Craft, I., Shelton, K., Yovich, J., & Smith, D. (1980). Ovum retention in the human. Fertility and Sterility, 34(6), 537-541. https://doi.org/10.1016/s0015-0282(16)45191-5
Craft I, Shelton K, Yovich J, Smith D. Ovum retention in the human. Fertil Steril. 1980;34(6):537-541. doi:10.1016/s0015-0282(16)45191-5
Craft, Ian, et al. "Ovum retention in the human." Fertility and Sterility, vol. 34, no. 6, 1980, pp. 537-541.
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Ovum retention occurred in two women with normal ovulation markers
Two women had a mature egg still inside a follicle that had already ruptured, and each had a normal luteal phase with a progesterone rise. This 1980 London case report describes one natural cycle and one cycle induced with clomiphene and human chorionic gonadotropin. The authors suggest the term ovum retention for the finding.
Key Findings
Case 1, a 35-year-old woman in a natural cycle: laparoscopy showed a collapsed follicle holding a mature oocyte. The oocyte did not fertilize, a failure the authors attributed to poor sperm quality.
Case 2, a 40-year-old woman in a clomiphene and human chorionic gonadotropin cycle: a ruptured 1.5-cm follicle held a mature oocyte. It and two others fertilized and reached eight cells.
Both women had a normal luteal phase with a progesterone rise indicating ovulation. Case 1 also had a biphasic basal body temperature chart, and case 2 had early secretory phase endometrium.
Ninety-five ovum collections, 50 in infertile women with tubal damage and 45 in fertile women at sterilization, found five postovulatory follicles. Two held a retained ovum.
The authors suggest the term ovum retention for a mature ovum kept in the follicle cavity after the contents are discharged, in contrast to ovum entrapment in periovarian adhesions.
Interpretation
The report describes two women in a hospital research program. In each, a follicle ruptured yet kept its egg while the luteal phase looked normal. Case 1 also had a biphasic temperature chart, and case 2 had early secretory phase endometrium. The authors conclude that clinicians cannot yet define precisely whether ovulation with ovum release has occurred. They cite a clomiphene series with ovulation in 66.5% and a pregnancy rate of only 25%, and suggest retention might explain some failures to conceive. The finding warrants further specific study, the authors state.
RRM Context
Restorative reproductive medicine looks for the cause of infertility. Ovum retention is one proposed reason a cycle can look ovulatory while no pregnancy follows. A root-cause evaluation can keep it on the list.
Our editorial summary of this paper, not the article's abstract.
Abstract
Two cases of ovum retention occurring in postovulatory follicles are described. The ova were recovered at laparoscopy by aspiration of decompressed ovulatory follicles, one during a natural cycle and the other following a programmed clomiphene/human chorionic gonadotropin cycle. Each patient had a normal luteal phase with an increased progesterone level indicative of ovulation. The implications of these findings and their relevance to human fertility studies are discussed.
