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

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

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


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.

Case series.

Academic infertility center.

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.


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

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%.

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.

  • Sonia Herraiz

    Congratulations to the authors for the encouraging results obtained after the employment of this ES-IVM protocol.
    The obtained fertilization rates for both 24 and 48h matured oocytes seems to be very
    consistent even when data were sorted and separated by diagnosis. Low
    variability between the rates obtained for all the diagnoses included in your
    study group may lead to the future improvement of IVM outcomes by using cheaper
    treatments that could be affordable by a higher proportion of patients.

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