In Vitro Maturation (IVM)

What is in vitro maturation?

In IVM, immature eggs are collected from smaller follicles contained in the ovary and then, matured in the laboratory under specific culture conditions. Multiple embryos can be produced without administering high doses of stimulating injections and the risk of side effects. In conventional IVF, the ovaries are hyperstimulated and several mature oocytes are produced. Until recently, IVF laboratories could only work with mature oocytes, and the immature oocytes would be discarded.

When is IVM recommended?

IVM is an ideal procedure for women who have irregular anovulatory cycles like PCOS. It is also recommended for women who have suffered negative side effects from previous hormonal therapy like OHSS. Women who have been diagnosed with cancer may be advised to avoid hormones that may stimulate tumor growth. Those who want to preserve fertility for the future for any reason would benefit from the IVM procedure of egg removal and then cryopreservation.

Are there any risks of IVM?

Like with any other kind of ART, there is a risk of multiples pregnancy if more than one embryo is planted.

What is the Procedure for IVM?

The procedure for IVM is as follows:

Step 1. As in conventional IVF, eggs are collected, but at an earlier stage, when they are immature. This means that you do not need to take as many ovary-stimulating hormones before your eggs are collected.

Step 2. Next, the eggs are kept in a dish for maturation and placed in an incubator in the laboratory for about a day or two.

Step 3. Once mature, the eggs are fertilised with the donor sperm. Similar to traditional IVF treatment, the embryos are cultured before being transferred to the womb.

What is my chance of having a baby with IVM?

The chances of a successful pregnancy with IVM are similar to those with conventional IVF with the following additional risks:

• Because the eggs are not fully mature at the time of collection, the number of eggs collected are fewer than in a traditional IVF cycle.
• There is also a risk that not all the eggs will mature sufficiently to be fertilized with your partner’s or a donor’s sperm.

What IVM Treatment Benefits are there?

Patients who have been diagnosed with Polycystic Ovarian Syndrome (PCOS), a metabolic disorder, are at an increased risk of developing Ovarian Hyperstimulation Syndrome or OHSS following FSH therapy. OHSS may cause abdominal bloating, weight gain, nausea, and cysts. In extreme cases, there may be swelling in the ovaries. This may cause excess fluids in the blood vessels to leak into the chest and stomach, resulting in respiratory problems and kidney disorders. Such complications often require hospitalization, extensive medical care, or surgeries, and the end of the cycle. Because IVM requires a much shorter course of FSH therapy (3 days as opposed to 10-14+ days for traditional IVF), the risk of OHSS is lessened. This shortened FSH therapy cycle is beneficial not only to patients with PCOS, but to cancer patients as well. If a patient has been diagnosed with cancer, especially breast cancer, she will likely have an extreme sensitivity to oestrogen, making a long course of FSH therapy difficult, if not impossible. Earlier, a patient intending to have her eggs extracted before cancer treatment caused fertility damage would have to delay treatment for about 10 to 14 days to have the eggs extracted for cryopreservation. But with IVF, a brief course of Follicle-stimulating hormone or FSH Therapy enables the patient to resume cancer treatment shortly.