In Vitro Maturation of Human Oocytes: Current Practices and Future Promises
Catherine M.H. Combelles
BiologyDepartment, Middlebury College, Middlebury, VT, USA
The in vitro maturation (IVM) of oocytes entails the retrieval of immature oocytes that, upon release from the follicle, spontaneously resume meiosis from prophase-I arrest. The in vitro matured oocyte (now in metaphase-II arrest) may be fertilized and used for clinical treatment. Following the first human birth from in vitro matured oocytes , ART clinics began offering IVM as a clinical option in the 1990s. IVM remains a technique deemed experimental by the American Society for Reproductive Medicine , although its clinical utility is evident. At this point, the efficacy and safety of IVM remains to be established so that it can become a mainstream treatment. When compared to conventional IVF, there are numerous advantages to IVM, including cost-effectiveness, reduced risks, and overall patient-friendliness (including less intense monitoring).
The success of IVM can exceed 30% pregnancy rates, but rates vary greatly across the wide range of patient characteristics and protocols (stimulation, oocyte retrieval, embryo transfers, etc.). In select patient populations, IVM has begun to prove favorable over conventional IVF (e.g., polycystic ovary syndrome) but this isn’t yet applicable across all patient types and circumstances. Currently, there isn’t a standardized IVM system either; on the contrary, the relative infancy of the field and the dire need for optimization have led to the use of many different approaches and protocols. In this chapter, aspects that are critical
Human Reproduction: Updates and NewHorizons, First Edition. Edited by Heide Schatten. © 2017 John Wiley & Sons, Inc. Published 2017 by John Wiley & Sons, Inc.
and unique to IVM treatment are presented, along with a discussion of specific areas in need of attention.