Clusters of smooth endoplasmic reticulum are absent in oocytes from unstimulated women: data from comprehensive morphological analysis of ex vivo collected oocytes after IVM

Abstract Research Question: What is the frequency of morphological dysmorphisms in human immature oocytes collected from small antral follicles ex vivo and matured in vitro? Design: Human ovaries (n=56) were excised for ovarian tissue cryopreservation (OTC). None of the patients had received exogenous gonadotropins prior to the procedure. Immature oocytes released from small antral follicles were collected in connection with isolation of the cortex for OTC. Their maturation stage and the morphological characteristics of the cytoplasm, zona pellucida, perivitelline space and first polar body were assessed after in vitro maturation (IVM). Results: A total of 1649 immature oocytes were collected: 30% of oocytes matured to the MII stage after IVM, while MIs, GVs and degenerated oocytes accounted for 20%, 24% and 26%, respectively. The percentages of oocytes without any dysmorphisms were 53%, 92%, and 97% for the MII, MI, and GV oocytes, respectively. The most frequently observed dysmorphisms among the MII oocytes were first polar body fragmentation (22%), homogeneously distributed cytoplasmic granularity (16%) and an enlarged perivitelline space (14%). Interestingly, none of the oocytes at any stage had clusters of smooth endoplasmic reticulum (SER). Conclusions: Morphological dysmorphisms are present among in vitro matured oocytes at all maturation stages. The incidence of dysmorphisms increases as maturation progresses. The most frequent dysmorphism amongst MII oocytes after IVM was fragmentation of the first polar body. Clusters of SER were not observed in oocytes from unstimulated patients.