In Vitro Maturation By: Amna Ashiq

In Vitro Maturation

    

 There are so many types of technologies out there and they are very useful to many. One of the many technologies is In Vitro Maturation (IVM). In vitro maturation is a type of technology that is used to help infertile couples conceive a child. It was also developed so that there is a cheaper and safer fertility treatment.

 Before I go on talking about what in vitro maturation actually is, you’re going to have to understand what each word means. In vitro is Latin for “in glass”. In vitro is a biological process that occurs and is controlled in laboratories in an artificial environment that is outside the organism’s normal setting. Maturation means the act or the process of maturing. If I put that together, it basically means an organism maturing in vitro or in a glass. Now that I have broken down the word, it will be easier to further understand what the whole technology is all about.

In vitro maturation is a procedure where immature eggs are collected from the ovaries and are matured in the laboratory and it takes only one to two days (24-48 hours).

The procedure for IVM:

1)      Eggs are collected when they are immature (that is the earliest stage of the egg).

2)      In the laboratory, the eggs are matured in a dish and are placed in an incubator and it takes only 24-48 hours. Small amounts or sometimes no hormones are added.

3)      The eggs are fertilized with the partners or donors sperm once they are mature.

4)      The embryos are then transferred to the womb 2-5 days after fertilization.

Immature Oocyte immediately after retrieval 

Mature Oocyte after 36 hours of retrieval

An embryo created through IVM

IVM is the process that was initially developed on cows and other domesticated animals. Pincus and Enzmann had first followed this procedure in 1935. Later on, in 1965, R.G. Edwards had demonstrated IVM of human eggs. In 1991, the first human birth resulted because of IVM. After that, there had been many modifications and changes done to process of IVM so there can be more efficient and improved outcomes.

Since IVM is a new technique and has only been around for a decade, not many doctors and scientists have researched more into this process and because there’s not much research done, this technology is still considered to be experimental. The rates for IVM being successful and what the long-term impacts are still not understood clearly because it has not been around for a long time.Only 400 babies around the world have been born through IVM. 

During this process, not many eggs are collected because they are still immature and also if they do get collected, the eggs sometimes don’t get fertilized by the partners or donors sperm because they haven’t matured. The eggs collected have to handled very carefully because they are not mature eggs and are very sensitive. Also, there can be a problem for the sperm to penetrate the eggs because the outer layer of the eggs can become very tough. The implantation rates through IVM are quite low. IVM does not guarantee 100% results.  Another factor that is not making IVM successful is the woman’s age. A normal 35 year old woman can expect 32 % success rates with IVM. Like other fertility treatments, IVM is not guaranteed.

Just like any other fertility treatment, IVM is not meant for all the women. Women that usually succeed from IVM are :

• women who have a higher risk of having ovarian hyperstimulation syndrome (OHSS) and also including women with polycystic ovarian syndrome (PCOS)
• women with normal menstrual cycle 
• women who are younger

 Women below the age of 35 hold a better likelihood of carrying many eggs so their success rates are higher. There is a 60-70% chance of collecting the immature eggs and then maturing them,  65-75% chance of fertilizing them, 10% chance of implanting the fertilized eggs in the womb and 20-30% chance of the women getting pregnant. Since the implantation rates are lower, there is not a high chance of the woman getting pregnant. The average clinical results of IVM are:

• about 350 cycles
• egg maturation : 80%
• clinical pregnancy rate : 33.3%
• live births : 70

IVM does not require alot of fertility medication which lowers your risk of having ovarian hyperstimulation syndrome (OHSS) which is a serious complication. The treatment for IVM requires shorter treatment (meaning less monitoring)  and less time. The good thing about in vitro maturation is that the treatment is not as expensive as compared to other fertility treatments like the traditional in vitro fertilization (IVF) which costs around $15,000 - $20,000 for a cycle. IVM costs around $3,000 - $6,000 for a cycle.

Since this technology, in vitro maturation, has not been around for a very long time, it does not have any ethical issues.

Video on IVM:
http://www.youtube.com/watch?v=3WqBqZ_SPq8

Scientists could improve this technology by actually spending more time researching into why there is not a higher rate of success for normal women that do not have OHSS and PCOS. Also, the children that have been born through the process of IVM, should be checked atleast every month to see what the effects of IVM are. Ex. does the child function normally, does the child have any disorders, etc. Lastly, there should be alot of labratories around the world that should encouraged to research more about IVM because there are alot of couples that are getting very bad responses through fertility treatments just because they are not well developed.

Do you think that this will be a successful treatment once there is enough research done and will there be any ethical issues regarding this technology?


Resources:

http://www.coopersurgical.com/ourproducts/Pages/IVMMediaKit.aspx?order1=ART-1600&lc=Sage%20Media&name=SAGE%C2%AE%20In-Vitro%20Maturation%20Media&tc=1

http://www.fertilityauthority.com/treatment/vitro-maturation-ivm
http://www.mcgillivf.com/e/McGillIVF.asp?page=184.186.212
http://discovermagazine.com/2009/jun/16-the-newest-in-fertility-treatments-pregnancy-for-half-the-cost
http://www.britishfertilitysociety.org.uk/practicepolicy/documents/vitro.pdf
http://www.ivfflorida.com/ivm.asp