In Vitro Maturation (IVM) of human eggs has at best, always held a niche place in clinical infertility treatment. IVM is an adjunct step that removes, or more commonly reduces, the hormone drugs used to stimulate ovarian follicle development. In a normal IVF cycle, a hormone cocktail is required and normally self-administered to enable a number of mature eggs (oocytes) to be collected. Over the last decade, these hormone treatments have become more sophisticated, but still there are patient groups that are unsuitable for normal treatment, such as those with polycystic ovaries, who are too sensitive to these hormones. During IVM, immature oocytes are recovered from the ovaries with little or even no hormone treatment, thereby an attractive alternative for those patients that are not able to pursue conventional hormone treatment. Nevertheless, the subsequent live-birth rates are lower, and therefore unattractive as a general treatment. However, researchers such as myself, believe that developments in the IVM culture system will eventually overcome this hurdle.
In recent times, remarkable development in human IVM research has been achieved. A new approach aims at allowing the recovered oocyte to first be cultured within specific medium conditions that allows the oocyte to remain “immature”, buying time for the internal machinery to develop sufficiently. When released from this “pre-maturation” medium, the oocyte more readily advances to maturity. In animal models, this has been shown to better prepare oocytes for fertilisation and further embryo development. Similarly, initial trials with human oocytes recorded positive responses. The big test for the new system was a larger, well conducted trial, directly comparing the new IVM system vs. IVF. Published recently (doi:10.1093/humrep/deaa240) in the prestigious journal, Human Reproduction, this collaborative work between Belgium, Australian and Vietnamese researchers demonstrated that the results, although historically better than previous IVM systems, still didn’t reach the levels of live-births when compared to IVF cycles performed at the same time. However, it does show that the concept of the “pre-maturation” approach is certainly one to follow in further work. And, we also believe our Fertilis system perfectly suits this concept of multiple medium formulations being delivered seamlessly across all stages of IVM-fertilisation-embryo culture and cryopreservation. Our development plan should see our first prototype completed within a year, and we look forward to working with these researchers.