Pennsylvania IVF and Infertility - Dr. Bruce Rose of Infertility Solutions, P.C.
IVM, or in vitro maturation, is a new extension of IVF which is easier
for a patient to undertake than IVF.
With traditional IVF a patient is treated with injectible medications for 10-12 days in order to get follicle cysts containing eggs to grow in her ovaries. This growth is monitored with ultrasound examinations and blood tests approximately every other day during this time period. The objective is to be able to remove as many mature eggs as possible from the patient’s ovaries. Only the mature eggs can be fertilized (with insemination or with ICSI). Fertilized eggs are then grown in media in the laboratory for a few days and eventually the best of the embryos are transferred in hopes of achieving pregnancy.
With IVM, immature eggs are aspirated from small follicular cysts that exist in the ovaries of most women of reproductive age. For our preferred version of IVM is a variation on natural cycle IVF. The ovaries are not treated with any gonadotropins to get the follicles to develop. The immature eggs obtained during this aspiration procedure are then treated in the laboratory to enable them to mature. About 50% of them will do so and these are then fertilized using ICSI (the sperm are directly injected into the eggs to cause fertilization). The rest of the procedure is the same as with routine IVF.
With IVM, the lining of a woman’s uterus is treated with oral estrogen as needed and evaluated by ultrasound before proceeding with an egg aspiration. Egg aspirations are done in the office while the patient is under conscious sedation. The transfer of the best embryos occurs a few days later and can also be scheduled in advance.
IVM is a new tool that augments our other infertility treatments. If patients don’t have many small follicular cysts (antral follicles) in their ovaries, then IVF is likely to be a better procedure for them than IVM. However, If a patient has a large number of antral follicles (such as our younger patients and patients with PCO- polycystic ovaries), IVM is a good procedure to do before trying IVF since the side effects of IVM are lower and the process is much easier.
Since we always do ICSI (where individual sperm are injected into eggs) as a part of the IVM procedure, almost all male factor issues can be compensated for with IVM.