)nA 27-year-old woman with tubal disease and polycystic ovaries.nnnINTERVENTION(S)nImmature oocytes were retrieved by transvaginal ultrasound guided follicle aspiration on day 13 of her natural menstrual cycle, matured in vitro and vitrified. The oocytes were thawed in a subsequent menstrual cycle, inseminated by intracytoplasmic sperm injection, and the resulting embryos transferred.nnnMAIN OUTCOME MEASURE(S)nOocyte maturation and survival rates, pregnancy, and live birth.nnnRESULT(S)nOne metaphase II and 18 germinal vesicle stage oocytes were collected; 16 out of 18 germinal vesicle oocytes matured, and a total of 17 oocytes were vitrified. After thawing, four IVM oocytes survived; three embryos were transferred. The woman went on to deliver a single healthy live baby at term.nnnCONCLUSION(S)nWe provide proof-of-principle evidence that the novel fertility preservation strategy of immature oocyte retrieval, IVM, and vitrification of oocytes can lead to successful pregnancy and healthy live birth.