join our egg freezing info session 02/05
At Marin Fertility Center, we are committed to advancing the global understanding of infertility 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 Reproducitve Medicine Annual Meeting 2023
Context: Leveraging timelapse technology to gain a deeper level of understanding about hypochlorous acid safety in the IVF laboratory.
Date: March 2023
Authors: Yu X, Yango P, Zhou A, Uzelac PN, Uzelac PS
Presenation: Pacififc Coast Reproducitve Society Annual Meeting 2023
Context: The pandemic ushered in unique issues to fertility clinics including mitigating infectious risk to staff and patient while keeping embryos safe. MFC is proud to have suggested this as one solution.
Date: October 2023
Authors: P. Uzelac, P. Yango, X. Yu
Presentation: American Society of Reproducitve Medicine Annual Meeting 2023
Context: Leveraging timelapse technology to gain a deeper level of understanding about hypochlorous acid safety in the IVF laboratory.
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 from extracorporeal ovarian tissue aspiration.
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 laboratory technique whereby immature oocytes, which are removed from ovarian follicles prior to completing their growth in vivo, are cultured from the germinal vesicle (GV) to the metaphase II (MII) stage. Upon reaching maturity in vitro, these eggs can then be fertilized and the resulting embryos can
be cultured using conventional in vitro fertilization (IVF) techniques and transferred or cryopreserved.
Except in the most experienced hands, IVM is a labor-intensive, experimental technology requiring meticulous laboratory skills in order to maximize embryonic potential. For that reason, its current place among other assisted reproductive technologies is controversial.
Nevertheless, IVM has several unique characteristics that make it an attractive option for fertility preservation. Most notably, IVM allows for extreme fl exibility in treatment timing and does not require hormonal stimulation prior to oocyte retrieval from the ovary. This facilitates rapid fertility preservation interventions in the face of impending cancer treatment. It also allows women with estrogen-sensitive cancers to avoid supraphysiologic elevations in serum estradiol levels with ovarian stimulation.
Cryopreservation of embryos, oocytes, or ovarian tissues is the main option for female fertility preservation. Oocyte cryopreservation has emerged as especially important: the dramatic increase in the number of infants born from vitrified oocytes indicates that it is becoming one of the most important intervention options. However, oocyte cryopreservation with standard controlled ovarian hyperstimulation may not be feasible for some cancer patients as there are serious concerns about the effect of ovarian stimulation with hormones on the risk of cancer recurrence.
Also, urgent gonadotoxic cancer treatment may not allow sufficient time for a patient to undergo hormonal ovarian stimulation. Thus, immature oocyte retrieval from ovaries without ovarian stimulation followed by in vitro maturation and vitrification is a promising fertility preservation option for women who cannot undergo ovarian stimulation or cannot delay their gonadotoxic cancer treatment. Immature oocytes can be collected from the ovaries during both the follicular and luteal phases, which maximizes the possibility for fertility preservation. The combination of ovarian tissue cryopreservation with immature oocyte collection from the tissue followed by oocyte vitrification via in vitro maturation represents another promising approach of fertility preservation in young women with cancer.
Objective: A growing body of literature suggests that, among some infertility patient populations, mild approaches in assisted reproductive technology (ART) may result in similar outcomes when compared to those utilizing controlled ovarian hyperstimulation (COH). Given the well-recognized decline in success of conventional in vitro fertilization (IVF) with age, it is unclear whether mild approaches in ART should be considered for women older than 35 years.
It is the aim of this paper to characterize the role of natural cycle IVF, minimal stimulation IVF and in vitro maturation (IVM) for women of advanced reproductive age.
Methods: A review and summary of the literature on mild approaches in ART for women over the age of 35 years is presented.
Results: Available evidence regarding natural cycle IVF and its variants suggest that it should not be routinely offered to women of advanced reproductive age, especially over the age of 39. Data from centers well-experienced with minimal stimulation IVF report per cycle live birth rates for several subgroups of women older than 35 years that are comparable to those in the 2010 US Assisted Reproductive Technology National Summary Report. Limited data on IVM suggests that it can be considered up until the age of 40.
Conclusions: Recent additions to the literature provide new insight into the efficacy of mild approaches in ART to women of advanced reproductive age. Suboptimal study designs, heterogeneity of protocols and variation in center experience make definitive conclusions difficult however there are several treatment options which would appear to be reasonable for select patient populations. Future studies addressing patient satisfaction, dropout rates and cost will further define the role of mild approaches in ART for this group of women.
Once you have booked your new patient appointment, you will be given instructions on how to complete all of the onboarding action steps. Below are some of the items needed...
Moderate IVF focuses on quality, not quantity. The goal of moderate (aka mini) IVF is to stimulate the ovary with a smaller amount of medication to promote the development of...
Egg freezing helps you gain time and the list of possible reasons to freeze your eggs continues to expand.