At Marin Fertility Center, we are committed to advancing the global understanding of infertility, fertility preservation, and assisted reproductive technologies such as IVF, ICSI, and egg freezing by actively publishing and contributing research that supports the broader medical community.
Date: October 2023
Authors: P. Uzelac, P. Yango, X. Yu
Presentation: American Society of Reproductive Medicine Annual Meeting 2023
Context: Leveraging time-lapse technology in the embryology lab to gain a deeper level of understanding about hypochlorous acid safety during egg retrieval procedures and IVF laboratory conditions.
Date: March 2023
Authors: Yu X, Yango P, Zhou A, Uzelac PN, Uzelac PS
Presenation: Pacific Coast Reproductive Society Annual Meeting 2023
Context: The pandemic introduced unique challenges to fertility clinics, including mitigating infectious risk to staff and patients while preserving embryo safety during IVF and cryopreservation of embryos. Marin Fertility Center contributed this approach as a potential solution.
Date: October 2023
Authors: P. Uzelac, P. Yango, X. Yu
Presentation: American Society of Reproductive Medicine Annual Meeting 2023
Context: Utilizing time-lapse technology to further evaluate IVF laboratory conditions and embryo development, supporting innovation in fertility preservation and alternative IVF approaches.
Objective To report a live birth after in vitro maturation (IVM) of oocytes retrieved from extracorporeal ovarian tissue aspiration in the setting of fertility preservation. Design Observational study. Setting Academic center. Patient(s) A 23-year-old woman. Intervention(s) IVM from extracorporeal ovarian tissue aspiration. Main Outcome Measure(s) Live birth after IVM. Result(s) A 23-year-old woman conceived with embryos
Objective
To report a live birth after in vitro maturation (IVM) of oocytes retrieved from extracorporeal ovarian tissue aspiration in the setting of fertility preservation.
Design
Observational study.
Setting
Academic center.
Patient(s)
A 23-year-old woman.
Intervention(s)
IVM following extracorporeal ovarian tissue aspiration without traditional ovarian stimulation.
Main Outcome Measure(s)
Live birth after IVM.
Result(s)
A 23-year-old woman conceived with embryos derived from extracorporeal oocyte aspiration followed by IVM, embryo freezing, and frozen embryo transfer.
Conclusion(s)
A healthy live birth from extracorporeal aspiration of immature oocytes, IVM, and a frozen embryo transfer after 5 years was documented. Consideration of this technique should be made as a primary or adjunct intervention in the setting of fertility preservation.
In vitro maturation (IVM) is an advanced embryology lab technique in which immature oocytes are retrieved before completing in vivo development and matured from the germinal vesicle (GV) stage to metaphase II (MII). Once matured, these oocytes can be fertilized using IVF or intracytoplasmic sperm injection (ICSI) and developed into embryos for transfer or cryopreservation of embryos.
IVM is a technically demanding and labor-intensive method requiring high-level laboratory expertise. As a result, its role among assisted reproductive technologies remains an area of ongoing clinical discussion.
However, IVM offers significant advantages for fertility preservation, including flexibility in timing and elimination of the need for hormonal stimulation prior to egg retrieval. This makes it particularly valuable for patients undergoing urgent cancer treatment or those with estrogen-sensitive conditions who must avoid elevated estradiol levels.
Cryopreservation of embryos, oocytes, or ovarian tissue remains a cornerstone of modern fertility preservation strategies. The increasing number of live births from vitrified oocytes demonstrates the growing importance of egg freezing as a reproductive option.
However, traditional egg freezing protocols involving controlled ovarian stimulation may not be suitable for all patients, particularly those with cancer due to potential risks associated with hormonal exposure.
In cases where time constraints prevent standard IVF cycles, immature oocyte retrieval followed by IVM and vitrification offers a promising alternative. This approach allows oocyte collection during both follicular and luteal phases, increasing the opportunity for successful fertility preservation.
Combining ovarian tissue cryopreservation with immature oocyte retrieval and IVM represents another emerging strategy, especially relevant for young women facing gonadotoxic treatments.
Objective: Emerging evidence suggests that mild approaches in assisted reproductive technology, including minimal stimulation IVF and IVM, may provide comparable outcomes to traditional IVF in certain patient populations.
Methods: A review of literature evaluating mild IVF protocols for women over age 35.
Results: Data indicate that natural cycle IVF is generally not recommended for women over age 39. However, minimal stimulation IVF demonstrates comparable live birth rates per cycle in selected patients, consistent with national ART data. Limited evidence suggests that IVM may be considered up to age 40.
Conclusions:
Recent research highlights the evolving role of mild IVF strategies in women of advanced reproductive age. While variability in protocols and study design limits definitive conclusions, individualized treatment—including IVF, IVM, and fertility preservation techniques such as egg freezing and embryo freezing—remains essential.
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