In vitro maturation 2.0: a new era for an underdog in ART.

Area of Science:

• Reproductive Biology
• Assisted Reproductive Technologies
• Oocyte Physiology

Background:

• In vitro maturation (IVM) is an underutilized assisted reproduction technique.
• Limited clinical adoption due to lower embryo development and live birth rates compared to in vitro fertilization (IVF).

Purpose of the Study:

• To review recent advances in IVM protocols and their potential to overcome previous limitations.
• To assess the clinical utility and safety of IVM for selected patient populations.

Main Methods:

• Review of recent innovations in IVM, including biphasic Capacitation (CAPA) systems and induced pluripotent stem cell-derived ovarian somatic support cells (iPSCs).
• Analysis of clinical studies comparing IVM outcomes with conventional IVF.
• Evaluation of safety data regarding genetic and epigenetic outcomes in IVM-derived offspring.

Main Results:

• Recent advances aim to better replicate the follicular environment and enhance oocyte competence.
• IVM shows modestly lower cumulative live birth rates than IVF but offers advantages for specific patients (PCOS, high reserve, fertility preservation).
• Evidence supports the genetic and epigenetic safety of offspring conceived via IVM.

Conclusions:

• Optimized IVM protocols are improving oocyte competence and clinical outcomes.
• IVM presents a viable, safer, and less invasive alternative for selected individuals undergoing fertility treatments.
• Continued refinement and education will expand IVM's role in assisted reproduction.