When a woman undergoes IVF (In Vitro Fertilisation), we usually administer gonadotropin medications to enable us to retrieve multiple eggs to facilitate the IVF process. These eggs are then collected before they are released from the ovary, and are then united with sperm in the laboratory for fertilization process to happen to create the embryo.
In some cases, some or all of the oocytes (eggs) that are collected are not mature and ready to be fertilized. Previously, if the eggs were immature, we were not able to use these eggs for IVF.
At MotherToBe, our expert embryologists take these immature eggs and mature them in vitro (in the laboratory). This is called IVM. The resultant mature eggs are then fertilised using a process called ICSI to facilitate fertilisation. The embryos are then either replaced or frozen for later use.
IVM can prevent ovarian hyperstimulation syndrome (OHSS) and can be considered primarily for women with polycystic ovary syndrome (PCOS) or PCO- like ovaries. These women are at greatest risk of OHSS.
OHSS is an exaggerated response to medicines used to induce ovulation, especially after the use of injectable gonadotropin agents when hCG is used for final follicular maturation. However, using different medication for final follicular maturation called GnRH agonist instead of hCG greatly reduces this risk and can be used as an alternative to IVM.
IVM may also be appropriate in women where there is no scope to get fully mature eggs before cancer treatment begins.
In cases of estrogen-sensitive cancers, IVM avoids the additional estrogen production that happens with conventional ovarian stimulation.
This process of retrieving immature eggs for later use is a way for these women to preserve their ability to have a child later.
IVM requires less medication than conventional IVF and lowers the immediate cost of treatment; however, the pregnancy rates are also lower. An IVM cycle also takes less time.
In general in IVM, no medications are given to stimulate additional eggs to grow; immature eggs are taken from unstimulated ovaries. However, in a modified IVM cycle, low-dose injectable medications may be given.
However, clinical studies have shown that low-dose ovarian stimulation for removal of immature eggs may yield more eggs and improve the lining of the uterus to receive the embryo.
At MotherToBe we offer this treatment in situations, particularly when conventional IVF is not possible as an alternative treatment. The immature oocytes obtained at the time of conventional IVF are matured in the laboratory and used for the IVF process in certain couples.