How to collect immature oocytes from small antral follicles for the Saigon biphasic in vitro maturation protocol

To provide a detailed description of the clinical procedure for aspirating small antral follicles (2.0-8.0 mm) as part of the Saigon biphasic in vitro maturation (IVM) protocol. This includes indications for the procedure, patient and equipment preparation, the aspiration process, laboratory techniques for identifying cumulus-oocyte complexes (COCs), and the timing for embryo transfer.

This instructional video presents real-time footage of clinical procedures and embryology practices. It offers step-by-step guidance and practical recommendations for conducting a gonadotropin-free biphasic IVM cycle, also known as capacitation-IVM (CAPA-IVM).

Patients undergoing IVM treatment. All individuals featured in the video have provided informed consent for its publication and online distribution, including on social media, journal websites, scientific platforms, and other relevant platforms.

The video includes an introduction and patient consent process; indications for IVM; timing of oocyte aspiration, patient and equipment preparation, including types of aspiration needles; potential technical and clinical complications; timing for fresh embryo transfer; visual demonstration of the aspiration procedure, including ultrasound guidance, needle pressure, flushing, and aspiration technique; and laboratory demonstration of oocyte search and IVM preparation, including filtration of follicular aspirate and identification/classification of compact COCs.

Clinical techniques for immature oocyte retrieval and compact COCs identification for the gonadotropin-free CAPA-IVM protocol.

Numerous viable COCs can be retrieved successfully using the oocyte retrieval techniques outlined for gonadotropin-free CAPA-IVM. The video demonstrates an efficient and flexible approach to identifying compact COCs, adaptable to various clinical conditions. Embryo transfer subsequently may be performed as either a fresh or frozen cycle, depending on the patient's choice.

(s): In vitro maturation is a safe and effective treatment option for eligible patients, particularly those with high ovarian reserve or polycystic ovary syndrome. This technique enables the retrieval of multiple immature COCs without ovarian stimulation. The procedures outlined may differ from those used in other centers, offering a standardized approach for collecting COCs from small follicles for IVF and gamete banking. The Saigon protocol, which combines gonadotropin-free CAPA-IVM with fresh embryo transfer, underscores the clinical potential of IVM as a practical alternative to conventional stimulation protocols.