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A fresh start for IVM: capacitating the oocyte for development using pre-IVM
Robert B Gilchrist1, Tuong M Ho2, Michel De Vos3,4
1Fertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine, University of New South Wales Sydney, NSW, Australia.
Human Reproduction Update
|August 28, 2023
Summary
Recent advances in in vitro maturation (IVM) include biphasic approaches, utilizing pre-IVM culture for immature oocytes. This novel technique shows promise for improving ART outcomes, especially for patients with PCOS.
Area of Science:
- Reproductive biology and assisted reproductive technologies (ART).
- Oocyte biology, maturation, and developmental competence.
- Follicular development and ovarian stimulation protocols.
Background:
- In vitro maturation (IVM) of oocytes has not achieved widespread clinical adoption globally.
- Recent breakthroughs in animal oocyte biology have spurred novel IVM approaches.
- Biphasic IVM, involving a pre-IVM step, is a significant recent advancement.
Approach:
- Collect immature oocytes from small antral follicles without hCG priming.
- Perform a pre-IVM culture (∼24 hours) in an advanced system to enhance oocyte development.
- Follow with standard in vitro fertilization (IVF) procedures.
Key Points:
- Pre-IVM aims to improve developmental competence of oocytes from minimally stimulated cycles.
- Pre-IVM induces cellular changes in cumulus cells to support oocyte needs.
- Capacitation-IVM (CAPA-IVM), a pre-IVM method, has shown preclinical safety and efficacy.
Conclusions:
- Biphasic IVM, exemplified by CAPA-IVM, offers a low-intervention, patient-friendly ART alternative.
- Clinical results with CAPA-IVM demonstrate live birth rates comparable to conventional IVF.
- This approach holds potential for PCOS patients, fertility preservation, and social oocyte freezing.
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