Obstetric, neonatal and infant outcome in babies conceived by in vitro maturation (IVM): Initial five-year results 1998–2003

IVM is an alternative for patients with PCO after failed conventional IVF attempt

PURPOSE

To determine if IVM of oocytes from unstimulated cycle is a treatment option for patients who did not deliver after standard IVF-ET.

METHOD

Twenty three women with PCO, thirteen of them with normal cycles and all <35 years old, who failed IVF served as their own control. During the control IVF cycle patients were stimulated with 1730.7 ± 639.5 IU recombinant FSH, a long Buserelin acetate protocol was used and embryo transfer was performed on day 2 or 3 after ICSI. After failed IVF immature oocytes were aspirated transvaginally from antral follicles during spontaneous menstrual cycle. Embryo transfer was performed 2 or 3 days later.

RESULT

11.4 ± 4.8 mature oocytes and 6.7 ± 3.2 embryos were produced with IVF, which served as the control, compared to 9.7 ± 4.5 mature oocytes and 6.2 ± 3.2 embryos with IVM. There was one clinical pregnancy in the IVF group which did not result in a live birth where as five singleton and one pair of twins with healthy live births and one miscarriage in the IVM group.

CONCLUSION

IVM does not involve ovarian stimulation with possible financial and health consequences. İt may be an useful treatment after unsuccessful IVF.

In vitro maturation of human oocytes for assisted reproduction

OBJECTIVE

To describe and evaluate the current practice of in vitro maturation of oocytes for assisted reproduction.

DESIGN

Review of the available and relevant literature regarding in vitro maturation of oocytes.

CONCLUSION(S)

In vitro maturation of human oocytes retrieved from antral ovarian follicles is an emerging procedure quickly being incorporated into the realm of assisted reproductive technologies. This new technology has several potential advantages over traditional controlled ovarian hyperstimulation for IVF, such as reduction of costs by minimizing gonadotropin and GnRH analogue use, elimination of ovarian hyperstimulation syndrome, and simplicity of protocol. In vitro maturation of oocytes for assisted reproduction in human beings still is undergoing refinement but currently is providing efficacy and safety outcome comparable to that of traditional IVF in recent selected studies. Implementing in vitro maturation into an established IVF practice is feasible and requires only a few simple adjustments. Crucial to the advancement and optimization of the technology is a better understanding of how to maximize immature oocyte developmental competence and endometrial receptivity.