IVM取卵之時間點(前或晚濾泡期，黃體期)取卵結果無明顯差異(濾泡期略優於黃體期)
IVM形成之胚胎染色體異常率與一般IVF形成之胚胎染色體異常率無明顯差異
IVM形成之M2卵子經ICSI受孕率與一般IVF形成之M2卵子受孕率無明顯差異
IVM目前最常適應症為癌症病患，須立刻取卵保存或避免施打排卵針
但取卵數量偏低(7-8顆)，卵子成熟率偏低(50-58%)及胚胎數量均偏低(2-3顆胚胎)
IVM第二適應症為PCO
PCO病患卵子數量多，經IVM可以量取勝獲得足夠之胚胎
https://www.researchgate.net/publication/303868847_In_Vitro_Maturation_of_Oocytes_Current_Status_and_Controversies
https://www.ncbi.nlm.nih.gov/pubmed/27810160
Fertil Steril. 2016 Oct 31. pii: S0015-0282(16)62872-8. doi: 10.1016/j.fertnstert.2016.09.041. [Epub ahead of print]
Immature oocyte retrieval and in vitro oocyte maturation at different phases of the menstrual cycle in women with cancer who require urgent gonadotoxic treatment.
Abstract
OBJECTIVE:
To evaluate the feasibility and the efficacy of in vitro maturation (IVM) when immature oocyte collection was performed in the early follicular, late follicular, or luteal phases in women with cancer who require urgent chemotherapy.
DESIGN:
Retrospective cohort study.
SETTING:
University teaching hospital.
PATIENT(S):
One-hundred and sixty-four women with cancer undergoing IVM treatment for fertility preservation.
INTERVENTION(S):
Oocyte retrieval, IVM, cryopreservation.
MAIN OUTCOME MEASURE(S):
Medians (interquartile range) of oocytes collected, maturation rates after 48 hours of culture, and metaphase II oocytes cryopreserved.
RESULT(S):
The analysis included a total of 192 cycles grouped into early follicular phase (n = 46), late follicular phase (n = 107), or luteal phase (n = 39). Embryo cryopreservation was performed in 82 cycles, and oocyte cryopreservation in 105 cycles. Between the early follicular, late follicular, and luteal phases, no statistically significant differences were found in the number of oocytes collected (8.5 [4-15.8], 8 [5-14], and 7 [4-9], respectively), the maturation rates after 48 hours of culture (53.5% [39.8-77], 58% [44-82], and 50% [33-67], respectively), or the number of oocytes cryopreserved (3 [0-7.3], 3 [0-7], and 3 [1-5.5], respectively). Similarly, the fertilization rates (77 [62.8-92.5], 75 [60-100], and 63.5 [50-75], respectively) and number of embryos cryopreserved (3 [2-5.8], 3 [0.5-5], and 2 [1-3], respectively) were not statistically significantly different among the groups.
CONCLUSION(S):
Our study confirms the feasibility of IVM collection at any time during the menstrual cycle. Treatment with IVM is an alternative method when chemotherapy cannot be delayed or ovarian stimulation is contraindicated. The long-term outcomes remain to be studied.
https://www.ncbi.nlm.nih.gov/pubmed/26759139
Hum Reprod. 2016 Mar;31(3):623-9. doi: 10.1093/humrep/dev325. Epub 2016 Jan 11.
Similar in vitro maturation rates of oocytes retrieved during the follicular or luteal phase offer flexible options for urgent fertility preservation in breast cancer patients.
Abstract
STUDY QUESTION:
Are in vitro maturation (IVM) rates of cumulus-oocyte complexes (COCs), retrieved from breast cancer patients seeking urgent fertility preservation (FP) before neoadjuvant chemotherapy, different between those recovered in the follicular or in the luteal phase of the cycle?
SUMMARY ANSWER:
The present investigation reveals no major difference in the number of COCs recovered or their IVM rates whatever the phase of the cycle at which egg retrieval is performed, suggesting that IVM is a promising tool for breast cancer patients seeking urgent oocyte cryopreservation.
WHAT IS KNOWN ALREADY:
FP now represents a standard of care for young cancer patients having to undergo gonadotoxic treatment. Mature oocyte cryopreservation after IVM of COCs has been proposed for urgent FP, especially in women, who have no time to undergo ovarian stimulation, or when it is contraindicated.
STUDY DESIGN, SIZE, DURATION:
From January 2011 to December 2014, we prospectively studied 248 breast cancer patients awaiting neoadjuvant chemotherapy, aged 18-40 years, candidates for oocyte vitrification following IVM, either at the follicular or the luteal phase of the cycle.
PARTICIPANTS/MATERIALS, SETTING, METHODS:
Serum anti-Müllerian hormone and progesterone levels and antral follicle count (AFC) were measured prior to oocyte retrieval. Patients were sorted into two groups according to the phase of the cycle during which eggs were harvested (Follicular phase group, n = 127 and Luteal phase group, n = 121). Number of COCs recovered, maturation rates after 48 h of culture and total number of oocytes cryopreserved were assessed. Moreover, the oocyte retrieval rate (ORR) was calculated by the number of COCs recovered ×100/AFC.
MAIN RESULTS AND THE ROLE OF CHANCE:
In the Follicular and the Luteal phase groups, women were comparable in terms of age, BMI and markers of follicular ovarian status. There was no significant difference in the number of COCs recovered (mean ± SEM), 9.3 ± 0.7 versus 11.1 ± 0.8, and ORR (median (range)) 43.1 (1-100) versus 47.8 (7.7-100)%. Moreover, maturation rates after 48 h of culture (median (range)) were comparable in the follicular and luteal phase groups, 66.7 (20-100) versus 64.5 (0-100)%. Finally, the total number of oocytes cryopreserved (mean ± SEM) was similar in both groups (6.2 ± 0.4 versus 6.8 ± 0.5).
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