In-Vitro Maturation (IVM) is an innovative treatment for couples seeking fertility. IVM involves removing oocytes from a woman’s ovaries while immature to be incubated and matured in a laboratory facility. With all the revolutionary techniques couples facing infertility use, IVM is an alternative to IVF or other procedures that uses matured oocytes. The female’s ovaries contain over million oocytes at birth with only <500 oocytes reaching ovulation in the average fertile woman. With technological advances, retrieving these oocytes before destruction and maturing them provides a pathway to folliculogenesis and successful pregnancies in those deemed infertile. Let’s take a look at the procedure for IVM and the necessary steps to achieve fertilization and ultimately, pregnancy.
Candidates who are best suited or interested in IVM are those who have female or male factor infertility. A major syndrome known as ovarian hyper stimulation is for females attempting to get pregnant benefit from IVM. Females with this syndrome are poor candidates for IVF due to the need for ovary maturing medications and stimulating hormones. They develop shock, swollen ovaries, rapid weight gain and painful abdominal and ovarian pain. Therefore IVM is preferred due to the elimination of such hormones and drugs and maturation in vitro. In addition, those with uterine and ovarian cancers benefit from the lack of hyperstimulation, which can negatively affect the tumors in malignancy.
The maturing oocyte is termed folliculogenesis. This includes the 1°, 2°, and 3° stages with a final preovulatory oocyte follicle. IVM is usually conducted in the tertiary state due to earlier stages being more susceptible to damage if removed early. If faster maturation is desired, hormones and human chorionic gonadotropins (HCG) can be implemented to mature oocytes in the ovary. However, unlike IVF where maturation is essential prior to retrieval, IVM eliminates the hyperstimulation.
IVM works as follows. Oocytes are harvested from the female’s ovary and stored in sterile petri dishes. These oocytes are then matured in an incubator for 2-3 days until they are ready for fertilization. Excess oocytes can be cryopreserved for days to years as an artificial ovarian reserve if more cycles or oocytes are needed. Once matured, the oocytes are fertilized with viable sperm and transferred back into the uterus as in regular IVF treatment. As for risks, IVM poses the same as any IVF procedure or less. A smaller sample of oocytes is collected in IVM compared to IVF so successful implantation is necessary. Patients generally have the risk of the oocytes having genetic or undiagnosed malformations rendering them unpalatable. Risks from surgical procedures such as anesthesia induced complications, ovarian or oocyte damage and costs poses as reasons one may not want to go with IVM.
For those having issues getting pregnant and are not candidates for hormonal ovarian maturation, In-Vitro Maturation provides a better alternative. Rather than collecting one mature oocyte during IVF, IVM allows a greater amount of oocytes to be preserved to increase a couple’s chances of fertilization. The choice is subjective but the outcome is always hopefully for a successful fertilization and pregnancy.