A modification to traditional in vitro fertilization (IVF),
IVM is an innovative treatment that limits a patient's exposure
to fertility drugs that can cause complications in women
with specific fertility problems.
During a traditional IVF procedure, the patient is treated
with hormones (gonadotropins) for
10-14+ days, after which mature oocytes (unfertilized
egg cells) are extracted and fertilized in vitro.
In contrast, an IVM
treatment begins with 3 days of FSH therapy, and is followed
by the extraction of immature oocytes. The immature oocytes
are then matured in the laboratory using a special culture
solution. Once matured, the oocytes are fertilized in the
same manner as a traditional IVF procedure.
IVM Treatment Benefits
Patients who have been diagnosed with Polycystic
Ovarian Syndrome (PCOS), a metabolic disorder, are at an increased
risk of developing Ovarian Hyperstimulation Syndrome (OHSS)
as a result of FSH therapy. OHSS can cause cysts, abdominal
bloating, nausea, and excessive weight gain. In severe
cases of OHSS, ovaries become swollen, causing dangerous
amounts of excess fluids to move from the blood vessels to
the stomach and chest, which can result in kidney and respiratory
problems. Often, these complications can require extensive
medical treatment, hospitalization, or surgical procedures,
and the termination of the cycle.
Because IVM requires a much shorter course of
FSH therapy (3 days as opposed to 10-14+ days for traditional
IVF), the risk of OHSS is lessened. This shortened FSH therapy
cycle is beneficial not only to patients with PCOS, but to
cancer patients as well. If a patient has been diagnosed with
cancer, especially breast cancer, she will likely have an extreme
sensitivity to estrogen, making a long course of FSH therapy
difficult, if not impossible. In the past, a patient who wished
to have eggs extracted before cancer treatment damaged her
fertilty would need to delay cancer treatment 10-14+ days in
order to extract mature eggs for cryopreservation. With IVM,
the shorter course of FSH therapy allows the patient to begin
cancer treatment sooner.
IVM Pioneered at DVIF&G
For two years,
the experts at DVIF&G worked with the International Review
Board to develop treatment protocol for IVM. Along the way,
Dr. Taliadouros and Jessica Macdonald were invited to participate
in an international IVM experts meeting with other physicians
and scientists from 11 countries. Only one practice from each
country was invited to participate, and DVIF&G represented
the United States.
