What Is In Vitro Maturation?

In-vitro maturation (IVM) is an assisted reproductive technique in which a woman’s ovarian follicles are removed from the ovaries and mature in the laboratory prior to in-vitro fertilization. The difference between IVM and conventional IVF lies in the relative immaturity of the follicle as compared to the oocyte.

Folliculogenesis begins with the primordial follicle, which undergoes stages of development from primary, secondary, early tertiary (antral), late tertiary, and preovulatory. In-vitro maturation can be performed on follicles that have at least achieved the early tertiary stage of development.

Younger follicles are more susceptible to changes in their surrounding environments, thus early-stage IVM is still under development. A primordial follicle has been shown to successfully mature into a secondary follicle outside the body by growing it in ovarian tissue culture, while maturity into the next stage can be conducted in a test tube.

IVM also has several modifications to improve success. Ovarian tissue can be exposed to human chorionic gonadotropin (hCG) in a technique known as hCG priming, resulting in a dispersed pattern of the cumulus oophorus. Intracytoplasmic sperm injection (ICSI) is another expansion to the technique of IVM, similar to its application in in-vitro fertilization.

Among the benefits of IVM is the elimination of ovulation induction by hyperstimulation, which is commonly used in IVF. Thus, the adverse effects that can arise as a result of erroneous hormone dosages can be mitigated or averted altogether.

IVM also allows for the potential for a greater proportion of follicles to reach maturity. At birth, a female infant has about one million follicles, however, only 400 will achieve maturation and release during ovulation. By extracting follicles before the monthly onset of ovarian follicle atresia, these cells may be used for further study, maturation, and fertilized.

Patients for whom IVM may be recommended include women who are susceptible to developing ovarian hyperstimulation syndrome (OHSS), such as those diagnosed with polycystic ovarian syndrome. Also, couples whose infertility has been identified as being solely due to male infertility are good candidates for IVM.

Since IVM is a relatively new assisted reproductive technology, Philippines-based fertility centers are still studying its utility and feasibility in the local setting. There is not yet enough evidence of its success, let alone its safety. Only a few hundred children worldwide have been born as a result of IVM treatment, and they are still very young. Since fewer eggs are harvested than in conventional IVF, the sample size for determining success rates is still too small to declare a consensus.