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In Vitro Maturation (IVM) of Immature Human Eggs: Will Fertility Drugs Become Unnecessary for IVF?

Dr. Geoffrey Sher Recommends

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In the mid‑1990s a group at Monash University in Melbourne, Australia, reported the world’s first baby born from an embryo derived from an immature egg that had been matured in the embryology laboratory, and then fertilized and transferred to the uterus. The process has come to be known as In vitro maturation (IVM) of eggs. In so doing, these researchers in fact opened the door to retrieving numerous healthy eggs from women who had not received fertility drugs at all in advance of the egg retrieval, and so potentially transforming the entire IVF arena. More recently, Sean Ling Tan, MD from Mc Gill University in Montreal, Canada reported on impressive results using IVM, claiming success rates that are comparable to those being reported for conventional IVF. A few other centers are reporting a similar experience.

How is the IVM process conducted?
Within 6-8 days of a natural menstruation, an ultrasound examination is done to see how many early follicles have developed. A few days later, 10,000 units of hCG is administered, and approximately 36 hours after that, an egg retrieval is performed and eggs are aspirated from the follicles. These eggs are then allowed to mature in special media and under special conditions. Many of them develop into mature (M2) eggs. The eggs can then be fertilized in the embryology lab and transferred to the uterus as embryos/blastocysts (3-6 days after fertilization), or vitrified (frozen) as eggs or embryos and cryobanked for subsequent dispensation.

At SIRM we are in the process of undertaking a study that will combine IVM with CGH testing of all M2 (matured) eggs. We believe that by doing so we might be able to further improve success rates associated with IVM.

What are the possible benefits and advantages of IVM?
Immediate benefits of IVM would be seen in the arena of Fertility Preservation (FP) where women who for medical or personal reasons would bank their frozen eggs for future dispensation. This would be most applicable in cases where women who have certain types of cancer need to undergo chemotherapy or radiotherapy that could damage their eggs and/or launch them into premature ovarian failure. IVM could also be used to access large numbers of donor eggs for dispensation to women who require egg donor-IVF. It would definitely simplify the entire process to the benefit of all.

No doubt, the ability to generate and acquire viable eggs and embryos without using fertility drugs to stimulate multiple follicle development would constitute a major breakthrough in the field of IVF. It would reduce cost dramatically (for IVF drugs often constitute more than one third of the total cost). It would eliminate side effects from, and all risk of serious complications associated with, use of fertility drugs, and it would expand the reproductive choices available to women.

Simply stated, IVM is a much needed approach in view of the physiological, emotional, and financial costs associated with the administration of fertility drugs. Frankly, the widespread introduction of IVM could herald the end of the era of fertility drugs being required to perform IVF. Wouldn’t that be a blessing?

Tags: Egg Freezing, Fertility Medications, Fertility Preservation, In Vitro Maturation, IVF Authority, IVM

10 Responses to “In Vitro Maturation (IVM) of Immature Human Eggs: Will Fertility Drugs Become Unnecessary for IVF?”

Vee says:

July 19, 2011 at 1:32 pm

Hello
Thank you for posting such excellent information. I have just gone through my first cycle of IVM and found out today that it failed. I had 2 top quality embryos transferred. I have 3 more frozen. My question is, I know the odds for IVM success are lower than IVM but in terms of implantation do we stand the same chance? Would we have more chance starting again and creating fresh embryos on an IVF cycle? I have bad PCOS which is why my clinic suggested IVM but I would rather pursue the treatment that stood the best chance. My understanding was that IVM has lower success due to all the ''if'' factors before the transfer (will eggs mature, will they fertilize) but if fertilization was successful and embryos created then the success rate for implantation should be the same as IVF (they are all embryos after all, transferred the same way). A I correct or does IVF produce better sticking / quality embryos?
Sorry for such a long comment, IVM is still such a new practice and there seems to be such limited resources out there. Thanks for taking the time to read this and comment is you think you can

Reply
Geoffrey Sher, MD says:

July 19, 2011 at 3:16 pm

I will be able to provide you with a lot of valuable information at the conclusion of a very intensive and detailed study we are now involved in.

We are looking closely at number of immature eggs derived per patient at drug free ER, the chromosomal integrity (CGH determined) of IVM-derived eggs, their subsequent freezability (by vitrification), their post-thaw survival rate and fertilization potential, the blastocyst generation rate and the baby rate per transfer of blastocysts derived from chromosomally normal IVM eggs.

The study should be over by October 2010.

I suggest you call 702-699-7437 and set up a free consultation with me to discuss this, then. Until this is concluded, I am afraid it is not possible for me to answer your valid and highly relevant questions.

Geoff Sher

Reply
Vee says:

July 20, 2011 at 9:38 pm

Thank you, I would love to meet you but I am based in Europe – I just happened to come across your site. Thanks for the advice and good luck with the study – I look forward to more info being made available on this!

Reply
Geoffrey Sher, MD says:

July 21, 2011 at 10:01 am

You are most welcome Vee!

Good luck!

Geoff Sher

Reply
D B says:

December 11, 2012 at 11:35 am

Hi,

Has there been any updated to the IVM treatment since the study was completed? Success rates? Etc…

Thanks in advance for any feedback.

Reply
- Geoffrey Sher says:
  
  December 11, 2012 at 9:26 pm
  
  I am afraid the results were disappointing.
  
  Geoff Sher
  
  Reply
capucine says:

March 13, 2013 at 7:51 pm

Hello!
I had an attempt of IVF in January which did not work . Do you think IVM could be a solution for me : I have very high level of FSH , irregular cycles , small ovaries but 2 to 3 follicles seen in each regularly …My ovaries do not react properly for unexplained reasons . I am 35 . Thank you for your advice

Reply
- Geoffrey Sher says:
  
  March 13, 2013 at 9:43 pm
  
  Frankly, in my opinion, results with IVM have been disappointing.
  
  Geoff Sher
  
  Reply
  - Pav says:
    
    April 14, 2013 at 10:35 pm
    
    Hello Doctor,
    I’m 26 yrs PCOS anovulatory patient.
    I had 4 failed IUIs and 3 failed IVF’s. I was advised IVM due to poor response to Gonal-F , the follices grow well, but the oocytes retrieved are of poor quality.
    Last month, I underwent an IVM cycle that failed , 14 immature oocytes retrieved, 8 mature after 24hrs, 8 fertilized with ICSI, day 3 embryo transfer one 5 cell grade 1 (good morphology, equal size blastomeres,no fragmentation), one 6 cell Grade 2(slight fragmentation) and two 4 cell grade 2, Endometrium thickness on the day of transfer 8mm.
    beta HCG was negative.
    This cycle, we are going to freeze the embryo’s obtained from IVM on day 2 and transfer it in the next cycle to ensure optimim endometrium thickness.
    Please advise your opinion on the same.
    If you can share the info,I would like to know at what stage were the results disappointing in your IVM study?
    Regards
    
    Reply
    - Geoffrey Sher says:
      
      April 14, 2013 at 10:39 pm
      
      We should talk. I need much more information to be of help.Call 800-780-7437 and please set up a Skype consultation.
      
      Geoff Sher
      
      Reply

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