Embryos from in Vitro Maturation (IVM) Technique Can Be Successfully Vitrified Resulting in the Birth of a Healthy Child

Abstract

IVM can be an advantageous technique when applied to PCOS (Polycystic Ovarian Syndrome) patients. The oocytes are retrieved from antral follicles of non-stimulated ovaries, specially preventing hyperstimulation syndrome. Apart from its role as a reproductive treatment, IVM has emerged as a promising tool for emergency fertility preservation, since it can be performed flexibly in either follicular or luteal phase. A 34-year-old patient with PCOS, high body mass index and tubal factor was submitted twice to IVM treatment. Her husband has low count spermatozoa. The first IVM cycle was in 2009, she transferred 3 fresh embryos and got pregnant giving birth to a healthy boy weighing 3.3 kg. In 2013, the patient returned for another IVM cycle and the embryos had to be vitrified because she failed to develop an adequate endometrium for transfer. In the next cycle, the endometrium was prepared using estrogen and progesterone and the two best embryos were warmed up and transferred. She became pregnant and after 36 weeks gave birth to a healthy girl weighing 2.7 kg. She still has four embryos left to transfer. IVM may be an alternative technique to be considered when dealing with PCOS patients. Although clinical outcomes are currently inferior when compared with conventional hormone driven ART (Artificial Reproductive Techniques), it does apply in some cases while preventing hyperstimulation risks. Thus, embryos obtained by IVM can also be vitrified with successful outcomes.

Vitrification of human immature oocytes before and after in vitro maturation: a review

“…It is of note that the birth of a healthy child has been successfully obtained after the implantation of vitrified/warmed embryos obtained by IVM in a PCOS patient [57].…”

In vitro maturation of human immature oocytes for fertility preservation and research material

“…It is used clinically primarily to avoid ovarian hyperstimulation syndrome (OHSS), as well as to decrease the costs that are associated with ovarian stimulation, when performing in vitro fertilization . Over 4000 babies have been born by assisted reproductive technology (ART) by IVM and these children have manifested no health problem . The incidence of anomalies is not elevated among babies born by IVM, although the possibility must be considered that oocyte methylation is altered during the maturation process .…”

“…Furthermore, the rate of chromosomal abnormality is higher in blastocysts that are obtained from IVM than in blastocysts that are obtained from conventional ART . As mentioned above, babies born following IVM are reported to be healthy, but long‐term follow‐up is also necessary …”

“…4 Over 4000 babies have been born by assisted reproductive technology (ART) by IVM and these children have manifested no health problem. 5,6 The incidence of anomalies is not elevated among babies born by IVM, although the possibility must be considered that oocyte methylation is altered during the maturation process. 7 In addition, the IVM procedure facilitates the salvage of immature oocytes.…”

Advances in the Treatment and Prevention of Chemotherapy-Induced Ovarian Toxicity

“…Over 4000 babies have been born by assisted reproductive technology (ART) using IVM, mainly in women with PCOS and no increase in congenital defects or developmental delays due to IVM have been reported [ 118 , 119 ]. There are now a number of case reports of IVM success and live births in women with cancer, using IVM culture following ex vivo collection of immature oocytes after an oophorectomy [ 120 , 121 ].…”