In vitro maturation (IVM) is a technique of extracorporeal fertilization, which means it occurs outside the human body. IVM relocates follicle maturation in vitro (egg maturation in a test tube).
The procedure avoids side effects and risks of hormone therapy.
In vitro maturation is usually offered in combination with in vitro fertilization (IVF; Latin for “fertilization in a glass”).
Indications (areas of application)
- Women with a positive history, i.e., ovarian hyperstimulation syndrome (OHSS) in a past stimulation (oocyte maturation therapy).
- Women with polycystic ovary syndrome (PCO syndrome; PCOS).
- Patients with a limited time window before cytotoxic (cell-damaging) therapy for malignant (malignant) diseases as a fertility-preserving measure in patients with PCOS or high antral follicle count (AFC; number of small, so-called “antral” follicles).
- Patients who are low-/non-responders (insufficient follicle formation/ovule formation under gonadotropin stimulation) with good anti-Müllerian hormone (AMH) or high AFC (worth discussing).
In polycystic ovary syndrome, there is an increased risk of developing OHSS due to gonadotropin stimulation. Furthermore, IVM can thereby avoid aspirating a higher than average number of immature oocytes (eggs).
Note: Women younger than 30 years also have an increased risk of OHSS with stimulation therapy.
The procedure
Nowadays, IVM is mostly preceded by short-term stimulation with gonadotropins (follicle-stimulating hormone (FSH) and luteinizing hormone (LH)) at low doses, or stimulation is omitted altogether.
Follicular aspiration (oocyte aspiration/ovulation) of the ovarian follicles (egg follicles; “follicles”) is performed transvaginally (“through the vagina”).
The contents of the ovarian follicles and the oocytes within them are cultured. The following solution is used: patient serum (final concentration 0.1 ml/ml IVM medium). FSH (final concentration 0.08 IU/ml IVM medium) and HCG (final concentration 0.1 IU/ml IVM medium).The luteal phase is supported with 6 mg estradiol orally from oocyte retrieval and 600 mg progesterone vaginally from oocyte insemination.
The oocytes (eggs) thus matured in vitro are thereby fertilized (inseminated) with the male’s sperm (semen) in a typical manner and transferred as embryos (embryo transfer, ET).On average, 4.3 embryos are transferred per treatment internationally.
Pregnancy rates
Pregnancy rates per cycle range from 15% to 48%.
Please note
The physical and mental health of both man and woman as well as a healthy lifestyle are important prerequisites for successful fertility treatment.
Before starting therapeutic measures, you should in any case – as far as possible – reduce your individual risk factors!
Therefore, before starting any reproductive medical measure (e.g. IUI, IVF, etc.), have a health check and a nutritional analysis performed to optimize your personal fertility (fertility).
