Oocyte quality affects early embryonic survival, the establishment and maintenance of pregnancy, fetal development, and even adult disease. Quality, or developmental competence, is acquired during folliculogenesis as the oocyte grows, and during the period of oocyte maturation. Assisted reproductive technologies involving ovarian hyperstimulation, or collection of immature oocytes followed by maturation in vitro, perturb this process and result in oocytes with reduced quality. In domestic livestock species, offspring have been produced using in vitro oocyte maturation, although only a small percentage of the original pool of immature oocytes is capable of developing to the blastocyst stage and subsequently resulting in pregnancy. In vitro maturation, as it is currently undertaken, does not support the correct development of oocyte competence. Follicle size affects oocyte quality, potentially implicating messenger RNA or protein stores as factors involved in oocyte competence. Oocytes from preantral follicles grown in vitro are competent to resume meiosis, although development to the blastocyst stage is decreased. An offspring from oocytes produced using this technique was normal at birth but experienced delayed onset health issues, highlighting the importance of oocyte quality long after embryogenesis. Metabolism may play a critical role in oocyte quality because glycolytic activity in mature oocytes is correlated with increased embryonic development. Communication between the oocyte and its surrounding cumulus cells is also important for the development of a competent oocyte. Ovarian stimulation causes delayed embryonic development, increased abnormal blastocyst formation, fetal growth retardation, and increased fetal loss. Thus, although meiosis and even early development may be completed successfully, there are a variety of other processes occurring within the cytoplasm of the oocyte that are required for complete developmental competence. However, the cellular mechanisms that impart oocyte quality are unclear. Until the mechanisms involved in oocyte quality are elucidated, any effort to use assisted reproductive technologies in animals for production or biomedical purposes will be inefficient at best.