In-Vitro Maturation, or IVM, is a technology involving collecting a woman’ ova, via a surgical procedure before they are matured artificially. Immature eggs are grown and matured in a laboratory setting. Then, they are matured either using hormones or in recent methods by a protein dimer called Cumulin. Later, the matured eggs are fertilized using a process called intracytoplasmic sperm injection (ICSI). In the end, they are then transferred into the candidate’s womb for development until pregnancy occurs. In contrary to the in-vitro fertilization (IVF), in this fertility treatment, the egg is not stimulated to become mature. In IVM, the egg is matured after being retrieved.

Advantages of IVM

A great advantage of in vitro maturation is the minimization of using drugs, consequently, having less possible side effects, during treatment and later on. Since IVM applies little to no hormone to stimulate ovaries, it greatly eliminates the risk of developing ovarian hyperstimulation syndrome (OHSS), a risk that candidates for IVF surgery may confront. Further advantage of IVM compared to other options such as IVF is harvesting multiple oocytes instead of one to increase the chance of having viable eggs for the success of an operation.

In-vitro maturation candidates

In general, IVM is cheaper and safer to some other reproductive options, so it benefits younger couples to have a better chance of achieving pregnancy. There are cases of in vitro fertilization that candidates’ collected eggs are immature. With IVM procedures and techniques there is the availability of maturing these cells and creating a better condition for pregnancy. There are also candidates whose eggs, for some reasons, have been dropped in number and IVM provides them with more opportunities to preserve the eggs. IVM is also a viable option for couples who suffer male factor infertility, such as decreased sperm count or motility and couples with unknown infertility. It also helps women with blocked or damaged fallopian tubes or those who have had their fallopian tubes removed and women with ovulation disorders. While IVM is a suitable alternative for previously failed IVF cycles, individuals with a genetic disorder, also can choose IVM as well as IVF as their fertility treatments.

IVM Procedure

Once it becomes the right time for retrieval, with little to no ovarian stimulation and by using a hollow needle guided through the pelvic cavity, immature eggs are extracted. Ultrasound imaging is used to locate and remove the eggs. Collected immature eggs are then either stimulated with hormones or with Cumulin, with the intention of reaching maturity. This stage can take about 24 up to 48 hours. The processes for the IVM and IVF is quite similar once the eggs were retrieved and matured in the lab. The eggs and semen can be mixed in a container or intracytoplasmic sperm injection (ICSI) is used to manually fertilize the eggs. With ICSI, the semen is inoculated into the egg, using a microinjection device. Soon after the eggs were fertilized and began growing, one or more embryos is inserted into the female uterine until the signs of pregnancy are identified and success of the operation is displayed.

Pre-retrieval examinations

Initial ultrasound and blood tests help to determine the best time for retrieving the eggs. Some cases may also be asked to take stimulating pills or suppository hormones prior to the procedure.

IVM and use of medication

While there is extremely low need to stimulating hormones, yet, a major concern in IVM is the preparation of the uterus for implantation in only a few days after retrieval and the time embryo is transferred. What is mainly advised to prepare uterus internal layer, consists of 2 to 4 mg daily of estradiol valerate from the oocyte retrieval. Intravaginal progesterone also may start up to 48 hours later at the time of microinjection or insemination.

IVM common risks and side effects

After the operation, if the doctor finds the cycle successful, the newly pregnant woman will start her post-treatment cares and medications. However, in some cases, the cycle is not successful, and the couple may need to undergo another cycle of IVM. This condition may be accompanied by a feeling of depression and disappointment in them. Generally, the rate of implantation decreases as women age, therefore, more embryos may be agreed to be implanted to increase the likelihood of success. In that case, like with any type of artificial reproductive option, if a greater number of embryos is transferred, it would increase chances of having multiple pregnancies. IVM process is relatively new. Whilst it is safer, simpler and cheaper, the success rate is half in each cycle compared to IVF. Because less medication is used, there is the possibility that fewer eggs be retrieval. There is also the possibility that all immature eggs will not be matured in the lab, resulting in a smaller number of viable eggs for IVF treatment. The treatment can be followed by inflammation of breasts, bloating, constipation and light muscle cramps as side effects.

Post-operative embryo transfer

One to two hours after the embryo transfer, the patient can be discharged and resume their daily activities. It is recommended to avoid strenuous activities that can lead to excessive fatigue during 3-4 days after the operation. Certainly, mental and psychological relaxation and avoiding extreme anxiety conditions can be effective in the success of the operation. Patients should contact their doctors if faced severe discomfort or pain after the surgery. Usually, 10 to 12 days after the embryo was transferred, the patient needs to return, so blood levels of BHCG can be measured. The increase in this hormone is the first sign of pregnancy.

IVM in Iran

Because In-Vitro Maturation is a complicated procedure, not every fertility center offers this treatment. However, highly equipped fertility clinics and institutes in Iran, such as “Royan Institute”, “Avicenna Fertility Clinic” and “Reproductive Sciences Institute” in Yazd offer their services at a global level. The provision of fertility treatment services has made these centers known as leading centers in infertility treatment. Specialized clinics of these centers, has made their treatments more comprehensive and privileged than the past, providing diagnostic services, including cytology and genetic tests, ultrasound and radiography as well as the provision of all fertility-related advice such as nutrition, psychiatry, genetics and sexual health. Patients are welcomed from around the world to receive quality treatments in these centers.

IVM cost in Iran

IVM has the viability of being cheaper than IVF as it is more likely that no fertility drugs are required. The fertility drugs used in IVF treatment can cost sometimes up to £2,000 in the UK, which contributes to the higher cost of IVF. On the other hand, the price of IVM treatment globally differs from country to country. The costs of treatment vary considerably from UK, USA or Asia. The present cost for an IVM cycle in the U.S may range somehow from $5,000 to $7,000.

Currently, among countries in Asia, Iranian clinics provide more quality and affordable infertility treatments. The cost of IVM operation in Iran is more affordable and it is less than a third of its price in neighboring countries in the region and even less than that compared with its fees in the UK or in the US, making Iran a desirable country for having IVM surgery.

If you are looking for an affordable and effective IVM treatment, contact us for more information, including a price quote. We will assist you to choose the best doctor and clinic and then we will make the necessary arrangements for you to travel and have your treatment.