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Maturational Asynchrony between Oocyte Cumulus-Coronal Morphology and Nuclear Maturity in Gonadotropin-Releasing-Hormone Agonist Stimulations
Journal article   Open access   Peer reviewed

Maturational Asynchrony between Oocyte Cumulus-Coronal Morphology and Nuclear Maturity in Gonadotropin-Releasing-Hormone Agonist Stimulations

Diane G Hammitt, Craig H. Syrop, Brad J Van Voorhis, David L Walker, Terri M Miller and Kathrynne M Barud
Fertility and sterility, Vol.59(2), pp.375-381
02/01/1993
DOI: 10.1016/S0015-0282(16)55680-5
PMID: 08425634
url
https://doi.org/10.1016/S0015-0282(16)55680-5View
Published (Version of record) Open Access

Abstract

Objective: To determine oocyte meiotic maturity and asynchrony between cumulus-coronal morphology and nuclear maturity after gonadotropin-releasing hormone agonist (GnRH-a) and norethindrone-programmed stimulations. Design: Oocyte meiotic maturity was evaluated at follicular aspiration in 4,961 oocytes after GnRH-a/follicle-stimulating hormone (FSH)/human menopausal gonadotropin stimulations (hMG) for in vitro fertilization patients and 299 oocytes after norethindrone-programmed clomiphene citrate (CC)/hMG in oocyte donors. Maturational asynchrony between the oocyte's cumulus-coronal morphology and nuclear maturity was evaluated in 2,336 oocytes. Setting: In vitro fertilization program at the University of Iowa Hospitals and Clinics; academic tertiary care center. Interventions: After evaluating oocyte cumulus-coronal maturity, cumulus masses were spread to determine oocyte nuclear maturity. Results: Fourteen percent, 17%, 50%, 17%, and 2% of oocytes were prophase I, metaphase I, metaphase II, postmature metaphase II, and atretic, respectively. Asynchrony was noted in 28% of prophase I, 71% of metaphase I, 11% of metaphase II, 45% of postmature metaphase II, 32% of atretic, and 28% of all oocytes. Significant differences were not found between GnRH-a and norethindrone-programmed stimulations in asynchrony between cumulus-coronal morphology and nuclear maturity or percentage of prophase I, metaphase I, metaphase II, postmature metaphase II, or atretic oocytes. Sixty-seven percent of oocytes possessed a polar body at retrieval. The rate of fertilization was significantly higher for metaphase II oocytes than postmature metaphase II and metaphase I oocytes > prophase I oocytes. Parthenogenetic activation tended to be highest for postmature metaphase II oocytes. Embryo cleavage was significantly higher for postmature metaphase II, metaphase II, and metaphase I oocytes than for prophase I oocytes. Conclusions: This is the first report of asynchrony between cumulus-coronal morphology and nuclear maturity at follicular aspiration in GnRH-a and norethindrone-programmed stimulations. Asynchrony was observed in 28% of oocytes. A higher percentage of oocytes possessed a polar body at egg retrieval with these stimulation regimens compared with rates reported previously for FSH, FSH/hMG, and CC/hMG stimulations.
 Obstetrics and Gynecology

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