{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:03:33Z","timestamp":1791821013006,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundamental Research Grant Scheme (FRGS)","award":["FRGS\/1\/2021\/SKK01\/UKM\/02\/1"],"award-info":[{"award-number":["FRGS\/1\/2021\/SKK01\/UKM\/02\/1"]}]},{"name":"Secretariat of Research &amp; Innovation (SPI) of the Faculty of Medicine at the National University of Malaysia","award":["FRGS\/1\/2021\/SKK01\/UKM\/02\/1"],"award-info":[{"award-number":["FRGS\/1\/2021\/SKK01\/UKM\/02\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>An overall in vitro fertilization (IVF) outcome is dynamic. Good oocyte quality is important for achieving a better IVF pregnancy. Various methods have been used for OQ assessment (OQA). However, due to inconclusive evidence, one method\u2019s superiority has not been proposed over others. Thus, OQA should be consolidated based on the current evidence for this matter. Our study aims to summarize the current OQA used and compare their recommended methods. Our results revealed that the optimal OQA for cost-effectiveness and clinical implementation is still via morphological assessment. The current method most opted for is total oocyte scoring. Although other methods\u2014follicular fluid evaluation, mitochondria spindle assessment, or live zona imaging\u2014can be applied with better precision, due to cost, additional tools, and expertise, and they should cater to research purposes and selected centers. Our results added value as a current strategy for optimizing OQA in IVF practice, aiming at cost-effectiveness and reproducibility for better clinical implementation.<\/jats:p>","DOI":"10.3390\/biology13120978","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T11:26:08Z","timestamp":1732706768000},"page":"978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Oocytes Quality Assessment\u2014The Current Insight: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-3274","authenticated-orcid":false,"given":"Mohd Faizal","family":"Ahmad","sequence":"first","affiliation":[{"name":"Advanced Reproductive Centre (ARC) HCTM UKM, Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9343-7954","authenticated-orcid":false,"given":"Marjanu Hikmah","family":"Elias","sequence":"additional","affiliation":[{"name":"Faculty of Medicine & Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norazilah","family":"Mat Jin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh 47000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-572X","authenticated-orcid":false,"given":"Muhammad Azrai","family":"Abu","sequence":"additional","affiliation":[{"name":"Advanced Reproductive Centre (ARC) HCTM UKM, Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9960-4888","authenticated-orcid":false,"given":"Saiful Effendi","family":"Syafruddin","sequence":"additional","affiliation":[{"name":"Medical Molecular Biology Institute, National University of Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ani Amelia","family":"Zainuddin","sequence":"additional","affiliation":[{"name":"Advanced Reproductive Centre (ARC) HCTM UKM, Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7440-8127","authenticated-orcid":false,"given":"Nao","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, St Marianna School of Medicine, Kawasaki 216-0015, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4796-1613","authenticated-orcid":false,"given":"Abdul Kadir","family":"Abdul Karim","sequence":"additional","affiliation":[{"name":"Advanced Reproductive Centre (ARC) HCTM UKM, Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11113-023-09765-3","article-title":"Projecting the Contribution of Assisted Reproductive Technology to Completed Cohort Fertility","volume":"42","author":"Lazzari","year":"2023","journal-title":"Popul. Res. Policy Rev."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kamath, M.S., Vogiatzi, P., Sunkara, S.K., and Woodward, B. (2021). Oocyte activation for women following intracytoplasmic sperm injection (ICSI). Cochrane Database Syst. Rev., 2021.","DOI":"10.1002\/14651858.CD014040"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Vo, K.C.T., and Kawamura, K. (2021). In Vitro Activation Early Follicles: From the Basic Science to the Clinical Perspectives. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22073785"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"eClinicalMedicine (2023). The current status of IVF: Are we putting the needs of the individual first?. EClinicalMedicine, 65, 102343.","DOI":"10.1016\/j.eclinm.2023.102343"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Satouh, Y., and Sato, K. (2023). Reorganization, specialization, and degradation of oocyte maternal components for early development. Reprod. Med. Biol., 22.","DOI":"10.1002\/rmb2.12505"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lemseffer, Y., Terret, M.E., Campillo, C., and Labrune, E. (2022). Methods for Assessing Oocyte Quality: A Review of Literature. Biomedicines, 10.","DOI":"10.3390\/biomedicines10092184"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s10815-021-02370-3","article-title":"Does morphological assessment predict oocyte developmental competence? A systematic review and proposed score","volume":"39","author":"Bartolacci","year":"2022","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_8","unstructured":"Giovanni Coticchio, A.A., Arroyo, G., Balaban, B., Campbell, A., De, M.J., Los Santos, T.E., Gardner, D., Kova\u010di\u010d, B., Lundin, K., and Magli, C. (2024). The Istanbul Consensus Update: A Revised ESHRE\/ALPHA Consensus on Oocyte and Embryo Static and Dynamic Morphological Assessment, European Society of Human Reproduction and Embryology."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1093\/humupd\/dmq029","article-title":"Predictive value of oocyte morphology in human IVF: A systematic review of the literature","volume":"17","author":"Rienzi","year":"2011","journal-title":"Hum. Reprod. Update"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"i2","DOI":"10.1093\/humrep\/des200","article-title":"The oocyte","volume":"27","author":"Rienzi","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1007\/s43032-020-00384-3","article-title":"Degenerative Oocytes in the Aspirated Cohort Are Not Due to the Aspirating Needle: A Prospective Randomized Pilot Study with Sibling Oocytes","volume":"28","author":"Atzmon","year":"2021","journal-title":"Reprod. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lazzaroni-Tealdi, E., Barad, D.H., Albertini, D.F., Yu, Y., Kushnir, V.A., Russell, H., Wu, Y.G., and Gleicher, N. (2015). Oocyte Scoring Enhances Embryo-Scoring in Predicting Pregnancy Chances with IVF Where It Counts Most. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0143632"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S502","DOI":"10.1016\/j.fertnstert.2013.07.307","article-title":"A new oocyte scoring system with better predictability for clinical pregnancy than day 3 embryo quality","volume":"100","author":"Lazzaroni","year":"2013","journal-title":"Fertil. Steril."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/S1472-6483(10)60656-6","article-title":"Meiotic spindle presence and oocyte morphology do not predict clinical ICSI outcomes: A study of 967 transferred embryos","volume":"13","author":"Chamayou","year":"2006","journal-title":"Reprod. Biomed. Online"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1016\/j.fertnstert.2007.09.024","article-title":"Significance of metaphase II human oocyte morphology on ICSI outcome","volume":"90","author":"Rienzi","year":"2008","journal-title":"Fertil. Steril."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.4103\/0974-1208.101020","article-title":"Assessment of oocyte quality in polycystic ovarian syndrome and endometriosis by spindle imaging and reactive oxygen species levels in follicular fluid and its relationship with IVF-ET outcome","volume":"5","author":"Rajani","year":"2012","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/S1472-6483(10)61296-5","article-title":"Polar body morphology and spindle imaging as predictors of oocyte quality","volume":"11","author":"Cino","year":"2005","journal-title":"Reprod. Biomed. Online"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ejogrb.2020.06.021","article-title":"Effects o follicular fluid oxidative status on human mural granulosa cells, oocyte competency and ICSI parameters","volume":"252","author":"Karabulut","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/2046-4053-1-2","article-title":"The nuts and bolts of PROSPERO: An international prospective register of systematic reviews","volume":"1","author":"Booth","year":"2012","journal-title":"Syst. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S1472-6483(10)60762-6","article-title":"Donor oocyte dysmorphisms and their influence on fertilization and embryo quality","volume":"14","author":"Ten","year":"2007","journal-title":"Reprod. Biomed. Online"},{"key":"ref_22","first-page":"7","article-title":"Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: What are they and which is better?","volume":"7","author":"Ma","year":"2020","journal-title":"Mil. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.fertnstert.2023.12.014","article-title":"Impact of oxygen tension during in vitro maturation: A sibling-oocyte prospective double-blinded study","volume":"121","author":"Boumerdassi","year":"2024","journal-title":"Fertil. Steril."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Robin, C., Uk, A., Decanter, C., Behal, H., Collinet, P., Rubod, C., Barbotin, A.L., and Robin, G. (2021). Impact of endometriosis on oocyte morphology in IVF-ICSI: Retrospective study of a cohort of more than 6000 mature oocytes. Reprod. Biol. Endocrinol., 19.","DOI":"10.1186\/s12958-021-00798-x"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.fertnstert.2021.02.022","article-title":"Predictive value of cytoplasmic granulation patterns during in vitro fertilization in metaphase II oocytes: Part I, poor-prognosis patients","volume":"116","author":"Hu","year":"2021","journal-title":"Fertil. Steril."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1472-6483(10)60580-9","article-title":"Oocyte zona birefringence intensity is associated with embryonic implantation potential in ICSI cycles","volume":"16","author":"Montag","year":"2008","journal-title":"Reprod. Biomed. Online"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/S1472-6483(10)61996-7","article-title":"Spindle imaging in human oocytes: The impact of the meiotic cell cycle","volume":"12","author":"Montag","year":"2006","journal-title":"Reprod. Biomed. Online"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.fertnstert.2014.09.040","article-title":"Is polycystic ovarian morphology related to a poor oocyte quality after controlled ovarian hyperstimulation for intracytoplasmic sperm injection? Results from a prospective, comparative study","volume":"103","author":"Sigala","year":"2015","journal-title":"Fertil. Steril."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1093\/humrep\/deh258","article-title":"The relationship between pregnancy outcome and smooth endoplasmic reticulum clusters in MII human oocytes","volume":"19","author":"Otsuki","year":"2004","journal-title":"Hum. Reprod."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Wang, Y., Zhang, M., Shi, H., Yi, S., Li, Q., Su, Y., Guo, Y., Hu, L., Sun, J., and Sun, Y.P. (2021). Causes and Effects of Oocyte Retrieval Difficulties: A Retrospective Study of 10,624 Cycles. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.564344"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1093\/oxfordjournals.humrep.a138200","article-title":"Effect of aspirating needle calibre on outcome of in-vitro fertilization","volume":"8","author":"Aziz","year":"1993","journal-title":"Hum. Reprod."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Chamayou, S., Giacone, F., Cannarella, R., and Guglielmino, A. (2023). What Does Intracytoplasmic Sperm Injection Change in Embryonic Development? The Spermatozoon Contribution. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020671"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/GCO.0b013e32832924ba","article-title":"Impact of oxidative stress on female fertility","volume":"21","author":"Ruder","year":"2009","journal-title":"Curr. Opin. Obstet. Gynecol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"304","DOI":"10.5468\/ogs.23268","article-title":"Clinical effectiveness of spindle-view intracytoplasmic sperm injection compared to conventional intracytoplasmic sperm injection in patients with poor ovarian response and previous implantation failure","volume":"67","author":"Kim","year":"2024","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.fertnstert.2011.05.023","article-title":"Does meiotic spindle normality predict improved blastocyst development, implantation and live birth rates?","volume":"96","author":"Kilani","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Revelli, A., Delle Piane, L., Casano, S., Molinari, E., Massobrio, M., and Rinaudo, P. (2009). Follicular fluid content and oocyte quality: From single biochemical markers to metabolomics. Reprod. Biol. Endocrinol., 7.","DOI":"10.1186\/1477-7827-7-40"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s10815-018-1143-3","article-title":"Influence of follicular fluid and cumulus cells on oocyte quality: Clinical implications","volume":"35","author":"Giorgi","year":"2018","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1038\/s41419-019-1797-5","article-title":"Transforming growth factor-beta is involved in maintaining oocyte meiotic arrest by promoting natriuretic peptide type C expression in mouse granulosa cells","volume":"10","author":"Yang","year":"2019","journal-title":"Cell Death Dis."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/13\/12\/978\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:40:03Z","timestamp":1760114403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/13\/12\/978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,26]]},"references-count":38,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["biology13120978"],"URL":"https:\/\/doi.org\/10.3390\/biology13120978","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,26]]}}}