Ever since the 1930s, science and medicine have been searching for an effective way to collect immature eggs from the ovaries and mature them in the lab so they can be successfully fertilized. In Vitro Maturation – or IVM – has captured the imaginations of various researchers but results to this point have never been reliable or consistent. Over the years there have been scattered successes, and one estimate is that there are 500 or so babies born this way. Unfortunately, results were so non-reproducible that few programs bothered with it – until now.
Researchers at Brown University report that their IVM technique has produced consistent pregnancy results. Overall, they believe that their IVM technique can achieve a success rate that is approximately 80 percent as strong as traditional In Vitro Fertilization (IVF) rates. Certainly this is great news for those patients who would most benefit from IVM – namely Polycystic Ovarian Syndrome (PCOS) and cancer patients.
Recently, the Fertility Partnership team was invited to Brown to undergo the training program necessary to bring IVM to our area. In fact, we already have patients who are ready to undergo our very first IVM procedures. We are looking forward to working with patients who understand IVM and want to be a part of this exciting process that may not only give them the baby they’ve been waiting for but also have a major impact on fertility care.
Why is IVM so attractive? There are a number of very good reasons.
Traditional IVF requires the use of strong and expensive “fertility drugs”(gonadotropins) and a long preparation process that lasts weeks before the mature eggs are retrieved in a process called “superovulation.” With IVM, the patient receives little or no stimulation meds, and the patient’s preparation for egg retrieval takes just a few days. The eggs get the fertility stimulation in the lab rather than in the woman’s body, requiring a tiny fraction of the amount of the drugs.
Why is this good and who does it help? When going through IVF, patients with PCOS may be at risk of superovulation and can develop a dangerous condition called Ovarian Hyperstimulation Syndrome (OHSS). PCOS patients represent 12-15 percent of the general population and 20-30 percent of IVF patients, so that means almost one-third of the women going through IVF are at risk for OHSS. Since IVM avoids hyperstimulation altogether, Ovarian Hyperstimulation Syndrome in PCOS patients is entirely avoidable.
IVM also provides a huge benefit to women diagnosed with cancer who want to preserve their fertility. These patients find out suddenly one day they have a disease such as leukemia or breast cancer and need (and want) treatment as soon as possible, but they quickly learn the treatments may destroy their ovarian function. They’re faced with a terrible choice – take the treatments that may save their life but leave them infertile, or avoid the cancer treatments and gamble with their life. Normally with IVF, we go ahead with the collection and freezing of eggs for later use, but this traditional approach delays their cancer treatment by several often critical weeks. IVM allows the eggs to be retrieved quickly - within just a few days; in fact, the retrieval probably is done before the work-up for the cancer is completed.
Perhaps the greatest feature of In Vitro Maturation is that it can potentially eliminate the danger of superovulation for everyone since patients do not need to be given daily injections of powerful and expensive medicines. This will end the need for women to inject large doses of hormones, and it also should dramatically reduce the cost of infertility treatments. IVM should cost one third of IVF with minimal medication costs, and I am looking forward to offering it as another option for our patients at Fertility Partnership.
