Oocyte donation has become a standard treatment for women with diminished ovarian reserve and/or who are of advanced reproductive ages women affected by, or who are carriers of a significant genetic defect; and women with poor oocyte and/or embryo quality (44). Oocyte donation results in a high pregnancy rate for patients with an otherwise grave reproductive prognosis; the accumulated pregnancy rate may increase up to 94.8% after four transfers (45). The risk of OHSS, complications associated with oocyte collection, and concern about the inconvenience of a large number of hormone injections as well as possible long-term side effects (46,47) may deter some potential oocyte donors. Indeed, results of a recent survey indicate that three-quarters of potential donors changed their mind about donating after receiving information on the procedures involved (48). Avoiding ovarian stimulation would obviously eliminate the associated risks to oocyte donors and would drastically reduce the costs of donation cycles (49). As discussed earlier, the first reported IVM pregnancy was conceived from immature oocytes retrieved and donated to a woman with premature ovarian failure (24). At our center, 12 oocyte donors (age 29 ± 4) with high antral follicle counts (29.6 ± 8.7) underwent immature oocyte collection without ovarian stimulation. A mean of 12.8 ± 5.1 germinal vesicle (GV) oocytes were collected, 68% matured and underwent intracytoplasmic sperm injection (ICSI). A total of 47 embryos were transferred to 12 recipients and six (50%) conceived, of which four have resulted in live births (Holzer H, Chian RC, Scharf E, Tan SL. IVM oocyte donors: oocyte donation without ovarian stimulation, in preparation). Therefore, collecting immature oocytes from a donor's unstimulated ovaries in oocyte donation programs seems prudent and worthwhile.
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