This revolutionary fertility treatment was developed to provide a safer and a cheaper alternative to conventional IVF. Improved IVM techniques are developing rapidly and an increasing number of fertility clinics are offering IVM. The concept of IVM technology remains attractive. However, its introduction in routine clinical IVF program is, at present, a distant goal.
What is IVM treatment involves?
IVM involves collection of Immature eggs under ultrasound scan guidance from the antral follicles of unstimulated or minimally stimulated ovaries. The immature eggs are then matured in the laboratory for 24-48 hours using culture medium with added small quantities of hormones. Intracytoplasmic sperm injection (ICSI) is used for fertilization of the matured eggs. The resulting embryos are transferred to the women's wombs.
How does IVM differ from IVF?
Stimulated IVF is associated with the risk of developing ovarian hyperstimulation syndrome (OHSS) which is a potentially fatal condition and IVM eliminates this risk because it does not involve ovarian stimulation. Also, IVM is less expensive than IVF because it does not involve taking costly gonadotropin injections and involve less monitoring. Moreover, IVM is a shorter treatment regimen compared with in vitro fertilization. Fertilization rates with IVM and ICSI is similar to conventional IVF and ICSI.
Who would benefit from IVM treatment?
A number of people may benefit from IVM treatment:
- As an alternative to IVF for women with PCOS; these patients are at significant risk of OHSS
- As an alternative to IVF for younger women with normal menstrual cycles, IVM being less costly and safer
- Fertility preservation in young cancer women who are going to receive chemotherapy or radiotherapy
- Salvaging immature eggs collected during a standard IVF/ICSI (when unexpectedly a significant number of eggs collected are immature)
- Women who will benefit most from in vitro maturation are women aged 35 and younger and have antral follicle count of 10 or more.
How effective treatment IVM compared with IVF?
Over 400 babies have been born worldwide through IVM treatments with no apparent increase in congenital anomalies; so far IVM seems to be safe. However, long-term safety records are lacking. Over a million children have already been born after IVF treatment and over 100,000 children have been born after ICSI and long-term data on safety and efficacy are available. Clinical pregnancy rates of 38% for women aged 35 years or under having IVM has been reported which compares favourably with that of conventional IVF. Bucket and colleagues (2007) reported an increased risk of miscarriage after IVM compared with IVF and ICSI.