Preconception nutrition and the microenvironment of the human oocyte: Proteomic and epidemiologic studies on IVF/ICSI treatment outcomes

Since the first successful application of In Vitro Fertilization (IVF) in 19781 and Intracytoplasmic Sperm Injections (ICSI) in 1992,2 there has been a steady increase in the utilization of these assisted reproduction techniques (ART) to achieve pregnancy in subfertile couples. Initially, the natural menstrual cycle was allowed to recruit the ovarian follicle for IVF. The ovarian follicle is the microenvironment in which the oocyte matures. However, the lack of control of ovulation and the low propensity for a viable embryo and pregnancy after single oocyte fertilization led to the development of Controlled Ovarian Hyperstimulation treatment (COH) to yield more oocytes. The advantage is that COH overcomes the inefficiency of monofollicular ovulation in women and it extends the range of indications for IVF/ICSI treatment. The principal aim of COH is to stimulate growth and maturation of multiple ovarian follicles, which is achieved through the use of Follicle Stimulating Hormone (FSH) analogues.

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