Autologous mature follicular fluid: its role in in vitro maturation of human cumulus-removed oocytes

Objective To assess the effects of autologous mature follicular fluid (FF) on the in vitro maturation (IVM) outcome of human cumulus-removed oocytes from routine stimulated ovaries, particularly on the IVM co-culture outcome with autologous cumulus cells. Design Prospective comparison study. Setting A provincial reproductive medicine and research center. Patient(s) A total of 196 germinal vesicle (GV) and 192 metaphase I (MI) stage oocytes were recruited from 151 infertile women by ovarian stimulation for routine intracytoplasmic sperm injection (ICSI) program. Intervention(s) Two novel IVM systems assisted with either autologous mature FF alone or both autologous mature FF and autologous cumulus cells were developed to mature in vitro MI and GV stage oocytes, respectively. A standard IVM system was used as the control. Main Outcome Measure(s) Cumulative IVM rate of oocytes and the subsequent fertilization, cleavage, and preimplantation embryonic development. Result(s) By adding autologous mature FF to the medium of the IVM system, the nuclear maturation of human cumulus-removed oocytes was significantly promoted in both speed and rate, but not the corresponding fertilization, cleavage, and preimplantation embryonic development. Conclusion(s) Autologous mature FF favors the IVM of human cumulus-removed oocytes, including the IVM co-culture with autologous cumulus cells, mainly in nuclear, but not cytoplasmic, maturation.