Clinical Indications for IVM

Ovarian Hyperstimulation Syndrome (OHSS)

Human IVM remains employed in select clinical cases although the indications for its use have greatly expanded over time. Historically, IVM was considered for women particularly sensitive to the gonadotropins used in controlled ovarian stimulation (COS) protocols, and thus for women at risk for ovarian hyperstimulation syndrome (OHSS), an iatrogenic complication that can be life threatening [3]. Since either minimal or no gonadotropin stimulation is used for the retrieval of immature oocytes, IVM can prevent OHSS. While IVM can prove useful in patients at risks for OHSS, it isn’t the most common recourse for treatment: likely due to the current limitations associated with IVM (see other sections). Other OHSS preventive strategies are thus under investigation and measures include the cryopreservation of oocytes or embryos, stimulation with GnRH antagonists, or the use of GnRH agonists and kisspeptin [4, 5], although none of these hormone-based strategies may ever eliminate the risk of OHSS altogether. Lastly, improvements in the identification of patients at high risk for OHSS [6] will help tailor the best treatment strategy, which may include IVM - perhaps increasingly so if the success of IVM advances further.

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