Human Reproduction, Vol 13, 1912-1915, Copyright © 1998 by Oxford University Press
C Bergh, H Broden, K Lundin and L Hamberger
Ovarian stimulation for in-vitro fertilization (IVF) causes development of
several cohorts of follicles. At the time of oocyte collection, oocytes are
thus retrieved from a wide range of follicles of different sizes and
developmental stages. A relationship between size of follicles and
pregnancy rates has earlier been demonstrated. The aim of the present study
was to compare fertilization, cleavage and pregnancy rates between oocytes
retrieved from large and small follicles in conventional IVF and
intracytoplasmic sperm injection (ICSI). A total of 200 conventional IVF
patients and 175 ICSI patients underwent oocyte retrieval where oocytes
from both large and small follicles were collected. A follicle with a
volume of > or = 2 ml, corresponding to a follicular diameter > or =
16 mm as determined by ultrasound, was regarded as a large follicle. Only
one cycle from each patient was included. Fertilization and cleavage rates
were calculated per patient for oocytes from large and small follicles. The
mean fertilization and cleavage rates for conventional IVF and ICSI cycles
were calculated. Comparison of pregnancy rates was performed for patients
receiving embryos derived from oocytes of only large or only small
follicles. For conventional IVF patients, fertilization rates were 71.4 and
58.1% (P < 0.01, Wilcoxon paired test) for oocytes of large and small
follicles respectively. The corresponding cleavage rates were 95.4 and
93.9% respectively. The pregnancy rate for the two groups was 47% (60/127)
and 15% (2/13) (P < 0.05, chi2 test). For ICSI patients the
fertilization rate was 72.0 and 71.1% for oocytes of large and small
follicles respectively. The corresponding cleavage rate was 93.0 and 91.1%.
The pregnancy rate in the two groups was 41% (46/113) and 42% (5/12). The
results show that oocytes from smaller follicles also yield fertilization
and pregnancies, although in conventional IVF to a lesser extent than
oocytes from larger follicles. For IVF cycles, a higher proportion of
immature oocytes (which are normally not included in the ICSI procedure) in
the group of oocytes from small follicles is most probably the explanation
for the lower fertilization rate. The decrease in pregnancy rate with
oocytes from small follicles in the IVF cycles was not observed in the ICSI
cycles. The possibility of evaluating the degree of oocyte maturation prior
to fertilization may be an advantage of the ICSI technique. This suggests
that the disadvantages of oocytes from small follicles might be overcome by
means of ICSI.
ARTICLES
Comparison of fertilization, cleavage and pregnancy rates of oocytes from large and small follicles
Department of Obstetrics and Gynaecology, Sahlgrenska Hospital, Goteborg University, Sweden.
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