International Dexeus Forum - 44th edition

REPRODUCTION > MANAGEMENT OF HIGH RESPONDERS

“In vitro maturation of oocytes”

Michel De Vos, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels (Belgium)

In spite of the great success of the “freeze all” strategy to eliminate the risk of OHSS in high responder patients who undergo artificial reproductive treatment (ART), conventional hormone-driven ART is not the one-and-only treatment approach for all patients with an elevated follicle count. A subset of these patients prefers a mild-approach treatment, with fewer hormonal side effects.


In vitro maturation of oocytes

In spite of the great success of the “freeze all” strategy to eliminate the risk of OHSS in high responder patients who undergo artificial reproductive treatment (ART), conventional hormone-driven ART is not the one-and-only treatment approach for all patients with an elevated follicle count.

A subset of these patients prefers a mild-approach treatment, with fewer hormonal side effects. Moreover, some patients with PCOS have a severe phenotype and appear to have narrow dose-response curves with often suboptimal outcomes when treated with conventional ART.

Other indications for an alternative approach include high responders with WHO I anovulation who will not respond to a GnRH agonist trigger in GnRH antagonist protocols, and patients with FSH resistance. For these patients, the development of in vitro maturation of oocytes as a patient-friendly and safe method of assisted reproduction is highly valuable. For these patients, but also for cancer patients who require urgent fertility preservation, there is a highly relevant incentive to develop more efficient clinical and laboratory protocols for IVM.

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