In Vitro Maturation IVM
The way forward for the future? An Alternative approach to IVF
A team of Canadian doctors have described an alternative to IVF where the woman is stimulated to produce several eggs. In "in vitro maturation," or IVM — allows a woman's egg to mature outside her body (in culture) before it is fertilized and re-implanted in her womb. At a press conference this week, doctors at the McGill University of Health in Montreal said a baby girl conceived by the IVM method was recently born there. Four other women have reportedly had babies by the same method. According to wire reports, Dr. Siang Lin Tan of McGill told reporters he believed the new procedure was safer and cheaper than the more traditional IVF because it negated the need to use costly drugs to stimulate the ovaries of women who have difficulty conceiving. "It avoids the potential side effects that drugs may occasionally cause," he said.

Source "Daily Briefings" November 19 1999

Editorial comment: This is a technique which the world of Assisted Reproductive Medicine has been waiting - a cautious welcome has be given to this announcement with a warning that (as far as is known) it is not yet available elsewhere. 

The principle is a simple one - the practicalities more difficult. Immature follicles (marked pf in the diagram above are grown in culture in carefully balanced culture medium and in the presence of  the same hormones that would be present during follicular development within the body. The difference is that only minute amounts of hormones are necessary since they don't have to travel around the body in the blood stream.

  

In IVF large amounts of the hormones are used - this is expensive and has the potential for over stimulation resulting in Ovarian Hyper Stimulation Syndrome (OHSS). If IVM can become a routine alternative the side effects of injecting large amounts of gonadotrophins can be avoided. The difficulty is getting cells and tissues in culture to behave in the same way as they do when they are within the body. No doubt this is the method of the future and we all look forward to further developments in this field.