Estrogen-suppressed in vitro maturation: a novel approach to in vitro maturation

Objective: To evaluate the laboratory and clinical outcomes of estrogen-suppressed in vitro maturation (ES-IVM), a novel IVM protocol that eliminates the need for FSH stimulation and cycle monitoring. Design: Case series. Setting: Academic infertility center. Patient(s): Eighteen infertile couples undergoing ES-IVM (n = 20). Eligible candidates included women <= 38 years old with either polycystic ovarian syndrome, antral follicle count >= 15, and/or history of ovarian hyperstimulation syndrome. Intervention(s): ES-IVM. Main Outcomes Measure(s): Oocyte yield, maturation, fertilization, embryo quality, implantation, clinical pregnancy, and live-birth rate were analyzed. Result(s): The average number of oocytes retrieved was 16.7 +/- 5.9, with a 52.1% maturation rate and a 58% fertilization rate by intracytoplasmic sperm injection. The average number of embryos transferred was 2.85 +/- 0.6. The implantation rate was 17.5%, the clinical pregnancy rate was 40%, and the live-birth rate was 40%. Conclusion(s): The efficiency of ES-IVM appears to be similar to natural cycle and low-stimulation IVM protocols with respect to laboratory and clinical outcomes, while eliminating the need for FSH stimulation and cycle monitoring. (C)2013 by American Society for Reproductive Medicine.