Debate: IVM results are as good as IVF

For in vitro maturation (IVM), oocytes are retrieved at of the prophase of the first meiotic division before final cytoplasmatic and nuclear maturation occurs. Although IVM was introduced in ART more than 10 years ago, the literature on the benefit of this technique is still rare and controversial.

IVM is reported primarily to be a good alternative strategy for PCO patients with increased risk to develop severe OHSS. However to minimize these risks even in classical stimulation protocols other easy to apply and better studied approaches are already established such as a primary cryo-cycle. Some groups state, that with IVM overall results similar to a classic IVF with the induction of final oocyte maturation in vivo can be obtained.  However it is now evident that even in IVM it is necessary to work with primary cryo-cycles in order to have a well prepared endometrium for implantation.

Are we technically already at a stage where we can mimic the natural environment for oocyte development as closely in an artificial environment that we get similar results? I personally doubt this, as there are no scientific evidence based studies yet available. Controlled prospective randomized trials are mandatory to approve this technique as safe for the patients as oocyte maturation is a critical point and any disturbance might impact the genetic and epigenetic health of the offspring. A recent meta-analysis presented at the European Society of Human Reproduction and Embryology in Rome reported a higher miscarriage rate after IVM and a higher birth weight of children born after IVM.  

I state that IVM at this point of time is still an experimental procedure and therefore should not be used in patients where alternative stimulation options are available with the current knowledge.

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