scholarly journals The Place of In Vitro Maturation in Assisted Reproductive Technology

2019 ◽  
Vol 01 (01) ◽  
pp. 11-15 ◽  
Author(s):  
Lan N. Vuong ◽  
Tuong M. Ho ◽  
Robert B. Gilchrist ◽  
Johan Smitz
Keyword(s):  
Assisted Reproductive Technology ◽  
Ovarian Stimulation ◽  
In Vitro Maturation ◽  
Polycystic Ovary ◽  
Reproductive Technology ◽  
Vitro Fertilization ◽  
Medication Costs ◽  
Main Barrier ◽  
Patient Burden

In vitro maturation (IVM) is an assisted reproductive technology (ART) whereby immature cumulus-oocyte complexes are collected and matured in vitro, without need for controlled ovarian stimulation and ovulation triggering. Advantages of IVM over in vitro fertilization (IVF) include mild or no stimulation, lower medication costs and less patient burden. However, early clinical outcomes with IVM were suboptimal. More recently, clinical studies reported live birth rates after IVM of about 40%. New IVM culture systems are being used to improve the efficacy of IVM. These have been in widespread use for animals for many years and are now showing promise in the clinical setting. Patients more likely to benefit from IVM over IVF include those at risk of OHSS (e.g. women with polycystic ovary syndrome), when the time for ovarian stimulation is limited, or where sustained elevations of estradiol are contraindicated (e.g. oncofertility indications). The main barrier to use of IVM to date was its relative efficacy compared with IVF, and there have also been concerns over the health of infants born following IVM. However, no differences in congenital abnormalities between IVM and other ARTs have been identified. In addition, there is a lack of both experience and standardized protocols. Strategies to overcome barriers to the use of IVM include better training for clinicians, more and better funded research in the field, and improved recognition of IVM by fertility specialists. Overall, IVM offers a valuable alternative for ART in select patient populations. New approaches to IVM appear to have the potential to achieve pregnancy outcomes equivalent to those after IVF. Increasing the use of IVM in the future can be achieved with improved training and education for fertility specialists, and increased funding for IVM research, with the ultimate goal of improving fertility outcomes.

scholarly journals Outcomes and Recommendations of an Indian Expert Panel for Improved Practice in Controlled Ovarian Stimulation for Assisted Reproductive Technology

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Baiju Ahemmed ◽  
Vani Sundarapandian ◽  
Rohit Gutgutia ◽  
Sathya Balasubramanyam ◽  
Richa Jagtap ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Ovarian Stimulation ◽  
Strong Association ◽  
Reproductive Technology ◽  
Data Availability ◽  
Controlled Ovarian Stimulation ◽  
Cohort Size ◽  
Serum Progesterone ◽  
Vitro Fertilization

Purpose.To improve success of in vitro fertilization (IVF), assisted reproductive technology (ART) experts addressed four questions. What is optimum oocytes number leading to highest live birth rate (LBR)? Are cohort size and embryo quality correlated? Does gonadotropin type affect oocyte yield? Should “freeze-all” policy be adopted in cycles with progesterone >1.5 ng/mL on day of human chorionic gonadotropin (hCG) administration?Methods.Electronic database search included ten studies on which panel gave opinions for improving current practice in controlled ovarian stimulation for ART.Results.Strong association existed between retrieved oocytes number (RON) and LBRs. RON impacted likelihood of ovarian hyperstimulation syndrome (OHSS). Embryo euploidy decreased with age, not with cohort size. Progesterone > 1.5 ng/dL did not impair cycle outcomes in patients with high cohorts and showed disparate results on day of hCG administration.Conclusions.Ovarian stimulation should be designed to retrieve 10–15 oocytes/treatment. Accurate dosage, gonadotropin type, should be selected as per prediction markers of ovarian response. Gonadotropin-releasing hormone (GnRH) antagonist based protocols are advised to avoid OHSS. Cumulative pregnancy rate was most relevant pregnancy endpoint in ART. Cycles with serum progesterone ≥1.5 ng/dL on day of hCG administration should not adopt “freeze-all” policy. Further research is needed due to lack of data availability on progesterone threshold or index.

scholarly journals In Vitro Maturation (IVM) of Human Oocytes: Promising Potential, Challenges and Chances for Improvement

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Roza Silvia
Keyword(s):  
In Vitro Fertilization ◽  
Assisted Reproductive Technology ◽  
In Vitro Maturation ◽  
Reproductive Technology ◽  
Human Oocyte ◽  
Routine Practice ◽  
Vitro Fertilization ◽  
Human Oocytes ◽  
Maturation In Vitro

AbstractIn Vitro Maturation (IVM) of human oocytes is an innovation in Assisted Reproductive Technology (ART). It is believed more patient-friendly than conventional In Vitro Fertilization (IVF) method. It is a simple protocol that needs only less injection of ovarian stimulation for the patients and fewer blood sample and ultrasound scans, so this technique may become more favorable. Patients are also prevented from higher cost treatments and quite long control in the hospital. However, there are some problems to be addressed, such as how to improve the success rate, how to assure the safety and to avoid the health risk for the offsprings. Modification in IVM medium and optimizing the IVM protocols have increased the results in some studies. However, further investigation related to all aspects influencing the human oocyte maturation in vitro is still needed to make it enable to be a routine practice in ART centers for a defined group.Kata kunci: in vitro maturation, human oocyte, in vitro fertilization, assisted reproductive technology AbstrakMaturasi oosit in vitro atau In Vitro Maturation (IVM) terhadap oosit manusia merupakan suatu inovasi dalam Teknologi Reproduksi Berbantu (TRB). Teknik ini dianggap lebih nyaman bagi pasien dibandingkan dengan metode Fertilisasi In Vitro (FIV) konvensional. Metode IVM ini sederhana dan hanya membutuhkan lebih sedikit penyuntikan obat stimulasi ovarium ke pasien serta lebih sedikit pemeriksaan darah dan ultrasonografi, sehingga memungkinkan untuk menjadi suatu pilihan yang disukai oleh pasien. Pasien juga bisa terhindar dari biaya terapi yang lebih mahal serta waktu kontrol yang lama di rumah sakit. Namun demikian, terdapat beberapa masalah yang perlu ditangani terkait metode ini, seperti bagaimana meningkatkan angka keberhasilan serta memastikan keamanan dan mencegah resiko kesehatan pada anak yang akan dilahirkan. Modifikasi pada medium IVM serta pengoptimalan protokol IVM telah meningkatkan hasil pada beberapa penelitian. Penelitian yang lebih mendalam terkait semua aspek yang mempengaruhi maturasi in vitro oosit manusia masih diperlukan menuju penerapan rutin prosedur IVM untuk kelompok pasien tertentu di pusat-pusat pelayanan TRB.Keywords: maturasi in vitro, oosit manusia, fertilisasi in vitro, teknologi reproduksi berbantu

Follicular fluid and assisted reproductive technology programs outcomes (literature review)

GYNECOLOGY ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 36-40
Author(s):  
Anna G. Burduli ◽  
Natalia A. Kitsilovskaya ◽  
Yuliya V. Sukhova ◽  
Irina A. Vedikhina ◽  
Tatiana Y. Ivanets ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Assisted Reproductive Technology ◽  
Follicular Fluid ◽  
Economic Cost ◽  
Reproductive Technology ◽  
Art Programs ◽  
Vitro Fertilization ◽  
Non Invasive ◽  
Established Fact

The review presents data on metabolites in the follicular fluid (FF) from the perspective of reproductive medicine and their use in order to predict outcomes of assisted reproductive technology (ART) programs. It considers various components of this biological medium (hormones, lipids, melatonin, etc.) with an assessment of their predictive value in prognosis of the effectiveness of in vitro fertilization (IVF) programs. The data on experimental directions in this field and the prospects for their use in clinical practice are presented. The article emphasizes that the growing clinical need and the unsolved problem of increasing the effectiveness of ART programs determine the need for further studies of the FF composition. Materials and methods. The review includes data related to this topic from foreign and Russian articles found in PubMed which were published in recent years. Results. Given the established fact of a direct effect of FF composition on growth and maturation of oocytes, and further, on the fertilization process, various FF metabolites are actively investigated as non-invasive markers of quality of oocytes/embryos. The article provides data on the experimental directions in this field and the prospects for their use in clinical practice. However, clinical studies of a relation between various FF metabolites levels and outcomes of IVF programs are contradictory. Conclusion. Owing large economic cost for treatment of infertility with IVF, there is need for expansion and intensification of studies to identify and use reliable predictors in prognosis of ART programs outcomes.

Pregnancy Outcomes Using Assisted Reproductive Technology After Fertility-Preserving Therapy in Patients With Endometrial Adenocarcinoma or Atypical Complex Hyperplasia

2009 ◽  
Vol 19 (1) ◽  
pp. 147-151 ◽  
Author(s):  
Aera R. Han ◽  
Yong-Soon Kwon ◽  
D. Y. Kim ◽  
J. H. Kim ◽  
Y. M. Kim ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Assisted Reproductive Technology ◽  
Intrauterine Insemination ◽  
Medical Center ◽  
Endometrial Adenocarcinoma ◽  
Controlled Ovarian Hyperstimulation ◽  
Reproductive Technology ◽  
Vitro Fertilization ◽  
Asan Medical

Objectives:To evaluate the outcomes of pregnancy in young women (<40 years old) with early endometrial cancer or atypical complex hyperplasia who were treated by conservative management followed by assisted reproductive technology (ART).Materials and Methods:Medical charts of 11 patients treated from January 1997 to October 2007 at Asan Medical Center were retrospectively reviewed. These patients had all been treated with progestin and serial dilatation and curettage as primary fertility-preserving therapies.Results:After pathological remission of disease, 10 patients tried to become pregnant by ART, 4 by in vitro fertilization and embryo transfer, and 6 by controlled ovarian hyperstimulation, with or without intrauterine insemination. Eight women had intrauterine pregnancies, and 6 patients had live births. Patients have been followed up for 9 to 51 months (mean, 21 months) after delivery, with no evidence of tumor recurrence.Conclusions:Fertility-preserving therapy followed by ART can be a good option in well-selected patients with early endometrial cancer who want to become pregnant.

In Vitro Fertilization, Assisted Reproductive Technology

2013 ◽  
pp. 1050-1052
Author(s):  
Marie Boltz ◽  
Holly Rau ◽  
Paula Williams ◽  
Holly Rau ◽  
Paula Williams ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Assisted Reproductive Technology ◽  
Reproductive Technology ◽  
Vitro Fertilization

scholarly journals The Place of In Vitro Maturation in PCO/PCOS

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Shital Julania ◽  
Melanie L. Walls ◽  
Roger Hart
Keyword(s):  
In Vitro Fertilization ◽  
In Vitro Maturation ◽  
Culture Media ◽  
Polycystic Ovary ◽  
Pregnancy Rates ◽  
Ovary Syndrome ◽  
Successful Pregnancy ◽  
Vitro Fertilization ◽  
In Pregnancy

In vitro maturation (IVM) of human oocytes is an emerging treatment option for women with polycystic ovary/polycystic ovary syndrome (PCO/PCOS) in addition to the standard in vitro fertilization (IVF) treatment. There has been significant improvements in pregnancy rates with IVM over the last two decades. This article reviews the place of IVM for women with PCO/PCOS, placing an emphasis on the predictors of successful pregnancy, optimization of culture media, IVM protocols, pregnancy rates, and neonatal outcomes following IVM treatment.

scholarly journals Assisted Reproductive Technology

2014 ◽  
Vol 4 (1) ◽  
pp. 1-10 ◽  
Author(s):  
JP Deep
Keyword(s):  
Assisted Reproductive Technology ◽  
Human Sperm ◽  
Reproductive Technology ◽  
Human Reproduction ◽  
Unprotected Sexual Intercourse ◽  
Vitro Fertilization ◽  
Medical College ◽  
The United Kingdom ◽  
One Year

All the treatment or procedure that includes the handling of both human sperm and oocytes or embryos in vitro for the purpose of establishing a pregnancy in order to bypass some pathological obstacles in human reproduction is known as Assisted Reproductive Technology (ART). Now we must be approaching 1.5 million Assisted Reproductive Technology birth since the birth of the world’s first in vitro fertilization baby, Louise Brown, in the United Kingdom. The infertility is caused by various reason and factors from either or both partners. Infertility affects worldwide by 8-15 percent of couples in general and defined as a disease of the reproductive system by the failure to achieve a clinical pregnancy after one year or more of regular unprotected sexual intercourse. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10840 Journal of Chitwan Medical College 2014; 4(1): 1-10

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