The cytogenetic constitution of embryos derived from immature (metaphase I) oocytes obtained after ovarian hyperstimulation

ObjectiveTo examine the chromosomal content of embryos resulting from metaphase I (MI) oocytes obtained after ovarian hyperstimulation for IVF.DesignProspective cohort study.SettingUniversity-based IVF Center, Assaf Harofeh Medical Center, Tel Aviv University, Israel.Patient(s)One hundred fifty women undergoing assisted reproduction technique (ART).Intervention(s)Intracytoplasmic sperm injection (ICSI) was performed in MI oocytes that were retrieved after ovarian stimulation. A portion of these oocytes extruded their polar body (rescued in vitro-matured metaphase II [IVM-MII]) after different incubation periods and the remainder did not (arrested MI oocytes). Fluorescence in situ hybridization was performed using probes for chromosomes X, Y, 18.Main Outcome Measure(s)Fertilization rate, number of blastomeres, and embryo euploidy.Result(s)Embryos from rescued IVM-MII oocytes showed significantly higher fertilization rates and more blastomeres per embryo compared with those from arrested MI oocytes (58.5% vs. 43.9% and 5.7 vs. 5.0, respectively). The chromosomal analysis of these embryos revealed a high rate of aberrations (80.6%), mainly complex mosaics. This rate was elevated in embryos from arrested IVM oocytes (97.2%), and after longer incubation periods. No chromosomally normal embryos were found after 24 hours of incubation of their corresponding oocytes.Conclusion(s)Embryos originating from MI oocytes have a high rate of chromosomal aneuploidy, and their replacement should be reconsidered.