In vitro oocyte maturation is a technique of ART, in which the oocyte are matured outside of the female body.

1. UNIVERSITY OF
LADAKH
Presentation on:
IN VITRO OOCYTE
MATURATUION (IVM)
SUBMITTED BY:
STANZIN DOLMA
1st semester
M.sc. Zoology
SUBMITTED TO:
Dr. BASHARAT ALI
Department of Zoology

2. INTRODUCTION
• In vitro oocyte maturation (IVM) is a medical
technique used in assisted reproductive
technology.
• It involves the collection of immature
oocytes from a woman’s ovaries, which are
then cultured and matured in a controlled
laboratory environment.
• Once matured, these oocytes can be
fertilized, providing a potential solution for
infertility.
• IVM is particularly useful for individuals who cannot undergo traditional in vitro
fertilization (IVF) or those at risk of ovarian hyperstimulation syndrome (OHSS).

3. HISTORY
• In 1935, Pincus & Enzmann did the first experiment on immature rabbit
oocyte, showing in vitro spontaneous maturation and fertilization. They
showed maturation occurs in isolation from normal follicular
environment.
• In 1965 Edwards then continued IVM studies in mouse, sheep, cow, pig,
rhesus monkey and human.
• In 1991 the first human pregnancy was recorded using IVM followed by IVF.
• In 1994 the first birth using IVM oocytes from polycystic ovarian syndrome
patients was recorded highlighting that PCOS patient’s oocytes are capable
of maturation.

4. • Oocyte maturation is the physiological event that precedes, and is required
for, successful fertilization and embryo development
• During development in the fetal ovary, oocytes in most mammals become
arrested at the diplotene stage of prophase I (the germinal vesicle stage).
• Resumption of meiosis, triggered by the preovulatory surge of luteinizing
hormone, and progression through maturation results in further arrest at the
metaphase II (MII) stage with extrusion of the first polar body (PB) and
establishment of a DNA complement of 1n2C.
• Penetration of the sperm (1n1C) leads to extrusion of the second PB and
establishment of a 1n1C state in the oocyte leading to a diploid embryo (2n2C)
after the first mitotic division following fertilization. All subsequent divisions
are mitotic, resulting in two identical daughter cells.
WHAT IS OOCYTE
MATURATION?

5. DEVELOPMENT OF
FOLLICLES

6. PROCEDURE OF IVM
In vitro oocyte maturation is a medical procedure used in assisted reproductive
technology. The process includes are:
• Oocyte Retrieval: IVM typically starts
with ovarian stimulation, but in some
cases, it may involve unstimulated
cycles. Immature oocytes (eggs) are
collected from a woman’s ovaries.When
the follicles are mature, an oocyte
retrieval procedure is performed. This
involves a transvaginal ultrasound-
guided aspiration, where a needle is
used to aspirate the fluid from the
mature follicles. This fluid contains
immature oocytes.
• Oocyte Selection: After retrieval, the fluid is examined in the laboratory
to identify the immature oocytes. Not all collected oocytes are suitable
for IVM, so the best-quality ones are chosen for the next steps.

7. In Vitro Culture: The selected immature oocytes are placed in a culture
medium in a controlled environment within the laboratory.
• The culture conditions mimic the environment within the female body as
closely as possible to encourage maturation.
• There are two kinds of culturing methods:
1. Conventional IVM- In the conventional IVM, immature oocytes
were directly cultured to MII oocytes after oocyte .However,
conventional IVM focuses on nuclear maturation, ignoring the
synchronous maturation of cytoplasm.
1. BIPHASIC IVM- The biphasic IVM culturing system (also known as
capacitation IVM (CAPA-IVM)), which includes a pre-IVM culturing period
(around 24 h) before the IVM culturing has been well developed in animal
IVM.The pre-IVM culturing was mainly applied to inhibit resumption of
meiosis and promote synchronization between the nuclear and
cytoplasmic maturation

8. Maturation Process: Over the course of 24 to 48 hours, the immature oocytes
undergo maturation in the culture medium.
• This involves the development of the oocyte nucleus (germinal vesicle) and
the surrounding layers of cells, ultimately reaching the metaphase II (MII)
stage, where they are ready for fertilization.
• Hormone monitoring and microscopic evaluation are used to assess the
progression of maturation.
• This maturation involves the development of the oocyte nucleus and
surrounding layers of cells, ensuring they exhibit the signs of readiness for
fertilization.
Fertilization- Once the oocytes have reached the MII stage, they can be fertilized.
This can be achieved through traditional IVF, where they are exposed to sperm in
a laboratory dish, or by ICSI, where a single sperm is injected directly into each
mature oocyte. After fertilization, the resulting zygotes are cultured for a few
days.
Embryo Transfer- The best-quality embryos are selected for transfer into the
woman’s uterus. The choice of the number of embryos to transfer depends on
the woman’s age, embryo quality, and other factors.
The embryo transfer procedure is similar to traditional IVF, where one or more
embryos are carefully placed in the uterine cavity with the hope of establishing a
successful pregnancy.

9. WHY IVM IS DONE?
In vitro oocyte maturation (IVM) is done for several reasons:
• Polycystic Ovary Syndrome (PCOS): IVM is often used for women with PCOS, a
condition where multiple immature follicles develop in the ovaries.
Conventional ovarian stimulation in IVF can lead to a higher risk of ovarian
hyperstimulation syndrome (OHSS) in these cases, so IVM is a safer alternative.
• Ovarian Disorders: Women with certain ovarian disorders that prevent the
proper maturation of eggs may benefit from IVM.
• Cancer Patients: Some cancer treatments, such as chemotherapy, can harm a
woman’s ovarian function. In such cases, IVM allows for the retrieval and
preservation of immature oocytes before cancer treatment begins.
• Fertility Preservation: IVM can be used for fertility preservation purposes. For
instance, women who wish to delay childbearing for personal or medical
reasons may opt for IVM to freeze and mature their eggs at a later date.
• Low Ovarian Reserve: Women with a low ovarian reserve may have limited egg
production. IVM can help maximize the use of the few available oocytes.
• Patient Preference: In some cases, women may prefer IVM over conventional
IVF due to personal or medical considerations.

10. Differences IVM IVF
Oocyte Maturation In IVM, immature eggs
are retrieved directly
from the ovaries without
the need for extensive
ovarian stimulation.
In traditional IVF, mature
eggs are retrieved from
the woman’s ovaries after
undergoing ovarian
stimulation with fertility
medications.
Timing of Oocyte
Retrieval
Oocyte retrieval in IVM
takes place while the
oocytes are still
immature. They are
matured in vitro over a
period of 24 to 48 hours.
Oocyte retrieval in IVF
occurs after the eggs
have matured in
response to ovarian
stimulation, typically 36
hours after a trigger
injection.
Indication IVM is often considered
for specific situations,
such as women with
PCOS where ovarian
stimulation might carry a
higher risk of ovarian
hyperstimulation
syndrome (OHSS).
IVF is commonly used for
a wide range of fertility
issues, including male
infertility, tubal
blockages, and
unexplained infertility.
DIFFERENCE BETWEEN
IVM AND IVF

11. DIFFERENCES IVM IVF
Hormonal Stimulation IVM minimizes the use of
hormonal stimulation,
which may be more
suitable for certain
patients, especially those
at risk of OHSS.
IVF involves controlled
ovarian stimulation with
hormonal medications to
induce the growth of
multiple follicles.
Success Rates IVM success rates can be
lower, especially in
certain patient
populations. Not all
immature oocytes may
successfully mature.
IVF typically has higher
success rates compared
to IVM, as mature eggs
are used for fertilization.
Cost and Time
Commitment
IVM may be a more cost-
effective and less time-
consuming option for
some patients, as it
involves fewer days of
treatment.
IVF is often more
expensive due to the
need for hormonal
stimulation and a longer
treatment process.

12. SUCESS RATES OF IVM
The success rates of in vitro oocyte maturation (IVM) can vary widely depending
on several factors, including the patient's specific condition, the clinic's expertise,
and the underlying cause of infertility. In general, the success rates for IVM tend
to be lower than those for traditional in vitro fertilization (IVF) because IVM
involves maturing immature oocytes. However, here are some factors that can
influence the success of IVM:
• Underlying Cause of Infertility: The success of IVM may be higher for certain
conditions, such as polycystic ovary syndrome (PCOS), where it is commonly
used. Success rates can be lower for other causes of infertility.
• Patient Age: As with IVF, the age of the patient is a significant factor. Younger
patients tend to have higher success rates with IVM.
• Quality of Oocytes: The quality of the immature oocytes retrieved and their
ability to mature in vitro can impact success. Not all immature oocytes may
successfully mature.
• Expertise of the Clinic: The experience and expertise of the fertility clinic and
its laboratory team play a crucial role in the success of IVM.
• Fertilization Method: The method used for fertilization, whether traditional
IVF or ICSI (intracytoplasmic sperm injection), can influence outcomes.

13. REFERENCE
• https://en.m.wikipedia.org/wiki/In_vitro_maturation#:~:text=9%20References-
,History,pig%2C%20rhesus%20monkey%20and%20human.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715881/
• https://www.frontiersin.org/articles/10.3389/fcell.2021.654028/full
• https://rep.bioscientifica.com/view/journals/rep/152/5/R143.xml