Objective: In this case-control study, the suitability of germinal vesicle transfer (GVT), synchronous ooplasmic transfer (sOT), asynchronous ooplasmic transfer using cryopreserved MII oocyte (caOT), and asynchronous ooplasmic transfer using waste MII oocyte (waOT) for maturation of the human-aged non-surrounded nucleolus germinal vesicle-stage (NSN-GV) oocyte were investigated.
Materials and Methods: NSN-GV oocytes were subjected to four methods: group A (GVT), B (sOT), C (caOT) D (waOT), and E (Control). The fusion rates, MI, MII, ICSI observations and cleavage at 2-cell, 4-cell, and 8-cell stages were compared in the groups.
Results: In GVT, none of the oocytes fused. In sOT, all oocytes fused, 20 achieved the MI, 14 progressed to MII, 8 fertilized, 6 cleaved and 5, 4, and 3 achieved the 2-cells, 4-cells and 8-cells, respectively. In caOT, all oocytes fused and achieved the MI, 8 progressed to MII and fertilized, 6 cleaved and 6, 5, and 5 achieved the 2-cells, 4-cells, and 8-cells respectively. In waOT, all oocytes fused, 5 and 3 progressed to MI and MII, respectively, but only one fertilized, cleaved and reached a 4-cells stage. In group E, 6 and 2 oocytes progressed to MI and MII, respectively, and only one fertilized but arrested at the zygote stage. caOT had the highest survival rate when compared to sOT (p = 0.04), waOT (p = 0.002), and control (p = 0.001).
Conclusion: The caOT method was beneficial over sOT, waOT, and GVT in supplementing the developmental capacity of human-aged NSN-GV oocytes.
MATERIALS AND METHODS: This was a pilot study of N=50 women, who were planning for IVF treatment in University Malaya Medical Centre, Kuala Lumpur, Malaysia from July to December 2023. Women without prior nutritional treatment were consented and assigned to either the multinutrient supplementation (Omega 3, coenzyme Q10, folic acid, selenium, vitamin E, catechins) as the study group or 5mg folic acid daily as control group for at least a month prior to their IVF treatment. All women were treated using an antagonist protocol and ovarian stimulation was started with 200 -300IU of urinary HMG and or recombinant FSH. Antagonists (Ganirelix) commenced when the leading follicle reached a diameter of 11 mm. Triggering with hCG or GnRH agonist when at least 3 follicles of 17 mm in diameter were achieved. Oocyte retrieval was performed 36th hour after trigger. Conventional IVF/ICSI was used for fertilisation. All parameters recorded and analysed using SPSS.
RESULTS: The mean age (36.44 ± 3.33 vs 35.32 ± 3.47 years) and body mass index (25.28 ± 4.12 vs 24.80 ± 4.36 kg/m2) of women in multinutrient supplementation group was similar to control group. The Follicular Output Rate (FORT) in women on multinutrient supplementation showed a trend towards benefit compared to control group, although it is not statistically significant (68.12 ± 19.47 vs 64.91 ± 20.06, p=0.493). The mean number of MII oocytes retrieved from mature follicles and number of good quality embryo on day 3 after fertilisation were not statistically significant between the two groups (6.65 ±3.84 vs 6.09 ± 3.01, p=0.626 and 4.00 ± 3.10 vs 3.45 ± 2.30, p=0.549, respectively). In addition, there were no differences in endometrial thickness before embryo transfer in both groups (10.35 ± 1.32mm vs 10.36 ± 2.04mm, p=0.320). However, the total dose of follicle stimulating hormone and duration of controlled ovarian stimulation were lower in the study group compared to control group (2410 ± 656.82 IU vs 2706.82 ± 536.15 IU, p= 0.119 and 8.90 ± 2.13 days vs 9.68 ± 1.29 days, p=0.164, respectively).
CONCLUSION: A multinutrient supplementation given for a minimum of 28 days, may have a positive effect on FORT and lower use of gonadotropin. More and larger sample research is warranted to prove this effect.