In vitro maturation for patients with repeated in vitro fertilization failure due to “oocyte maturation abnormalities”

Objective

To investigate the efficacy of in vitro oocyte maturation (IVM) in women with repeated failure of IVF treatments due to follicular developmental abnormalities.

Design

Prospective longitudinal study.

Setting

The IVF unit of a university–affiliated medical center.

Patient(s)

Seven women with three or more IVF failures due to abnormal oocyte development resulting in no egg retrieval (empty follicle syndrome [EFS]), oocyte maturation arrest, or failure of fertilization.

Intervention(s)

Immature oocyte collection, with or without minimal ovarian stimulation, IVM of the oocytes, insemination by intracytoplasmic sperm injection (ICSI), and embryo transfer.

Main Outcome Measure(s)

Number of aspirated oocytes, maturation, fertilization and cleavage rates, pregnancy, and ongoing pregnancy.

Result(s)

Seven women underwent seven IVM cycles. Four of them received a minimal stimulation of 75 IU FSH for 3–4 days. Oocytes were retrieved from all subjects (mean 7.1 ± 3.3 oocytes/cycle). The in vitro maturation rate was 39.6% (mean 2.7 ± 2.9 matured oocytes available for fertilization in four patients). The mean fertilization rate was 45.8% ± 31.6%. Four women had embryo transfer. Two patients with previous genuine EFS conceived and delivered.

Conclusion(s)

IVM should be considered for women with previous genuine EFS. The role of IVM in other indications of oocyte maturation deficits warrants further investigation.

Key Words: In vitro maturation of oocytes (IVM), repeated failure, empty follicle, oocyte maturation arrest, IVF