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Invitro maturation

It is known that the success rate in IVF procedures is directly related to the number of good quality transferable embryos. When using modern IVF protocols, high doses of gonadotropic hormones are used to stimulate the ovarian structures, as a result of which many follicles, respectively eggs and embryos are formed. Not to be overlooked, however, is the price that patients pay for it – literally and figuratively. Some women are hypersensitive during stimulation with exogenous gonadotropins and they have an increased chance of development of ovarian hyperstimulatory syndrome (OHSS), which leads to hospitalization in about 2-3% of cases. Severe forms of OHSS sometimes cause complications such as pulmonary embolism, loss of renal function, peptic ulcer and cerebral palsy. On the other hand, there are still no known possible future side effects in the healthy state of the organism and the productive system. The fact that during frequent stimulations, in the indefinite future, there is a risk of ovarian and endometrial carcinoma and obesity will also be a concern. In addition, it is not clear whether the amount of stimulation would not lead to complete depletion of the ovarian tract.

Invitro maturation (IVM)  is an innovative infertility treatment designed to provide a safer and cheaper alternative to traditional invitro treatment. Invitro maturation is a relatively new procedure, similar to invitro fertilization, but there are some significant differences. In classical invitro fertilization, medications are used to bring the patient’s eggs to maturity before they are removed from the ovary. In invitro maturation, drugs are not used, and the eggs are extracted from the ovary in an immature stage of development and brought to maturity (maturation) in the laboratory.

Immature eggs are extracted from unstimulated or minimally stimulated ovaries under ultrasound control. Then, the immature eggs mature in the laboratory for 24-48 hours, using special culture media to which small amounts of hormones are added. Intracytoplasmic sperm injection (ICSI) is used to fertilize the mature eggs. The resulting embryos are transferred to the patient’s uterus.

In which cases IVM treatment is reccomended?

  • Women at high risk of ovarian hyperstimulation syndrome (OHSS);
  • Women with ovarian hyperstimulation syndrome (OHSS);
  • Cases of polycystic ovary syndrome (PCOS);
  • Young, tall and thin women with polycystic ovary structures.

Are there any risks?

Risks to women’s health are reduced compared to the classic invitro procedure. Regarding genetic risks, published data show that the percentage of congenital malformations in children conceived after IVM does not increase compared to children conceived by IVF and ICSI procedures.

Use of the IVM method in Bulgaria

Invitro Clinic ”SOFIA” is the first Bulgarian reproductive clinic, which began to study and apply the method of in vitro maturation in our country. The first baby conceived by in vitro maturation was born on February 20, 2008. Dr. Yavor Vladimirov reports on the Bulgarian experience at the first European IVM Congress, which took place in Monza, Italy at the end of 2008.