Using in vitro matured eggs in treatment In vitro maturation by tracy12


									Using in vitro matured eggs
in treatment
In vitro maturation (IVM) is the process
whereby eggs are collected when they
are still immature, and then matured in
the laboratory before being fertilised
with sperm.

What is involved in IVM?                                  If the woman does not have any fertility problems
                                                          (which might also be the case for single women using
Eggs are collected from the woman just as in              donor sperm), IVM could be
conventional IVF, but at an earlier stage, when they      considered as a way of reducing the need for follicle-
are immature. This means that you do not need to take     stimulating drugs.
as many ovary-stimulating hormones before your eggs
are collected, because they are collected at an earlier   Because the eggs are immature when they are
stage in their development.                               collected, it is likely that fewer eggs will be collected
                                                          than in a conventional IVF cycle. There is also a risk
Instead of maturing in your body before being             that not all the eggs will mature sufficiently to be
collected, the eggs are matured ‘in vitro’ in an          fertilised with your partner’s or a donor’s sperm.
incubator for one to two days. When they are mature,
they are fertilised with your partner’s (or a donor’s)    Are there any risks with IVM?
sperm, and replaced in your womb, just as they
would be with conventional in vitro fertilisation (IVF)   A clinic suggesting IVM should be doing so because
treatment.                                                they consider that your susceptibility to OHSS, if you
                                                          were to take the drugs and hormones involved in
Who might benefit from IVM?                               conventional IVF, is higher than average. If your clinic
                                                          offers this technique, they should provide you with
IVM could be an alternative to conventional IVF,          detailed information about why they think it is beneficial
especially for women with polycystic ovaries or           to you.
polycystic ovarian syndrome who may be more
susceptible to developing ovarian hyperstimulation        The HFEA’s Scientific and Clinical Advances Group
syndrome (OHSS) during treatment.                         has concluded that there are no studies on IVM which
                                                          suggest that the technique is dangerous to you and
OHSS is an excessive ovarian response to ovary-           there is no evidence of harm to the children who have
stimulating hormones which, in extreme cases, can be      been born following this treatment.
life-threatening (see Further reading).
                                                          However, in vitro maturation is still a relatively new
IVM could also be an option for couples where the         technique. To date (January 2007), about 300 children
cause of infertility has been identified as being male    have been born worldwide following immature egg
factor only.                                              retrieval and in vitro maturation. This means there is
                                                          insufficient evidence to be absolutely certain about the
                                                          safety of IVM at present.

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The number of children born is small and they are still     The HFEA encourages any clinic offering this
very young, so no long term follow up studies on these      treatment to ask patients if they will allow children born
children have been carried out. The HFEA will continue      as a result of IVM to take part in long-term follow-up
to monitor the safety of this technique.                    studies.

Long-term follow-up studies are required to determine       A clinic offering this treatment will have demonstrated
if there are any possible effects of using this technique   to the HFEA that they have expertise in maturing eggs
in treatment services.                                      in the laboratory before being granted a licence to offer
                                                            this treatment to patients.

    Useful contacts
    Infertility Network UK                                  3. Le Du A, Kadoch IJ, Bourcigaux N, Doumerc
    Charity providing practical and emotional support          S, Bourrier MC, Chevalier N, Fanchin R, Chian
    for people experiencing difficulties in conceiving.        RC, Tachdjian G, Frydman R, Frydman N: In Tel: 08701 188 088            vitro oocyte maturation for the treatment
                                                               of infertility associated with polycystic ovarian
    Fertility Friends                                          syndrome: the French experience. Human
    Fertility Friends is an online meeting place for the       Reproduction 2005; 20(2):420-424
    UK fertility community which aims to help people
    through the difficult process of assisted conception    4. Emery BR, Wilcox AL, Aoki VW, Peterson
    by sharing thoughts, experiences and knowledge             CM, Carrell DT: In vitro oocyte maturation and
    with others.                                               subsequent delayed fertilization is associated                                 with increased embryo aneuploidy.
                                                               Fertility and Sterility 2005; 84(4): 1027-1029

    Further reading                                         5. Mikkelsen AL, Smith SD, Lindenberg S: In-
                                                               vitro maturation of human oocytes from
     1. Info about risks for IVF, including OHSS, on           regularly menstruating women may be
        HFEA website and in Guide (page 24)                    successful without follicle stimulating hormone
     2. Papanikolaou EG, Platteau P, Albano C,                 Human Reproduction 1999 Jul;14(7):1847-51
        Nogueira D, Cortvrindt R, Devroey P, Smitz
        J: Immature oocyte in-vitro maturation: clinical    6.	 Chian	RC,	Lim	JH,	Tan	SL:	State	of	the	art	in-	 	
        aspects.                                            	 vitro	oocyte	maturation.	
        Reproductive medicine online 2005; 10(5):           	 Curr	Opin	Obstet	Gyecol.	2004;	16(3):211-219

                                                                                        Last updated on: 31/01/2007

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