The percentage of success with IVF procedures is directly linked with the number of transferred sound embryos. Modern IVF procedures use high doses of gonadotropic hormones to stimulate ovarian structures and hence produce a multiplicity of follicles and therefore egg cells and embryos. The price patients pay for this, both literal and metaphorical, is significant.
Some women who are sensitive to exogenous gonadotropic stimulation are at a high risk of developing ovarian hyperstimulation syndrome (OHSS) and of being hospitalised in some 2 to 3 per cent of cases. Acute OHSS might lead to complications such as lung thromboembolism, kidney failure, respiratory distress (ARDS) and even death in extremely rare cases.
The possible future side effects on the organism and the reproductive system after gonadotropin application are yet to become known, however. A number of authors propose the hypothesis that, in certain cases, lower degrees of implantation in sound embryo transfer reflect reduced uterine lining receptivity caused by hyperphysiological hormonal levels during stimulation. Also of concern is the circumstance that frequent stimulation might, in the long term, lead to risk of ovarian and endometrial cancer and particularly of breast cancer. Moreover, it is unclear whether many stimulations would not lead to an early depletion of the ovarian reserve.
For these reasons, medics are studying and debating alternatives to infertility treatment through assisted reproductive techniques (АRТ). In vitro maturation of immature egg cells (IVM) is a potential treatment which eliminates the above risks.
IVM can be applied to all forms of infertility, without the need for hormonal stimulation.
IVM may be applied as the first course of action prior to gonadotropin stimulation, making the sequence of treatment as follows: intrauterine insemination (IUI) ‑> in vitro maturation (IVM) ‑> stimulated IVF cycle.
The benefits of in vitro maturation (IVM)
- Reduced patient risk (zero risk of OHSS);
- Shorter treatment;
- Reduced financial outlay;
- Ethically, where the male partner is infertile, IVM treatment is fairer to the female partner.
When is IVM Treatment Suitable?
- With women with a high risk of ovarian hyperstimulation syndrome (OHSS);
- With women with a history of ovarian hyperstimulation syndrome (OHSS);
- With women with polycystic ovary syndrome (PCOS);
- With younger, taller and slimmer women with polycystic ovary structures;
- In all cases when IVF treatment is necessary;
- With women suffering from certain malignant conditions which require urgent chemotherapy treatment;
- With women suffering from conditions such as active systemic lupus erythematosus and certain types of breast cancer, where raising blood oestrogen levels is counter indicated.
Children born after IVM
Published data show that the proportion of congenital malformations does not increase among children born after IVM, compared to those born after IVM and ICSI procedures.