RESUMEN
OBJECTIVE: To compare oocyte maturation, fertilization and cleavage rates, and embryonic developmental quality after culture of human immature oocytes from polycystic ovary syndrome (PCOS) patients in human tubal fluid (HTF) or tissue culture medium (TCM) 199. DESIGN: Prospective, randomized, controlled trial. SETTING: University hospital. PATIENT(S): Thirteen women undergoing 23 in vitro maturation cycles, from whom 119 oocytes were retrieved. INTERVENTION(S): Cumulus-enclosed germinal vesicle-stage oocytes matured in TCM-199-supplemented or HTF-supplemented media. MAIN OUTCOME MEASURE(S): Oocyte maturation and fertilization rates, embryonic developmental quality. RESULT(S): Significant differences were observed between TCM 199 and HTF regarding maturation rate (82% vs. 56.9%), fertilization rate (70% vs. 39.4%), and embryo quality (81.3% vs. 41.7%). CONCLUSION(S): Human tubal fluid medium, although widely used for embryo fertilization and maintenance in IVF techniques, is not an appropriate medium for the maturation of oocytes obtained from PCOS patients in nonstimulated cycles.
Asunto(s)
Técnicas de Cultivo de Célula , Medios de Cultivo , Trompas Uterinas/metabolismo , Infertilidad Femenina/terapia , Recuperación del Oocito , Oocitos , Oogénesis , Síndrome del Ovario Poliquístico/terapia , Adulto , Fase de Segmentación del Huevo , Técnicas de Cultivo de Embriones , Transferencia de Embrión , Femenino , Fertilización In Vitro , Humanos , Infertilidad Femenina/etiología , Infertilidad Femenina/fisiopatología , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/fisiopatología , Embarazo , Estudios ProspectivosRESUMEN
PURPOSE: Determine if estrogen used since the beginning of the menstrual flow could improve endometrial tissue compared to standard endometrial preparation for in vitro maturation cycles. METHODS: Twenty polycystic ovary syndrome women were submitted to two estrogen therapy schedules: standard schedule; estrogen began on the day of planned egg retrieval (dosage was based on endometrial thickness); and long schedule; estrogen began on the first day of menstruation. No oocyte retrieval or embryo transfer was performed. Three-dimensional ultrasound was performed on the day of planned egg retrieval and one week later for endometrial evaluation. RESULTS: A higher endometrial thickness and volume was found in long schedule on both evaluations. The number of patients that have used 10 mg/day of estradiol was significant higher in the standard schedule (65%x0%). No other significant difference was found. CONCLUSIONS: The early use of estrogen improves endometrial tissue and requires lower daily dosage.