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IVM: in vitro maturation at Infertility Solutions
IVM is a variation of IVF which uses immature eggs removed from the ovaries without stimulating the ovaries with medications to produce mature eggs. The eggs are instead matured in the laboratory. They are then fertilized, cultured and transferred as in conventional IVF.
Role of In-Vitro Maturation in the Future of Infertility Treatments
If you are a candidate for conventional IVF, you should learn about IVM.
Most of the difficulty for a patient undertaking IVF is taking multiple medications requiring injections and the monitoring with blood tests and ultrasounds required to assess that process over a two week period of time. This approach is not necessary for many patients. Most young patients and many older patients who require IVF always have a number of small follicles or cysts visible in their ovaries by ultrasound. These small cysts are called antral follicles and contain immature eggs. If treated with gonadotropin mediations, these small cysts will grow and either ovulate or produce mature eggs that can be harvested with IVF. For IVM, eggs from these antral follicles are harvested without stimulation them to become mature.
IVM is a variation on natural cycle IVF, but is much more successful. At Infertility Solutions, our pregnancy rate with IVM is about 2/3rds our pregnancy rate with conventional IVF for the same aged patients. However, the process with IVM is much simpler for the patient. High doses of injectible medications are not used. Side effects from medications are much lower (especially for patients with PCOS). The treatment cycle is shorter. Almost no blood tests are required. Compared to conventional IVF, few ultrasound monitoring visits are required. The decrease in medications and monitoring reduces the self pay cost of an IVM cycle to about half of a conventional IVF cycle. In a study we published in The Journal of Reproductive Medicine, costs were reduced by an average of 45.9% (volume 59, pages 571-578).
Some patients who need an IVF procedure are afraid of having to subject themselves to putting lots of medications into their bodies. They are concerned about how they will feel when these medications produce very high doses of hormones as is required in a conventional IVF cycle. Such patients are very reassured by our approach to IVM, which is a variation of natural cycle IVF. in the study referred to above, injectins were reduced by 90%. Although some medications are used, the ovaries not not stimulated and patients do not feel different because of the medications. The difference in how patients feel is especially marked in the conventional IVF high responder (or PCO) patient where estrogen levels can be twenty to fifty times as high with conventional IVF compared to IVM.
We directly compared the cost and convenience requirements of IVF and IVM (see the list of publications on Dr. Rose's CV) and found that:
- Average medication cost (using Walgreens, CVS, or Rite-Aid) with conventional IVF was $6460 compared to $580 for IVM
- Number of office visits required during the cycle averaged 5.9 with IVM compared to 2.7 with IVM
- Number of venipunctures required averaged 5.5 with IVF compared to 1 with IVM
- Number of ultrasound exams required averaged 5 with IVF compared to 2.7 with IVM
- Number of injections given by the patient to herself averaged 54.3 with IVF compared to 5.6 with IVM
- Number of blood tests charged to the patient during the cycle was 11.4 with IVF compared to 0 with IVM
We are one of very few programs in the United States to offer IVM. We are certainly the first and most experienced program in the Lehigh Valley and in NE Pennsylvania to offer IVM. We also have the first pregnancies using IVM in Lehigh Valley/NE Pennsylvania.