{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:03:43Z","timestamp":1791389023239,"version":"4.3.3"},"reference-count":22,"publisher":"The Korean Society for Reproductive Medicine","issue":"4","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ecerm.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Reprod Med"],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:p>Objective: The impact of early mechanical removal of cumulus cells on fertilization and embryonic development is not yet precisely known. This study aimed to investigate the effects of early and late cumulus cell removal on fertilization, polyspermy, embryonic development potential, blastocyst development, and clinical outcomes.Methods: A prospective study was conducted of patients who underwent in vitro fertilization between September 2019 and October 2020. Sibling oocytes were randomly allocated after insemination to early cumulus cell removal at 6 hours (group I) and late cumulus cell removal at 16\u201318 hours (group II). If total fertilization failure (TFF) was determined to have occurred at early cumulus cell removal, rescue intracytoplasmic sperm injection (ICSI) was performed. Fertilization, embryonic development, and pregnancy outcomes were compared.Results: A total of 912 oocytes were assigned to group I (458 oocytes) and group II (454 oocytes). Fertilization, polyspermy, embryo quality, and pregnancy outcomes were not significantly different between both groups. Rescue ICSI enabled fertilization of 79.2% of the TFF oocytes.Conclusion: Early cumulus cell removal at 6 hours had no significant difference in fertilization, polyspermy, embryo development, or obstetric and perinatal outcomes compared to late removal. Early cumulus cell removal combined with early rescue ICSI may have the potential to help couples with TFF.<\/jats:p>","DOI":"10.5653\/cerm.2021.04497","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T08:08:55Z","timestamp":1637568535000},"page":"362-367","update-policy":"https:\/\/doi.org\/10.5653\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of embryonic competence and clinical outcomes between early and late cumulus cell removal for in vitro fertilization"],"prefix":"10.5653","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6068-2256","authenticated-orcid":true,"given":"Pallop","family":"Pongsuthirak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3624","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2004.02.121"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0531.2007.01036.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/s0015-0282(00)00522-7"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/s0015-0282(03)01154-3"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/09513590312331290288"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deg325"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/s1472-6483(10)61959-1"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-008-9240-3"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3109\/19396368.2012.708087"},{"key":"ref10","first-page":"99","volume-title":"","author":"Tucker","year":"2003"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt036"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2016.3827"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-016-0151-3"},{"key":"ref14","first-page":"50","volume-title":"Effect of early cumulus cell removal on the fertilization and clinical outcome in human in vitro fertilization","author":"Liu","year":"2015"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-013-0049-3"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-011-9630-9"},{"key":"ref17","first-page":"1743","volume-title":"Time-course of oocyte activation, pronucleus formation and cleavage in human oocytes fertilized by intracytoplasmic sperm injection","author":"Nagy","year":"1994"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/12.3.532"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1002\/jemt.10346"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/mrd.20436"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.12.035"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1101\/gr.136598.111"}],"container-title":["Clinical and Experimental Reproductive Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ecerm.org\/upload\/pdf\/cerm-2021-04497.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ecerm.org\/journal\/view.php?doi=10.5653\/cerm.2021.04497","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ecerm.org\/upload\/pdf\/cerm-2021-04497.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T02:31:37Z","timestamp":1638325897000},"score":1,"resource":{"primary":{"URL":"http:\/\/ecerm.org\/journal\/view.php?doi=10.5653\/cerm.2021.04497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,1]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.5653\/cerm.2021.04497","relation":{},"ISSN":["2233-8233","2233-8241"],"issn-type":[{"value":"2233-8233","type":"print"},{"value":"2233-8241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,1]]},"assertion":[{"value":"2021-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-22","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}