Sauerbrun-Cutler May-Tal, Vega Mario, Keltz Martin, McGovern Peter G
Researcher-Writer, Department of Obstetrics and Gynecology, Mount Sinai St Luke's-Roosevelt, Icahn School of Medicine at Mount Sinai.
Director, Division of Reproductive Endocrinology, Continuum Reproductive Center, Department of Obstetrics and Gynecology, St Luke's-Roosevelt Hospital Center, Mount Sinai Health System.
Obstet Gynecol Surv. 2015 Jan;70(1):45-57. doi: 10.1097/OGX.0000000000000150.
In vitro maturation (IVM) refers to maturation in culture of immature oocytes that may or may not have been exposed to short courses of gonadotropins. Approximately 5000 live births have occurred as a result of IVM since the 1970s. Currently, IVM is reserved for carefully selected patients at risk for ovarian hyperstimulation syndrome and for those with contraindications to hormone administration. The technology is still considered experimental.
The objective of this study was to identify a role for IVM and discuss clinical practices based on the current literature.
We conducted a literature review of all available and published data. Relevant studies were identified using PubMed and MEDLINE. Search parameters included "in vitro maturation or IVM" and "oocyte maturation." Multiple case-control studies were identified comparing reproductive outcomes between conventional in vitro fertilization (IVF) and IVM, but no randomized controlled trials have been reported to date comparing IVF and IVM.
Results from retrospective and prospective observational studies have shown decreased live birth and implantation rates in comparison to conventional IVF/intracytoplasmic sperm injection for patients with various indications for IVM. However, rates of ovarian hyperstimulation syndrome were significantly reduced in studies with patients with polycystic ovary syndrome.
Although the pregnancy rate is lower than conventional IVF, IVM is a safer and simpler alternative to conventional IVF. Future research needs to focus on improving implantation and live birth rates before universal implementation.
体外成熟（IVM）是指未成熟卵母细胞在培养中的成熟过程，这些卵母细胞可能已经或未曾接触过短期促性腺激素治疗。自20世纪70年代以来，IVM已促成约5000例活产。目前，IVM仅适用于精心挑选的有卵巢过度刺激综合征风险的患者以及那些有激素给药禁忌证的患者。该技术仍被视为实验性技术。
本研究的目的是确定IVM的作用，并根据当前文献讨论临床实践。
我们对所有可用的已发表数据进行了文献综述。使用PubMed和MEDLINE识别相关研究。检索参数包括“体外成熟或IVM”和“卵母细胞成熟”。我们识别出多项病例对照研究，比较了传统体外受精（IVF）和IVM之间的生殖结局，但迄今为止尚无比较IVF和IVM的随机对照试验报告。
回顾性和前瞻性观察性研究的结果表明，与传统IVF/卵胞浆内单精子注射相比，各种IVM适应证患者的活产率和着床率有所降低。然而，在多囊卵巢综合征患者的研究中，卵巢过度刺激综合征的发生率显著降低。
尽管妊娠率低于传统IVF，但IVM是传统IVF更安全、更简单的替代方法。在广泛应用之前，未来的研究需要专注于提高着床率和活产率。
