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  • Küçük Resim
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    Can in vitro maturation overcome cycles with repeated oocyte maturation arrest? A classification system for maturation arrest and a cohort study
    (Wiley, 2021) Hatirnaz, Safak; Basbug, Alper; Hatirnaz, Ebru; Tannus, Samer; Hatirnaz, Kaan; Bakay, Kadir; Dahan, Michael H.
    Objective To investigate the role of gonadotropin-stimulated and human chorionic gonadotropin (hCG) -primed in vitro oocyte maturation (IVM) in cases of repeated in vitro fertilization (IVF) failure due to various forms of oocyte maturation arrest (OMA). Methods Retrospective cohort study. Results In all, 63 women with IVF failure due to OMA were evaluated in this study. According to the Hatirnaz & Dahan classification, 11 (17.5%) women were OMA type 1, 22 (34.9%) were OMA type 2, 0 were OMA type 3, 11 (17.5%) were OMA type 4, and 19 women were OMA type 5 (30.1%). Fewer oocytes were retrieved in the IVM than in the IVF cycles. No embryos were produced from oocytes collected in the IVM cycles of women with OMA types 1, 2, and 4. In the OMA type 5 group, 9 (47.4%) day 2 embryos and 6 (31.6%) day 3 embryos were obtained. The difference between the groups was statistically significant (P = 0.001, P = 0.002, respectively). Single day 3 embryo transfer was performed for the six patients with OMA type 5 but no clinical pregnancies occurred. Conclusions Follicle-stimulating hormone-stimulated and hCG-primed IVM does not improve oocyte maturation, developmental potential, or pregnancy rates of women with OMA. Future studies directed to re-establishing normal cytoskeletal architecture and machinery, and resumption of meiosis may be beneficial for obtaining mature oocytes.
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    PROOF OF CONCEPT OF A TREATMENT FOR HUMAN OOCYTE MATURATION ARREST;TRANSVAGINAL OVARIAN NEEDLE INJURY PRECEEDING LETROZOLE PRIMING IN VITRO MATURATION
    (Elsevier Science Inc, 2020) Hatirnaz, Safak; Hatirnaz, Ebru; Basbug, Alper; Dahan, Michael H.; Hatirnaz, Kaan
    [Abstract Not Available]
  • Küçük Resim Yok
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    Testing the role of unstimulated in vitro maturation for potential development of immature oocytes in women with oocyte maturation abnormalities
    (Galenos Publ House, 2024) Kalyoncu, Senol; Basbug, Alper; Hatirnaz, Ebru; Kaya, Aski Ellibes; Gungor, Nur Dokuzeylul; Urkmez, Sebati Sinan; Urkmez, Yesim Civil
    Objective: The aim of this study was to investigate the developmental potential of immature oocytes and evaluate whether unstimulated in vitro maturation (IVM) could serve as a treatment option for women with oocyte maturation abnormalities (OMAs). Material and Methods: This cohort study was conducted between September 2019 and December 2022, and included women who underwent unstimulated, non-human chorionic gonadotropin (hCG) priming IVM. Oocytes were incubated with IVM medium for 26-48 hours and evaluated to compare their maturation profiles with the immature oocytes retrieved from the same patients in their previous in vitro fertilization cycles. Results: Among the twelve women in the study, eleven (91.6%) underwent whole exome sequencing analysis. Of these, 18 variants were identified in 10 individuals, excluding case 1, who had no previous mutation analysis. Of the mutations identified, 9 (50%) were located in FSHR, 5 (27.8%) in TUBB8, 1 (5.6%) in ZP1, 1 (5.6%) in SLFN14, 1 (5.6%) in AR , and 1 (5.6%) in STEAP3. Apart from one woman with resistant ovary syndrome (ROS), none treated with unstimulated IVM had oocyte maturation. Remarkably, the only patient to achieve oocyte maturation in an unstimulated IVM cycle was case 11, who had ROS and a single FSHR variant. Conclusion: Unstimulated, non-hCG primed IVM does not appear to be effective in the treatment of OMAs, perhaps with the exception of women with ROS. However, this study led our team to develop novel treatment options based on physiological mechanisms for some subtypes and supraphysiological approach for other subtypes of OMAs. (J Turk Ger Gynecol Assoc. 2024; 25: 219-23)