Purpose: The development of new methods for follicle aspiration in combination with innovative culture techniques for immature oocytes (in-vitro maturation, IVM) offers interesting perspectives for assisted reproduction. IVM aims at maturing oocytes from the germinal vesicle stage to the metaphase II stage in vitro, avoiding intensive ovarian hyperstimulation. This new technique was established and evaluated in a feasibility study at the Department of Obstetrics and Gynecology of the University Hospital of Lübeck. Material and Methods: The study population was treated in accordance with a uniform protocol with low dose FSH priming and ovulation induction until the leading follicle reached a diameter between 10-12 mm. All antral follicles were aspirated using high resolution ultrasound. Retrieved cumulus-enclosed oocytes were matured for 24-32 hours in vitro and fertilized by intracytoplasmic sperm injection (ICSI). If available 3 embryos were transferred and a combined estradiol plus progesterone scheme was administered for luteal phase substitution. Serum hCG was determined 12 to 14 days later. A neuropediatric follow-up of all children born was part of the study. Results: A total of 81 follicle aspirations was performed in 77 patients with a mean age of 34.3 ± 4.8 years. A mean of 8.9 ± 6.1 oocytes was retrieved per aspiration. The maturation rate was 56.0%; regular fertilization occurred in 45%. An embryo transfer was performed in 57 cases (70.3%). 7 clinical pregnancies were obtained, one ended as an early abortion in the 9th gestational week. The first German IVM birth derives from this study population. Conclusion: The data confirms the feasibility of IVM - however its efficacy is still low. In the long term it is expected that IVM will become an additional option in conventional assisted reproduction.
|Translated title of the contribution||Establishment of in-vitro maturation as an alternative treatment option in assisted reproduction - The experience of the Lübeck Working Group|
|Journal||Geburtshilfe und Frauenheilkunde|
|Number of pages||9|
|Publication status||Published - 09.2007|