Oocyte maturation abnormalities - A systematic review of the evidence and mechanisms in a rare but difficult to manage fertility pheneomina

Şafak Hatırnaz; Ebru Saynur Hatırnaz; Aşkı Ellibeş Kaya; Kaan Hatırnaz; Canan Soyer Çalışkan; Özlem Sezer; Nur Dokuzeylül Güngor; Cem Demirel; Volkan Baltacı; Seang Tan; Michael Dahan

doi:10.4274/tjod.galenos.2022.76329

Oocyte maturation abnormalities - A systematic review of the evidence and mechanisms in a rare but difficult to manage fertility pheneomina

Turk J Obstet Gynecol. 2022 Mar 28;19(1):60-80. doi: 10.4274/tjod.galenos.2022.76329.

Authors

Affiliations

¹ Medicana Samsun International Hospital, In Vitro Fertilization-In Vitro Maturation Unit, Samsun, Turkey.
² Private Office, Clinic of Obstetrics and Gynecology Specialist, Samsun, Turkey.
³ Ondokuz Mayıs University Faculty of Medicine, Department of Molecular Biology and Genetics, Samsun, Turkey.
⁴ University of Health Sciences Turkey, Samsun Training and Research Hospital, Clinic of Obstetrics and Gynecology, Samsun, Turkey.
⁵ University of Health Sciences Turkey, Samsun Training and Research Hospital, Clinic of Genetics, Samsun, Turkey.
⁶ Medikalpark Göztepe Hospital, In Vitro Fertilization Unit, İstanbul, Turkey.
⁷ Memorial Ataşehir Hospital, In Vitro Fertilization Unit, İstanbul, Turkey.
⁸ Microgen Genetic Diagnosis Center, Ankara, Turkey.
⁹ James Edmund Dodds Chair in ObGyn, Department of ObGyn, McGill University, OriginElle Fertility Clinic and Women, QC, Canada.
¹⁰ McGill Reproductive Centre, Department of ObGyn, McGill University Montreal, Quebec, Canada.

Abstract

A small proportion of infertile women experience repeated oocyte maturation abnormalities (OMAS). OMAS include degenerated and dysmorphic oocytes, empty follicle syndrome, oocyte maturation arrest (OMA), resistant ovary syndrome and maturation defects due to primary ovarian insufficiency. Genetic factors play an important role in OMAS but still need specifications. This review documents the spectrum of OMAS and to evaluate the multiple subtypes classified as OMAS. In this review, readers will be able to understand the oocyte maturation mechanism, gene expression and their regulation that lead to different subtypes of OMAs, and it will discuss the animal and human studies related to OMAS and lastly the treatment options for OMAs. Literature searches using PubMed, MEDLINE, Embase, National Institute for Health and Care Excellence were performed to identify articles written in English focusing on Oocyte Maturation Abnormalities by looking for the following relevant keywords. A search was made with the specified keywords and included books and documents, clinical trials, animal studies, human studies, meta-analysis, randomized controlled trials, reviews, systematic reviews and options written in english. The search detected 3,953 sources published from 1961 to 2021. After title and abstract screening for study type, duplicates and relevancy, 2,914 studies were excluded. The remaining 1,039 records were assessed for eligibility by full-text reading and 886 records were then excluded. Two hundred and twenty seven full-text articles and 0 book chapters from the database were selected for inclusion. Overall, 227 articles, one unpublished and one abstract paper were included in this final review. In this review study, OMAS were classified and extensively evaluatedand possible treatment options under the light of current information, present literature and ongoing studies. Either genetic studies or in vitro maturation studies that will be handled in the future will lead more informations to be reached and may make it possible to obtain pregnancies.

Keywords: Oocyte maturation abnormalities; empty follicle syndrome; in vitro maturation; oocyte maturation arrest; oocyte maturation gene expression/pathways.