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IVM

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bubble

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Wednesday, October 24th 2007, 6:07pm

IVM

Evening all. Just in case this is of interest to anyone the BBC1 news has a bit on IVM tonight - I'd never heard of it before so did some googling - the following is from the Oxford Fertility Unit. The IVF journey is very new to me but does anyone have any other knowledge or experience of this? x

In January 2007 we were the first unit in the country to be allowed by the HFEA to offer in-vitro maturation (IVM) of oocytes as a fertility treatment.

IVM is a suitable alternative to standard IVF for women <36 years of age who have polycystic ovaries on ultrasound scan. For other women IVF is likely to be a better treatment.

IVM involves taking immature eggs from unstimulated ovaries and then maturing them in the laboratory followed by their fertilisation using ICSI. Embryos are then transferred to the womb a few days later. The egg collection is performed in the same way as a standard IVF collection. Since no ovarian stimulation is required there is no need to buy and take daily gonadotropin injections for 2 weeks and no need to sniff a drug for 3 weeks before that. This means IVM is safer (no risk of ovarian hyperstimulation syndrome), cheaper (no need to buy injectable drugs) and quicker.

Around 400 babies have been born from IVM worldwide and to date there have been no safety concerns. However IVM is not as established a treatment as IVF.

As no ovarian stimulation is used it is vital that the woman’s ovaries contain a large number of resting 2-8mm follicles so that a satisfactory number of immature eggs are retrieved. The pregnancy rate is low for women with normal ovaries and 20-30% for women <36 with polycystic ovaries. In Oxford IVM will initially be offered to this group of women. The cost of IVM is the same as an IVF cycle (see price list) except that the IVM cost includes ICSI as standard and the drug costs are significantly less.

ttc since July 06. 8 cycles of clomid. BFP on cycle 5 (Dec 07) ended in m/c at 9.5 weeks. Second BFP on cycle 8 (May 08)




Eeyore

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Wednesday, October 24th 2007, 6:18pm

Thanks Bubble, there are a few posts about it which also may help

IVM

First baby from lab-matured egg





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bubble

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Wednesday, October 24th 2007, 6:32pm

Thanks Eeyore - sorry I forgot the search function, even with that cute little rabbit peering at me!

The following is the link to the bbc news story


http://news.bbc.co.uk/1/hi/health/7058291.stm

ttc since July 06. 8 cycles of clomid. BFP on cycle 5 (Dec 07) ended in m/c at 9.5 weeks. Second BFP on cycle 8 (May 08)




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Thursday, October 25th 2007, 12:05pm

I think it sounds really good, I am under 35 but dont have PCOS I wonder if any clinics abroad do the treatment?
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Thursday, October 25th 2007, 3:38pm

Apparently its the treatment of choice in Denmark. It sounds great doesn't it? It would certainly improve things a lot whilst at the same time saving money, whats not to like?





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Thursday, October 25th 2007, 4:35pm

this is front page on the idepenant today
TTC 12 years

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lots of ops and tx

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5th fresh short protocol
:BFP:

Tyler May born 5/5/2010 by emergency c section. Tyler is our sunshine

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Thursday, October 25th 2007, 4:41pm

By Jeremy Laurance, Health Editor - The Independent
Published: 25 October 2007


A landmark in the development of fertility treatment was announced by doctors yesterday with the birth of the first babies to be conceived using a revolutionary technique that offers a safer, cheaper alternative to IVF.

The twin boy and girl, who were born on 18 October at the Radcliffe Infirmary in Oxford, were conceived using In Vitro Maturation (IVM), a method that dispenses with the use of costly fertility drugs, saving up to £1,500 on the normal price of treatment.

The technique is also safer for the one in three women among those seeking fertility treatment who have polycystic ovaries, a condition that puts them at high risk of dangerous side effects from fertility drugs.

Specialists said the development could make in vitro techniques available to more infertile couples by cutting the cost of treatment. Infertility is estimated to affect one in six couples in the UK but IVF costs around £5,000 a cycle and treatment is restricted on the NHS.

Tim Child, a consultant gynaecologist at the Oxford Fertility Clinic and senior fellow in reproductive medicine at Oxford University, who led the work, said: "I think it is a safer, cheaper alternative to IVF for all women. However, for many women the success rates are currently much lower. Research in the future will address this."

The Oxford Fertility Clinic is the only one in the UK licensed to use the technique: 20 cycles of treatment have been carried out and four other women are currently pregnant, giving a pregnancy rate of 25 per cent. This is expected to improve with further experience. In addition, without the need for drugs, repeating the procedure would be less taxing on the woman. For standard IVF, the Oxford clinic's pregnancy rate is 45 per cent.

The parents of the babies, who have asked to remain anonymous, were delighted, Mr Child said. At birth the boy, born first, weighed 6lb 11oz and the girl weighed 5lb 14oz. "The parents are ecstatic. They have got absolutely stunning twins. They went home on Tuesday to start their new life together. It is wonderful."

In standard IVF, the woman takes fertility drugs for five weeks to stimulate production of her eggs, which are then collected direct from her ovaries under the guidance of ultrasound, before being fertilised in the laboratory. The drugs cost between £600 and £1,500, with charges often higher in London.

The procedure is time consuming and uncomfortable and for the third of women with polycystic ovaries there is a one in 10 risk of severe ovarian hyperstimulation syndrome, a dangerous side-effect that in rare cases can prove fatal.

IVM avoids the use of drugs and instead involves collecting eggs from the ovaries while they are still immature. The eggs are then grown in the laboratory for 24 to 48 hours before being fertilised and replaced in the womb.

Mr Child said: "The main advantage is improved safety for women. Women with polycystic ovaries have a one in 10 chance of severe ovarian hyperstimulation syndrome. IVM completely takes away that risk. IVF is also expensive. With IVM the cost is reduced, meaning it could become a more accessible form of fertility treatment."

The technique was pioneered by the University of McGill in Montreal, Canada, where Mr Child spent two years researching and developing it before joining the University of Oxford in 2004. It has also been used in Seoul, South Korea, and Scandinavia. To date about 400 babies have been born worldwide using IVM compared with around two million by IVF.

At present the Oxford Fertility Clinic is only offering the treatment to women with polycystic ovaries, but in the long term Mr Child said he hoped to offer the procedure to all women. "When we see patients we say these are the options and it is up to them to decide. We are not offering it to women with normal ovaries at present because we don't get enough eggs from them. It depends on the number of resting follicles and with normal ovaries you don't get so many.

"On average we get four eggs from a woman with normal ovaries compared with 16 from one with polycystic ovaries. The procedure involves a process of attrition – two-thirds mature and two-thirds of those fertilise – so you need a decent number to start with."

Research on developing the culture medium in which the eggs are matured in the laboratory could reduce the attrition rate so that fewer eggs are needed. The technique could then become suitable for women with normal ovaries, Mr Child said.

A second drawback of the procedure was that eggs grown in culture had a harder outer shell than those matured in the ovary and were more difficult for sperm to penetrate. The eggs had to be fertilised by ICSI – injecting a single sperm directly into the egg. "We hope to develop the culture medium so the egg doesn't mind being grown in the laboratory and we can use ordinary insemination [mixing eggs and sperm so fertilisation occurs naturally]. But in most IVF clinics, 50 per cent of patients are treated with ICSI anyway," he said.

A spokesman for the Human Fertilisation and Embryology Authority said IVF was expensive for most couples and a minority got treatment on the NHS. But it was too soon to tell whether IVM would replace IVF.

"Anything that reduces the cost of IVF, provided it is safe, means treatment could be available to more people. But this is an emerging technology – it is very early days. The most important thing is that patients get proper information so that they can make a decision on what is best for themselves."


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