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IVM – In Vitro Maturation Explained

IVM (In Vitro Maturation) is an advanced assisted reproduction technique in which immature egg cells are retrieved and matured outside the body in a laboratory. It is a gentler alternative to conventional IVF.

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Things worth knowing about "IVM"

IVM (In Vitro Maturation) is an advanced assisted reproduction technique in which immature egg cells are retrieved and matured outside the body in a laboratory. It is a gentler alternative to conventional IVF.

What is IVM (In Vitro Maturation)?

In Vitro Maturation (IVM) is an assisted reproductive technology (ART) in which immature egg cells (called oocytes) are retrieved from a woman´s ovaries and then matured in a specialized laboratory environment outside the body. The term comes from the Latin in vitro, meaning roughly in glass (i.e., outside the living organism), and maturation, referring to the ripening process of the egg cell.

IVM differs from conventional In Vitro Fertilization (IVF) primarily in that little or no hormonal stimulation of the ovaries is required. In standard IVF, the ovaries are intensively stimulated with hormones to produce as many mature eggs as possible. With IVM, the final maturation of the eggs takes place in the laboratory rather than inside the body.

How Does the IVM Process Work?

An IVM treatment cycle typically involves several key steps:

Retrieval of immature eggs: Using a vaginal ultrasound probe and a fine needle, immature egg cells are collected from the ovarian follicles in a procedure called follicle aspiration.
Laboratory maturation: The retrieved immature oocytes are placed in a specially formulated culture medium and incubated at body temperature until they reach the maturity needed for fertilization. This process usually takes 24 to 48 hours.
Fertilization: Once matured, the eggs are fertilized with sperm, either through conventional insemination or via intracytoplasmic sperm injection (ICSI).
Embryo transfer: After a few days of development, the resulting embryo or embryos are transferred into the woman´s uterus.

When is IVM Used?

In Vitro Maturation is particularly well suited for certain patient groups:

Women with polycystic ovary syndrome (PCOS), who are at elevated risk for ovarian hyperstimulation syndrome (OHSS) when treated with conventional hormonal stimulation.
Women wishing to preserve their fertility before undergoing chemotherapy or radiotherapy (fertility preservation).
Women for whom hormonal stimulation is medically contraindicated or undesirable, such as those with hormone-sensitive cancers.
Women who respond poorly to conventional ovarian stimulation protocols.

Advantages of IVM

Reduced OHSS risk: Because little or no hormonal stimulation is required, the risk of ovarian hyperstimulation syndrome is significantly lower.
Lower physical burden: Fewer or no hormone injections translate into a reduced physical and emotional burden for the patient.
Shorter treatment duration: Preparation for IVM is generally faster than for a conventional IVF cycle.
Potential cost savings: Reducing or eliminating expensive hormone medications can lower the overall cost of treatment.

Success Rates and Limitations

On average, IVM success rates are somewhat lower than those of conventional IVF, as the quality of oocytes matured in the laboratory can vary. However, studies show that in suitable candidates, particularly women with PCOS, acceptable pregnancy rates can be achieved. The technique is continuously being refined, and outcomes are steadily improving.

It is important that IVM is performed in specialized reproductive medicine centers equipped with appropriate laboratory facilities and experienced personnel. An individual consultation with a reproductive medicine specialist is essential to determine whether IVM is the right approach for a given patient.

References

Chian R-C, Uzelac PS, Nargund G. - In vitro maturation of human immature oocytes for fertility preservation. - Fertility and Sterility, 2013.
Walls ML, Hart RJ. - In vitro maturation. - Best Practice and Research Clinical Obstetrics and Gynaecology, 2018.
European Society of Human Reproduction and Embryology (ESHRE) - Guidelines on Ovarian Stimulation, 2020. Available at: www.eshre.eu

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