Estrogen suppressed in vitro maturation A novel approach to in vitro maturation

Capsule:
Estrogen-suppressed in vitro maturation eliminates the need for gonadotropin stimulation and cycle monitoring yet results in a 40% live-birth rate.

Authors:
Wendy S. Vitek, M.D., Jeannine Witmyer, Ph.D., Sandra A. Carson, M.D., Jared C. Robins, M.D.

Volume 99, Issue 7, Pages 1886-1890, June 2013

Abstract:

Objective:
To evaluate the laboratory and clinical outcomes of estrogen-suppressed in vitro maturation (ES-IVM), a novel IVM protocol that eliminates the need for FSH stimulation and cycle monitoring.

Design:
Case series.

Setting:
Academic infertility center.

Patient(s):
Eighteen infertile couples undergoing ES-IVM (n = 20). Eligible candidates included women ≤38 years old with either polycystic ovarian syndrome, antral follicle count ≥15, and/or history of ovarian hyperstimulation syndrome.

Intervention(s):
ES-IVM.

Main Outcomes Measure(s):
Oocyte yield, maturation, fertilization, embryo quality, implantation, clinical pregnancy, and live-birth rate were analyzed.

Result(s):
The average number of oocytes retrieved was 16.7 ± 5.9, with a 52.1% maturation rate and a 58% fertilization rate by intracytoplasmic sperm injection. The average number of embryos transferred was 2.85 ± 0.6. The implantation rate was 17.5%, the clinical pregnancy rate was 40%, and the live-birth rate was 40%.

Conclusion(s):
The efficiency of ES-IVM appears to be similar to natural cycle and low-stimulation IVM protocols with respect to laboratory and clinical outcomes, while eliminating the need for FSH stimulation and cycle monitoring.

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