In vitro egg maturation (IVM)

This is an automatically translated article.

This article is professionally consulted by Master, Doctor Nguyen Thi Cam Van - IVF Lab Doctor - Reproductive Support Center - Vinmec Times City International Hospital.
Growing immature eggs in vitro is an assisted reproductive technology that brings many benefits to patients such as simple procedure, reduced risk of ovarian hyperstimulation,...

1. What is egg culture technique?

In Vitro Maturation (IVM) is a method of taking eggs from the ovaries (not yet stimulated by hormones) and cultured in a specialized environment in the laboratory. After the eggs are mature, IVF can be performed as usual. This method aims to create mature oocytes for other assisted reproductive procedures.
With classic IVF, patients often have to inject ovarian stimulation drugs for several weeks in a row. Follow-up is expensive and time consuming. In addition, injecting ovarian stimulation drugs can also cause complications such as ovarian hyperstimulation syndrome (incidence of 5 - 10%). With IVM technique, patients can perform IVF without or need mild ovarian stimulation. The technique of in vitro egg maturation is gradually being widely applied because of its advantages such as: Simple procedure, no need to use ovarian stimulating hormone, thereby reducing the risk of hyperstimulation syndrome ovary .
Women who are indicated for IVF are:
Women with polycystic ovary syndrome, more than 10 secondary follicles, poor response to ovarian stimulation; Young women under the age of 35, having normal periods or having cancer; Cases where in vitro fertilization has failed or the cause of male infertility has been determined. The main subjects to perform IVM technique are women with polycystic ovary syndrome. The number of secondary follicles is the basis for deciding whether to perform IVM or not. If ultrasound results show less than 5 secondary follicles, then IVM is not recommended.

2. Details of immature egg maturation process in vitro

Using Hormonal Priming: The IVM set the most important criterion as the collection of immature eggs without hormone stimulation. However, the pregnancy rate according to this criterion is very low. Therefore, it is necessary to improve the number of high-quality immature eggs by using mild ovarian-stimulating gonadotropins; Choose the time to collect eggs: Because the ovulation cycle has a great influence on the results of egg collection, it is necessary to choose the right time to collect eggs. Ultrasound is the best supportive method. Research shows that follicles with a diameter of 12mm or more have a high number of eggs that are acquired, mature, fertilized and develop into embryos. Egg collection: Using ultrasound technique combined with egg aspiration needle to collect eggs. The cyst fluid was contained in 0.9% saline, supplemented with 2U of heparin. Because there is a lot of blood in the aspirated cyst fluid, it is necessary to filter it to make the process of collecting young eggs more smooth; IVM: The medium used for culturing young eggs requires the addition of gonadotropins, steroids, growth factors, serum and proteins. The time to raise mature eggs is from 28 to 52 hours. Eggs matured within 30 hours of collection were more likely to develop than eggs that took longer to mature.

3. Techniques to be used after mature eggs from IVM

The techniques used after the arrival of mature eggs from the IVM are as follows:
Insemination: Intracytoplasmic sperm injection (ICSI) is used after the mature eggs are obtained in vitro. If the sperm is of good quality, in vitro fertilization (IVF) can be used; Endometrial preparation: The collection of immature eggs is done before the follicles develop, so at the time of egg retrieval, estradiol levels in the endometrium are usually low. Because the result of external egg culture creates a phase difference between the embryo and the endometrium, it is necessary to prepare the endometrium by supplementing with 2 - 4 mg of estradiol valerate daily from the time of collection of immature eggs, combined with injection of progesterone into the endometrium. intravenously after this time 48 hours (time of ICSI or IVF); Pregnancy and childbirth: Women with polycystic ovary syndrome have a pregnancy rate of 22 - 30%, normal women are 18 - 30%. Pregnancy rates can be as high as 52% with blastocyst transfer after IVM (if the procedure is good). When a woman is pregnant, it is necessary to supplement with hormones at the right dose and time. The technique of raising mature eggs in vitro has many benefits for patients such as convenience, shortening treatment time, less drug injection, low treatment cost and high safety. When choosing this method of assisted reproduction, couples need to strictly follow the instructions and instructions of the doctor.

Reproductive Support Center - Vinmec International General Hospital is the leading center in Vietnam that is built and applied a treatment process that coordinates comprehensive examination, combining both male and female obstetrics and gynecology to give birth. the optimal method for each patient's case.
Advantages when customers choose infertility treatment - late at Vinmec Fertility Center include:
The center is home to a team of leading experts in the field of domestic and international infertility, trained at the world's leading assisted reproductive centers. A team of highly qualified and experienced doctors. Implement most advanced assisted reproductive techniques in the world such as ICSI (injection of sperm into the oocyte); support embryo escape membrane; Reproductive reserve: embryo freezing, sperm freezing, oocyte freezing to help customers take the initiative in giving birth at will, transferring embryos on day 5, minimizing pregnancy; male infertility techniques (PESA, MESA, TEFNA, TESE) Modern equipment system, ensuring absolute sterility, single cabinet system optimizes embryo quality, increases success rate. The Reproductive Support Center also receives technical support from many departments in the Vinmec International General Hospital system such as the Pediatric Center, the Department of Obstetrics and Gynecology, etc., constantly updating and developing new techniques. in infertility treatment.

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