In Vitro Maturation (IVM)

The McGill Reproductive Centre is a pioneer in the application of In Vitro Maturation treatment. With “in vitro maturation” treatment no hormone therapy is taken to produce large numbers of mature eggs at egg retrieval; instead, immature oocytes are retrieved from the ovary and matured in the laboratory for 24-48 hours. Once the eggs have matured, fertilization is performed and then, fertilized eggs are transferred to the uterus as in conventional treatment.

We reported the first IVM baby birth in Canada in 1999 (see newspaper article in website) and today we have one of the highest pregnancy rates in the world, with more than 100 IVM babies born from our program.

IVM treatment is an important treatment option for women who want to avoid the inconvenience, cost and risks of gonadotropin therapy for ovarian stimulation. In general, the best candidates for IVM are women under the age of 38 who have a large number of ovarian follicles seen on ultrasound, and also, women who are at increased risk of OHSS or have indeed had OHSS before. Women who repeatedly produce poor quality embryos after conventional IVF, or who are expected poor responders to hormonal stimulation, for no obvious reason may also be a candidate for IVM treatment.

Procedure for IVM Treatment

IVM treatment is very easy and requires little time commitment compared to conventional IVF. Full treatment consists of two or three of ultrasounds followed by an injection of HCG (Human Chorionic Gonadotropin) to mature the eggs 38 hours prior to egg retrieval.

Following egg retrieval, immature eggs (see Figure 7) are cultured in a maturation medium for 24 to 48 hours and then mature eggs (not all eggs will mature) will be fertilized using the ICSI technique. Transfer is scheduled 2-5 days after fertilization.

As with conventional IVF treatment, medications are given following egg retrieval in order to make implantation easier, and to support the endometrium for pregnancy. Support of pregnancy is especially important in IVM treatment because the follicles that yield eggs (and would normally support pregnancy) are immature in IVM treatment. Medications taken following IVM egg retrieval include:

Embryo transfer takes place three, four, or five days after the immature oocyte collection, depending on the maturation rate of the oocytes and the division of the embryos. The embryos are loaded into a very fine catheter and inserted into the uterine cavity. This procedure takes only a few minutes and does not cause any discomfort. After an embryo transfer, you can resume your normal daily activities.

You should continue the use of Estrace and Progesterone until the pregnancy test is administered two weeks later. If the pregnancy test is negative, you should stop both medications. If it is positive, we advise you to continue the medication until twelve weeks of pregnancy ( ten weeks after embryo transfer) An ultrasound scan is usually scheduled two weeks after a positive pregnancy test to determine the number and position of any pregnancies. An ultrasound scan is safe to perform in early pregnancy.

After a satisfactory ultrasound scan, we discharge you from our care to your referring obstetrician.