In vitro maturation for patients with repeated in vitro fertilization failure due to "oocyte maturation abnormalities"

Objective: To investigate the efficacy of in vitro oocyte maturation (IVM) in women with repeated failure of IVF treatments due to follicular developmental abnormalities. Design: Prospective longitudinal study. Setting: The IVF unit of a university-affiliated medical center. Patient(s): Seven women with three or more IVF failures due to abnormal oocyte development resulting in no egg retrieval (empty follicle syndrome [EFS]), oocyte maturation arrest, or failure of fertilization. Intervention(s): Immature oocyte collection, with or without minimal ovarian stimulation, IVM of the oocytes, insemination by intracytoplasmic sperm injection (ICSI), and embryo transfer. Main Outcome Measure(s): Number of aspirated oocytes, maturation, fertilization and cleavage rates, pregnancy, and ongoing pregnancy. Result(s): Seven women underwent seven IVM cycles. Four of them received a minimal stimulation of 75 IU FSH for 3-4 days. Oocytes were retrieved from all subjects (mean 7.1 ± 3.3 oocytes/cycle). The in vitro maturation rate was 39.6% (mean 2.7 ± 2.9 matured oocytes available for fertilization in four patients). The mean fertilization rate was 45.8% ± 31.6%. Four women had embryo transfer. Two patients with previous genuine EFS conceived and delivered. Conclusion(s): IVM should be considered for women with previous genuine EFS. The role of IVM in other indications of oocyte maturation deficits warrants further investigation.