Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Na produÃÃo in vitro (PIV) de embriÃes bovinos vÃrios fatores contribuem para as variÃveis na produÃÃo e qualidade dos oÃcitos e embriÃes. Avaliou-se o uso parenteral de vitamina A (VA) e vitamina E (VE) na produÃÃo de oÃcitos colhidos por aspiraÃÃo folicular (OPU) e embriÃes por produÃÃo in vitro (PIV) em de vacas (n=22), sendo: Simental (S) (n=2); Nelore (N) (n=4); Brahma (B) (n=5) e Gir (G) (n=11). Todos os animais foram alocados na fase prÃ-tratamento (F1) (n=22) (nÃo receberam vitaminas) e os mesmos animais utilizados para a fase pÃs-tratamento (F2) (receberam 1.000.000 UI de vitamina A e 1g de vitamina E). A primeira OPU foi na F1, logo em seguida foi aplicado 1.000.000 UI de VA e 1g de VE, e apÃs 12 dias realizou-se nova OPU para fazer a F2. Os oÃcitos (CCO) foram maturados, fecundados e cultivados in vitro. As 44 OPU produziram 520 oÃcitos, 217 (F1) e 303 (F2), havendo efeito significativo, com acrÃscimo de 86 oÃcitos, obtendo mÃdia e desvio padrÃo 9,86Â5,53 F1 e 13,77Â2,0 F2, (*p<0,0219). Quando separada as raÃas NBG (Nelore, Brahma e Gir) (n=20) houve acrÃscimo de 95 oÃcitos, obtendo mÃdia e desvio padrÃo 9,90Â5,81 F1-NBG e 14,65Â9,44 F2-NBG, (*p<0,0085). As 44 PIV produziram 224 embriÃes, sendo 93 F1 e 131 F2, obtendo mÃdia e desvio padrÃo 4,23Â3,09 F1 e 5,95Â4,05 F2, (*p<0,0228). Quando separada as NBG a produÃÃo foi de 214 embriÃes, havendo acrÃscimo de 38 embriÃes, obtendo valores de 4,45Â3,15 F1 e 6,25Â4,09 F2, (*p<0,0285). Houve um efeito significativo na quantidade produzida de oÃcitos (n=22) e oÃcitos NBG (n=20). Houve efeito na produÃÃo de embriÃes de todas as raÃas (n=22) e embriÃes NBG (n=20). A suplementaÃÃo com VA e VE aumentou o nÃmero de oÃcitos totais (1,7Â0,7); oÃcitos NBG (1,8Â0,8); embriÃes totais (3,9Â1,6) e embriÃes NBG (4,7Â1,6). A resposta da F2 comparado com a F1 na produÃÃo de oÃcitos e embriÃes foi significativa quando todas as raÃas estavam agrupadas e tambÃm quando foi agrupado apenas as Bos taurus indicus (NBG). O uso das vitaminas A e E pode ser usada para maior recuperaÃÃo oÃcitÃria e embrionÃria em raÃas ZebuÃnas. / The in vitro (IVP) bovine embryos production has several factors that contribute to the variables in the production and quality of oocytes and embryos. We evaluated the parenteral use of vitamin A (VA) and vitamin E (VE) in the production of oocytes collected by follicular aspiration (OPU) and embryos by in vitro production (IVP) in cows (n = 22), where: Simmental (S) (n = 2), Nelore (N) (n = 4), Brahma (B) (n = 5) and Gir (G) (n = 11). All animals were allocated in the pre-treatment (F1) (n = 22) (not receiving vitamins) and the same animals used for post-treatment (F2) (received 1,000,000 IU of vitamin A and vitamin 1g E). The first OPU was in F1, soon after 1,000,000 IU was administered 1 g of VE and VA, and after 12 days was held to make the new OPU F2. Oocytes (COC) were matured, fertilized and cultured in vitro. The OPU 44 yielded 520 oocytes, 217 (F1) and 303 (F2), with significant effect, an increase of 86 oocytes, obtaining mean and standard deviation 9.86 Â 5.53 13.77 Â 2.0 F1 and F2, (*p <0.0219). When separate races NBG (Nelore, Brahman and Gir) (n = 20) there was an increase of 95 oocytes, obtaining mean and standard deviation 9.90 Â 5.81 and 14.65 NBG F1-F2-NBG Â 9.44, (*p <0.0085). The 44 IVP embryos produced 224, 93 F1 and 131 F2, getting mean and standard deviation 4.23 Â 3.09 5.95 Â 4.05 F1 and F2, (*p <0.0228). When separated from the NBG production was 214 embryos, with an increase of 38 embryos, obtaining values of 4.45 Â 3.15 6.25 Â 4.09 F1 and F2, (*p <0.0285). There was a significant effect on the quantity produced of oocytes (n = 22) and NBG oocytes (n = 20). It was an increased in all breeds embryos production (n = 22) and NBG embryos (n = 20). Supplementation with VE and VA increased the total number of oocytes (1.7 Â 0.7); NBG oocytes (1.8 Â 0.8); total embryos (3.9 Â 1.6) and embryos NBG (4 7 Â 1.6). The response of the F2 compared to F1 in the production of oocytes and embryos was significant when all races were grouped together and also when it was grouped only Bos taurus indicus (NBG). The use of vitamins A and E can be used to greater oocyte recovery and embryo in Zebu breeds.

This randomized, double-blind, placebo-controlled study was conducted to compare the effectiveness of intravenous acetaminophen vs. oral acetaminophen or placebo as an adjunct to opioids on lowering post-operative pain scores, discharge time, need for opioids, and opioid-related side effects, as well as assessing for any effects pain treatment has on embryological and pregnancy outcomes. Secondary analysis included identifying risk factors in patients that cause them to have worsening pain or minor relief from traditional pain management. This study was conducted at a single academic fertility center at Massachusetts General Hospital in Boston with a patient population of 159 English-speaking women between 18-43 years old, undergoing oocyte retrieval as a part of In Vitro Fertilization procedure. Participants were randomly placed in one of three treatment groups to receive either 1000mg IV acetaminophen and PO placebo (Group A), IV placebo, and 1000mg PO acetaminophen (Group B), or IV and PO placebo (Group C) as pain control before oocyte retrieval procedure. The primary outcomes measured were patient-reported post-operative visual analogue scale pain scores in the recovery room at 10 minutes, 30 minutes, and discharge time. Using these values to measure the effectiveness of each treatment at improving post-operative pain. To assess the relationship, if any, between demographical or clinical factors and pain, we analyzed what factors were common in those experiencing high or low pain. We used the Visual Analog Scale (VAS) which has patients rank pain from 1-10. For this analysis, low pain is defined as those whose 10-minute post-operative pain score was less than 5 (VAS score <5/10) and high pain as those whose 10-minute postoperative pain score is 5 or greater (VAS score 5+/10). Results showed that mean post-operative pain scores were similar between the study groups at 10 minutes (A:2.3, B: 2.6, C:2.8, p=0.51). Timing of discharge was also similar (A:60.1 mins, B: 58.8 mins, C:57.6mins; p=0.76). Although not statistically significant, the mean post-operative opioid dose for patients in group A was less than half of that in Group B and C (0.24mg vs. 0.59mg vs. 0.58mg; p=0.34) and fewer required rescue pain medication in the recovery room (4% vs. 19% vs. 15% respectively; p=0.24). There was a trend towards decreased side effects of constipation in Group A compared to Groups B and C (15% vs. 31% vs. 33%, respectively; p=0.07). There were no differences in embryological or early pregnancy outcomes between study groups. An analysis of predictors of pain, patients with BMI >/=30kg/m2 (obese) were more likely to report high post-operative pain (p=0.009). Prior abdominal surgeries, including pelvic laparoscopy and laparotomy, were associated with low post-operative pain (p=0.069 and p=0.025, respectively). Those who reported having pre-operative pain greater than zero were more likely to report lower postoperative pain (p=0.002). There was no significant relationship between race/ethnicity, infertility diagnosis, and procedure length and pain. This study's findings showed no significant difference between post-operative pain scores or discharge times in women undergoing oocyte retrieval when given IV acetaminophen, PO acetaminophen, or a placebo. There were severe findings that suggested that IV acetaminophen may reduce the need for post-operative narcotics and lead to fewer opioid-related side effects, however these findings while large were statistically insignificant. The predictors of higher post-operative pain we found, including high BMI, no prior history of abdominal procedures, and lack of pre-operative pain, indicate that further investigation into these predictors could be beneficial. This information may allow physicians and anesthesiologists to optimize their pain control.

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.