Fertility and sterility
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Retrieval of immature oocytes from unstimulated ovaries, followed by in vitro maturation (IVM) was initially proposed to avoid the risks and side effects of exogenous gonadotropin administration. Therefore, during the past decades, IVM was mainly offered to patients with polycystic ovary syndrome (PCOS) at high risk of ovarian hyperstimulation syndrome (OHSS). However, the development of fertility preservation has recently opened new perspectives in the field of IVM. The present review summarizes uncommon indications of IVM, which is a viable option to treat infertility in patients with ovarian resistance to FSH, but may also be considered to preserve fertility in leukemia as well as before ovarian transposition and endometrioma excision.
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Fertility and sterility · Apr 2013
ReviewIn vitro maturation of human immature oocytes for fertility preservation.
Cryopreservation of embryos, oocytes, or ovarian tissues is the main option for female fertility preservation. Oocyte cryopreservation has emerged as especially important: the dramatic increase in the number of infants born from vitrified oocytes indicates that it is becoming one of the most important intervention options. However, oocyte cryopreservation with standard controlled ovarian hyperstimulation may not be feasible for some cancer patients as there are serious concerns about the effect of ovarian stimulation with hormones on the risk of cancer recurrence. ⋯ Thus, immature oocyte retrieval from ovaries without ovarian stimulation followed by in vitro maturation and vitrification is a promising fertility preservation option for women who cannot undergo ovarian stimulation or cannot delay their gonadotoxic cancer treatment. Immature oocytes can be collected from the ovaries during both the follicular and luteal phases, which maximizes the possibility for fertility preservation. The combination of ovarian tissue cryopreservation with immature oocyte collection from the tissue followed by oocyte vitrification via in vitro maturation represents another promising approach of fertility preservation in young women with cancer.
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Fertility and sterility · Apr 2013
Optimizing human oocyte cryopreservation for fertility preservation patients: should we mature then freeze or freeze then mature?
To evaluate the maturation and post-thaw survival rates of immature oocytes to determine whether in vitro maturation (IVM) should be attempted prior to or after cryopreservation. ⋯ Oocyte cryopreservation is important for patients at risk of ovarian cancer, elective fertility preservation, and, potentially, for ovum donation. The superior maturation rate of GV and MI oocytes in the fresh versus post-thaw groups provides strong evidence for maturing oocytes to the MII stage before cryopreservation.
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Fertility and sterility · Apr 2013
Consecutive gonadotropin-releasing hormone-antagonist in vitro fertilization cycles: does the elapsed time interval between successive treatments affect outcomes?
To determine whether patients who failed an in vitro fertilization (IVF) cycle can proceed with a subsequent IVF cycle after waiting only one menstrual cycle, or whether there is a benefit to allowing two or more menstrual cycles to elapse before proceeding. ⋯ Delaying successive IVF cycle start for two or more menstrual cycles likely offers no advantage over pursuing repeated IVF after one menstrual cycle.
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Fertility and sterility · Apr 2013
Are sperm DNA fragmentation, hyperactivation, and hyaluronan-binding ability predictive for fertilization and embryo development in in vitro fertilization and intracytoplasmic sperm injection?
To determine the diagnostic value of the following sperm function tests in predicting the fertilizing ability of spermatozoa in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI): hyaluronan-binding assay (HBA), DNA fragmentation (Halosperm), and hyperactivity. ⋯ The Halosperm test, the HBA test, and induced hyperactivity are useful in predicting the ability of spermatozoa to fertilize oocytes in IVF and are helpful in distinguishing semen samples suitable for IVF or ICSI.