In vitro maturation and fertilization of oocytes from unstimulated normal ovaries, polycystic ovaries, and women with polycystic ovary syndrome

Objective: To investigate differences in immature oocyte maturation, fertil ization, and pregnancy rates among women with unstimulated normal ovaries, polycystic ovaries (PCOs), or PCOS. Design: Prospective observational study. Setting: University fertility clinic. Patient(s): One hundred forty-four women undergoing 180 in vitro oocyte mat uration treatment cycles. Intervention(s): Transvaginal immature oocyte recovery from unstimulated ov aries 36 hours after hCG priming. In vitro oocyte maturation and fertilizat ion. Fresh embryo transfer. Main Outcome Measure(s): Immature oocytes collected, metaphase II oocytes, and embryos produced. Implantation and pregnancy rates. Result(s): The overall oocyte maturation and fertilization rates attained w ere 80.3% (1,222 of 1,522) and 76.5% (935 of 1,222), respectively. Signific antly fewer immature oocytes were retrieved from normal ovaries (5.1 +/- 3. 7) compared with the PCO (10.0 +/- 5.1) or PCOS (11.3 +/- 9.0) groups. Fert ilization and cleavage rates were comparable among the three groups. The im plantation, pregnancy, and live birth rates per transfer for normal ovaries were 1.5%, 4.0%, and 2.0%, respectively; for PCOs 8.9%, 23.1%, 17.3%, resp ectively; and for women with PCOS 9.6%, 29.9%, and 14.9%, respectively. Conclusion(s): Immature oocytes retrieved from normal ovaries, PCOs, or wom en with PCOS, when using hCG priming before oocyte retrieval, have a simila rly high maturation, fertilization, and cleavage potential. In vitro matura tion is a useful treatment option, particularly for women with PCOs. (C) 20 01 by American Society for Reproductive Medicine.