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. 2020 Jul 15;18(1):71.
doi: 10.1186/s12958-020-00622-y.

Association between mild stimulated IVF/M cycle and early embryo arrest in sub fertile women with/without PCOS

Nagwa Elshewy  1 , Dongmei Ji  1   2   3 , Zhiguo Zhang  1   3   4 , Dawei Chen  1   3   4 , Beili Chen  1   2   3 , Rufeng Xue  1   2   3 , Huan Wu  1   3 , Jianye Wang  1   3 , Ping Zhou  5   6   7   8   9 , Yunxia Cao  10   11   12   13   14
Affiliations

Association between mild stimulated IVF/M cycle and early embryo arrest in sub fertile women with/without PCOS

Nagwa Elshewy et al. Reprod Biol Endocrinol. .

Abstract

Background: The in vitro maturation (IVM) technique has physical and financial benefits, but a lower efficiency and outcome that is still unclear whether it is related to polycystic ovary syndrome (PCOS) itself or the IVM procedure. In this study, we analyzed the clinical and laboratory outcomes of an optimized IVM protocol in patients with and without PCOS. We also discussed the possible reasons for early embryo arrest in the IVM cycle.

Methods: This prospective study involved 58 PCOS patients and 56 non-PCOS patients who underwent mild stimulated IVF combined IVM (IVF/M) cycles. The clinical and laboratory outcomes were compared between the two groups. Also, metaphase II (MII) oocytes were obtained after IVM from the two groups, and in vivo MII oocytes randomly collected from IVF patients were examined for mitochondrial function using a laser scanning confocal microscope (LSCM). The aneuploidy rate for arrested cleavage embryos from IVM and IVF oocytes were screened using Next Generation Sequencing (NGS).

Results: Mildly stimulated IVF/M resulted in cumulative clinical pregnancy and implantation rates (40.2, 28.7% in the PCOS group vs. 41.9, 36% in the non-PCOS group), respectively. The blastocyst formation rates were comparable (28% vs. 28.2%) in PCOS and non-PCOS groups, respectively. Using LSCM, there was a significant decrease in the mitochondrial membrane potential of IVM oocytes compared with the control IVF oocytes (P < 0.001), but no significant difference between the PCOS and non-PCOS groups. The NGS showed that the aneuploidy rates were comparable (75, 75, and 66.6%) in IVM-PCOS, IVM-non-PCOS, and control IVF arrested embryos, respectively.

Conclusions: The mildly stimulated IVF/M protocol produced acceptable clinical outcomes in PCOS and non-PCOS patients. IVM itself rather than the PCOS condition adversely affected the embryo development through its effect on mitochondrial function, which appeared to be a possible cause for the embryo arrest in the IVM cycles rather than chromosomal aneuploidy.

Keywords: Aneuploidy; Embryo arrest; IVM; Mitochondria.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Effect of IVM on the inner mitochondrial membrane potential (ΔΨm) measured by JC-1 fluorescence, a: Relative inner membrane potential in MII oocytes from A: IVM-PCOS, B: IVM-non PCOS and C: control IVF groups. b: Ratio of red to green JC-1 fluorescence in the three groups. Data measured by mean± SD, ** represent P < 0.05
Fig. 2
Fig. 2
NGS charts of arrested embryos with different types of chromosomal abnormalities, Notes: Arrows indicate chromosome errors.
See this image and copyright information in PMC

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