In-Vitro-Maturation

Nicole Wendler holds a PhD in biology in the field of oncology and immunology. As a medical editor, author and proofreader, she works for various publishers, for whom she presents complex and extensive medical issues in a simple, concise and logical manner.

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With in-vitro maturation (IVM), the egg cells do not mature in the woman's body (i.e. in the ovaries), but in the test tube before they are artificially fertilized. The procedure is supposed to put less strain on the female body, as there is no need for extensive hormone therapy. Here you can read everything you need to know about the implementation and the chances of success of the in-vitro maturation.

What is the In-Vitro Maturation?

In-Vitro-Maturation is a relatively new procedure and not yet established as a routine procedure. Immature egg cells (oocytes) are removed from the ovaries and hormonally driven in the test tube for further maturation. If this succeeds, these cells are available for artificial insemination.

The idea behind IVM is not to expose the woman's entire body to the hormone preparations for a long time in order to stimulate the ovaries and then to obtain mature egg cells, but only the previously isolated egg cells.

How does the in-vitro maturation work?

Before the reproductive medicine specialist removes egg cells for IVM, the ovaries usually do not need to be stimulated with hormones, or only very briefly. The collection takes place between the 8th and 10th day after the menstrual period. At this point in time, the egg cells are still in an immature stage. Only in a test tube in a nutrient solution do the cells receive the hormones (hCG and FSH) they need to mature.

Once the egg cells have matured sufficiently under laboratory conditions (approximately after 24 to 48 hours), they can be fertilized with the partner's semen. This is usually done using ICSI (Intracytoplasmic Sperm Injection). If the artificial insemination is successful, the doctor inserts the embryo into the uterus. Cryopreservation of the successfully fertilized egg cells for a later desire for children is also possible.

The IVM puncture - i.e. the removal of immature egg cells - is usually more complicated, requires significantly more experience and therefore usually takes twice as long as an egg retrieval after hormonal stimulation, as it takes place with IVF (In Vitro Fertilization) .

For whom is an in-vitro maturation suitable?

The method is suitable for women who cannot tolerate high levels of hormones. This is particularly the case with polycystic ovaries (PCO syndrome) - hormone treatment carries the risk of overstimulation syndrome. IVM is also well suited for women up to around 37 years of age.

In addition, due to the short therapy cycles, the method is particularly interesting for tumor patients immediately before chemotherapy or radiation, when there is no time left for a long hormone treatment with subsequent removal of mature egg cells. With in-vitro maturation, immature egg cells - for example from previously removed and frozen ovarian tissue - can be brought to maturity after cancer has been successfully overcome, artificially fertilized and then used in the woman.

In-Vitro Maturation: Chances of Success

Although around 5,000 children were born after IVM by 2014, there are still no reliable figures for the success rate after an in-vitro Maturation. Basically, it can be said that the implantation and birth rates after in-vitro maturation are significantly worse than with other methods of artificial insemination (IVF / ICSI). The information varies depending on the study: between 3 and 27 percent of women per cycle should become pregnant after IVM.

Advantages and disadvantages of in-vitro maturation

The great advantage of in-vitro maturation is the lower hormonal load for women and the significantly shorter therapy cycles. Even if the puncture of the cells requires better ultrasound equipment and an experienced doctor, IVM is generally considered to be safe to perform.

In practice, however, several cycles are usually necessary before success is achieved. And since in vitro maturation is not yet a standard procedure, the health insurance companies do not cover the costs. If several attempts are necessary, it can be quite expensive for a couple.

IVM pregnancy rates are now as good as those of conventional in vitro fertilization. Although the accelerated in-vitro maturation could have negative effects, no increased malformation rates have been reported so far. There is now a 2-year follow-up that showed no disadvantages of in vitro maturation (IVM) compared to in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with regard to the mental development of the children.

In the case of special risk constellations such as polycystic ovarian syndrome (PCO) or a woman up to 37 years of age, in-vitro maturation has now become a tried and tested method.

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