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Use of IVM Technology in Europe

Hakan Özörnek EUROFERTIL IVF Center Turkey. Use of IVM Technology in Europe. Patient friendly IVF. No or minimal stimulation Low cost Less monitoring Less side effects (OHSS) Acceptable pregnancy rate High patient compliance. Patient friendly IVF. Natural cycle

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Use of IVM Technology in Europe

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  1. Hakan Özörnek EUROFERTIL IVF Center Turkey Use of IVM Technology in Europe

  2. Patientfriendly IVF • No or minimal stimulation • Lowcost • Lessmonitoring • Lesssideeffects (OHSS) • Acceptablepregnancy rate • Highpatientcompliance

  3. Patientfriendly IVF • Naturalcycle • Mildstimulation • IVM

  4. Negativeremarks • Lowerpregnancy rate thanclassic IVF • OPU moredifficult • Labmorebusy • Lessembryoquality • No longtermfollowup data on IVM children

  5. Positiveremarks • No shortorlongtermsideeffects of gonadotropins • Prevention of OHSS • No extensivemonitoring • No expensivestimulation • Simplertherapy, lessstress • No needforwaitingbetweencycles

  6. IVM program in EUROFERTIL • Startingthe IVM program in January 2008 • Age ≤ 38 • FSH ≤ 12 mIU/ml • AFC ≥ 7

  7. Patients • PCO/PCOS • Maleinfertility • Unexplainedinfertility

  8. Priming • HCG priminginitiatesoocytematuration in vivoandproduces a favourableoutcome in IVM. • Primingwith FSH for 3 days in PCOS patientsmayimprovethematurationalpotential of theoocytes. • No beneficialeffect of FSH priming has beenobserved in regularcyclingwomen.

  9. Protokol (Non PCO/PCOS) • HCG Priming HCG OPU Ultrasound DAYS3 4 5 6 7 8 9

  10. Protokol (PCO/PCOS) • FSH/HCG Priming HCG OPU US rFSH 75 DAYS3 4 5 6 7 8 9

  11. OPU ICSI TRANSFER -1 0 +2 Protokol • Endometrium≥6mm • Leadingfollicle10-14 mm Oestradiol6 mg/die Progesterone600 mg/die Ultrasound βhCG test +14 DAYS

  12. EUROFERTIL IVM • 24 patients • 1 patient no oocyteretrieved • Meanage 30.0 years • Mean FSH 6.04 mIU/ml • Mean AFC 9.6 • 11 PCO/PCOS • 13 normocyclewomen

  13. Oocytecollection • General anestasia • 19 G needle • 80 mmHgaspirationpressure • Mediumwithheparinforpickup • Multipuncturetechnique

  14. MeanNr of oocytes

  15. EUROFERTIL IVM • MeanNr of oocytes 7.6 [2-14] • MeanNr of injectedoocytes 5.52 • Maturation rate 72.6 % • MeanNr of fertilisedoocytes 4.16 • Fertilisation rate 75.4%

  16. IVM Results

  17. EUROFERTIL IVM • ET day 2 after ICSI • Nr of transferedembryos 2.2 [1-4] • Clinicalpregnancy rate 17.4% (4/23)

  18. PCO/PCOS patients

  19. Regularcyclepatients

  20. Conclusion • Optimization of culturesystemsandclinicalmanagement of IVM cycleswillenhancepregnancyoutcome, sothat IVM mightreplaceconventional IVF in selectedpatients. • Morestudiesareneededforimprovingthesuccess of IVM.

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