Arguments Against Term Maturation
So far the arguments against Term Maturation theory can be explained away.
Patients who takes a long time to stimulate have low oocyte quality
One of the frequent objections to the concept of Term Maturation are clinical observations that when stimulation becomes very long, the quality of the embryos and the chance of pregnancy are low. However, when a patient has a very long cycle, we can never be sure that the cycle is ovulatory and not merely breakthrough bleeding. In these cases, some non-physiological mechanisms are in play. Similarly, when a patient fails to adequately respond to the normal stimulation regiment, there is something wrong with the physiology of their reproductive cycle and those cases must be treated as an exception.
Many women do great with short stimulation
The follicular phase has a considerable variation in duration. In some women, a very short, less than 10 days follicular phase may be sufficient for oocytes to reach term maturation. However, that is rare. The same token one may argue that 23 weeks of gestation is sufficient, because 30% of children will survive and do fine.
Data from the studies of chromosomal errors show similar trend despite the different duration of stimulation
If an embryo was able to reach a blastocyst stage when it could be chromosomally tested, it would be expected to have a similar chance of chromosomal errors irrespective of its prior history.
Retrospective study of donor cycles does not reveal an impact of the follicular cycle duration on the oocyte quality.
In order to prove or disprove the influence of the duration of the follicular phase on the outcome, one must only include those cases when the duration is a completely independent variable. In other words, the duration of stimulation must not depend on the patient’s response. This study does not fulfill this requirement. The more appropriate title for this work would be: “When follicular phase is extended because an egg donor fails to adequately respond to the high amounts of gonadotropins, the egg quality does not improve”.