RESUMO
OBJECTIVE: Although some patients may benefit from reduced follicle-stimulating hormone (FSH) application, in-vitro maturation (IVM) belongs to the rare treatment options in assisted reproduction. We summarize our five-year IVM experience. DESIGN: Retrospective, observational study. SETTING: Reproductive Medicine, University Hospital. SAMPLE: 115 patients with polycystic ovary syndrome (PCOS) as well as patients after ovarian hyperstimulation syndrome (OHSS) from February 2005 to December 2009. MATERIAL AND METHODS: Stimulation started between day 3-10 of the menstrual cycle and FSH dosage was 125IU/day over three days. Ovulation was induced on the third day of FSH injection or one day afterwards and oocyte retrieval was performed 33-38 hours later. Oocytes were cultivated for 24 hours in IVM medium. Fertilization was carried out one day after oocyte retrieval and embryo transfer two days afterwards. MAIN OUTCOME MEASURES: Pregnancy rates. RESULTS: 115 patients were included and 215 oocyte retrievals (intracytoplasmic sperm injection: n=125, 59%; in vitro fertilization: n=73, 34.4%) with 177 embryo transfers performed. The main reasons for IVM were: PCOS (71.7%) and OHSS (15.0%). Mean number of oocytes was 8.9/oocyte retrieval with 5.9 (64%) becoming mature, 2.8 (45.1%) being fertilized and 2.1 transferred. Pregnancy rate per transfer was 15.3% (n=27) with 13 live births (7.3%), one intrauterine death (0.6%), four miscarriages (2.3%) and nine biochemical pregnancies (5.1%). In 61 cases, fertilized oocytes were frozen and 32 cryotransfers were performed, resulting in three pregnancies. CONCLUSIONS: Although the pregnancy rate was low, IVM is very convenient for patients due to low FSH dosages and few appointments at low cost.
