Low oocyte maturity rate and asynchronous follicle development: other unnoticed groups in the Bologna Criteria for poor responders?

Abstract

Introduction: this study aimed to evaluate the prognosis of patients with low rates of oocyte maturity and compare those who are aforethought poor responders with respect to the Bologna criteria. Methods: all assisted reproductive technology (ART) cycles conducted from 2004 to 2018 in a tertiary center in Istanbul were analyzed retrospectively. Patients were grouped into three accordingly the count of total retrieved oocytes and metaphase-II [(M-II) -mature] oocytes after denudation (group 1: <= 3 oocytes and <= 3 M-II oocytes; group 2: >3 oocytes and <= 3 M-II oocytes; group 3: >3 oocytes and >3 M-II oocytes). A Low oocyte maturity rate was diagnosed when s50% of all harvested oocytes were in the M-II stage before the fertilization procedure. Results: during the study period 14,899 intracytoplasmic sperm injection cycles were evaluated. The study group's mean age was 32.6 +/- 5.3. The mean counts of total and mature oocytes were 9.8 +/- 5.9 and 7.3=4.5, respectively. A mean count of 2.38 embryos was transferred in 10118 cycles. The group 3 patients had a considerably higher live birth ratio compared to the group 1 and 2. Conclusion: we propose oocyte maturity rate and the count of M-I1 oocytes as two diagnostic criteria for the case definition of asynchronous follicle growth. Based on our findings, stimulation cycles ending with low oocyte maturity rate (<= 50%) and <= 3 M-II oocytes would be considered asynchronous follicle development. Patients with low oocyte maturity rate and asynchronous follicle development should be counseled and informed regarding potential poor prognosis of the treatment.