Clinical procedures for in vitro maturation treatment

Area of Science:

• Reproductive Endocrinology
• Assisted Reproductive Technologies

Background:

• In vitro maturation (IVM) is a valuable technique for oocyte maturation, particularly for patients with high ovarian reserve or those at risk of ovarian hyperstimulation syndrome.
• Standard IVM protocols often involve minimal or no ovarian stimulation, making it an attractive option for specific patient populations.

Purpose of the Study:

• To demonstrate and standardize clinical techniques for in vitro maturation (IVM) treatment.
• To provide guidance on ovarian stimulation, oocyte retrieval from small follicles, and the identification of compact cumulus-oocyte complexes (COCs).

Main Methods:

• Utilizes live-action surgical and embryology footage to illustrate a representative IVM cycle.
• Details step-by-step procedures for COC extraction, including needle selection, aspiration techniques, and ultrasound guidance.
• Demonstrates oocyte search and preparation, focusing on filtering follicular aspirate and identifying viable COCs for maturation.

Main Results:

• Successful IVM treatment is achievable with minimal ovarian stimulation, effective retrieval of oocytes from small follicles, and efficient identification of compact COCs.
• The approach allows for flexibility based on clinical constraints and individual center preferences.

Conclusions:

• In vitro maturation (IVM) is an efficacious and safe treatment for women with high ovarian reserve undergoing IVF.
• IVM enables the retrieval and maturation of multiple immature oocytes with minimal in vivo stimulation, offering an alternative to conventional IVF.
• Standardized techniques and practice recommendations can help expand the application of IVM across different fertility centers.