Avocados, bananas, and pancakes: Does the oocyte maturity ratio predict live birth rates in in vitro fertilization/intracytoplasmic sperm injection?

When I try to explain oocyte maturity to patients in the daily practice of assisted reproductive technology, I often talk about avocados and bananas. Most people can relate to the joy of eating a perfectly ripe banana or avocado and the dissatisfaction of biting into a green banana, a hard avocado, or a mushy version of either. Striving for the perfect ripeness of these fruits [yes, avocado is a fruit (1)] is similar to the quest to harvest oocytes at their “ripest,” most mature point in in vitro fertilization (IVF).