Only couples with normal BMI and no history of smoking, excess drinking, or use of recreational drugs were included. All patients included were Caucasian and had comparable durations and indications of infertility. The average AMH of the female partner was 3.2 ± 3 ng/mL, the average FSH was 5.3 ± 4 IU/mL, and the average peak estradiol for ICSI stimulation was 3066.3 ± 1731 pg/mL.
A similar superovulation protocol was used for all couples. Patients were treated with daily gonadotropins (Follistim; Merck, Kenilworth, NJ, USA; Gonal-F; EMD-Serono, Geneva, Switzerland; and/or Menopur; Ferring Pharmaceuticals Inc, Parsippany, NJ, USA). Precocious ovulation was prevented by GnRH antagonist administration (Ganirelix acetate; Merck, Kenilworth, NJ, USA; or Cetrotide; EMD-Serono Inc., Rockland, MA, USA). The trigger for final oocyte maturation with human chorionic gonadotropin (Pregnyl, Merck) was administered when the two leading follicles reached a diameter of ≥ 17 mm [22 , 23 (link)]. Transvaginal oocyte retrieval was performed under conscious sedation 35–37 h after hCG administration.
Cumulus-corona cells were removed by exposure to medium containing 40 IU/mL hyaluronidase (Cumulase; Halozyme Therapeutics, Inc., San Diego, CA) [24 ] and incubated 1–2 h prior to ICSI.
A similar superovulation protocol was used for all couples. Patients were treated with daily gonadotropins (Follistim; Merck, Kenilworth, NJ, USA; Gonal-F; EMD-Serono, Geneva, Switzerland; and/or Menopur; Ferring Pharmaceuticals Inc, Parsippany, NJ, USA). Precocious ovulation was prevented by GnRH antagonist administration (Ganirelix acetate; Merck, Kenilworth, NJ, USA; or Cetrotide; EMD-Serono Inc., Rockland, MA, USA). The trigger for final oocyte maturation with human chorionic gonadotropin (Pregnyl, Merck) was administered when the two leading follicles reached a diameter of ≥ 17 mm [22 , 23 (link)]. Transvaginal oocyte retrieval was performed under conscious sedation 35–37 h after hCG administration.
Cumulus-corona cells were removed by exposure to medium containing 40 IU/mL hyaluronidase (Cumulase; Halozyme Therapeutics, Inc., San Diego, CA) [24 ] and incubated 1–2 h prior to ICSI.