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In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
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Oogenesis,  the process of developing egg cells (female gametes), occurs within the ovaries and is fundamental to female fertility. This sequence begins during fetal development when diploid oogonia in the developing ovaries undergo mitotic divisions to produce primary oocytes. By birth, these primary oocytes enter prophase I of meiosis but become arrested in this stage, remaining suspended until puberty.
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Folliculogenesis is the development of ovarian follicles, the specialized structures within the ovarian cortex where oogenesis, or egg development, occurs. This process is essential for female reproductive health and begins during fetal development when primordial follicles are formed. Each primordial follicle comprises a primary oocyte in the center, surrounded by a single layer of squamous pre-granulosa cells. These follicles remain dormant in late prophase I of meiosis until triggered by...
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Meiosis II entails cell division and segregation of the sister chromatids, resulting in the production of four unique haploid gametes. The steps for meiosis II are similar to mitosis, except that meiosis II occurs in haploid cells, whereas mitosis occurs in diploid cells.
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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
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Human Egg Maturity Assessment and Its Clinical Application
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Accelerated Coasting Does Not Affect Oocyte Maturation.

Ahmed F Galal1, Hadeer Aly Abbassy, Ashraf Hany AbdElrahman

  • 1Department of Obstetrics and Gynecology, Alexandria University, Alexandria, Egypt.

Gynecologic and Obstetric Investigation
|June 12, 2017
PubMed
Summary
This summary is machine-generated.

Accelerated coasting using gonadotropin-releasing hormone antagonist (GnRH-ant) improved oocyte maturation and fertilization rates in women at risk for ovarian hyperstimulation syndrome (OHSS), while preventing OHSS.

Keywords:
CoastingGonadotropin releasing hormone antagonistIn vitro fertilizationOocyte maturationOvarian hyperstimulation syndrome

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Area of Science:

  • Reproductive Endocrinology
  • In Vitro Fertilization (IVF)
  • Ovarian Hyperstimulation Syndrome (OHSS)

Background:

  • Women undergoing IVF at risk for OHSS often require 'coasting' to reduce estradiol levels.
  • Traditional coasting involves withholding gonadotropin-releasing hormone agonist (GnRHa), potentially impacting oocyte maturation.
  • A novel approach using GnRH antagonist (GnRH-ant) alongside GnRHa aims to optimize coasting.

Purpose of the Study:

  • To evaluate the efficacy of accelerated coasting using GnRH-ant in women at risk for OHSS.
  • To compare oocyte maturation, fertilization, pregnancy rates, and OHSS incidence between accelerated and usual coasting protocols.

Main Methods:

  • Retrospective case-control study comparing 50 women undergoing accelerated coasting with 57 women undergoing usual coasting.
  • Both groups received GnRHa, but the accelerated group also received GnRH-ant on the day of triggering oocyte maturation.
  • Outcomes assessed included oocyte maturation, fertilization, pregnancy rates, and OHSS incidence.

Main Results:

  • Significantly higher oocyte maturation (83.05% vs. 67.62%) and fertilization rates (79.85% vs. 65.84%) in the accelerated coasting group (p < 0.001).
  • Higher, though not statistically significant, pregnancy rates in the accelerated group.
  • No significant difference in the incidence of mild, moderate, or severe OHSS between groups.

Conclusions:

  • Accelerated coasting with GnRH-ant after GnRHa pituitary suppression is a viable strategy to reduce estradiol levels.
  • This approach effectively prevents cycle cancellation and maintains high oocyte maturation and pregnancy rates.
  • It offers a novel method for OHSS prevention while optimizing IVF outcomes.