A new treatment to avoid severe ovarian hyperstimulation utilizing insights from in vitro maturation therapy

Excerpt

Ovarian hyperstimulation syndrome (OHSS) can be a serious complication of gonadotropin ovulation induction for IVF. These are a number of therapies (Table 1) designed to mitigate or avoid severe OHSS, but all of these generally either require pre-planning or alter the normal flow of an IVF-ET cycle. In vitro maturation with IVF (IVM) is an established approach for avoiding any degree of OHSS in patients requiring advanced reproductive technology treatment since oocytes are harvested from medium to large antral follicles before in vivo follicle selection begins [1, 2]. With IVM, immature oocytes complete meiosis II over the next 48 h and are then fertilized once they become mature. Some IVM practitioners have advocated “rescue IVM” as a way of preventing severe OHSS in the setting of conventional IVF [3]. “Rescue IVM” means that the physician has concluded that a conventional IVF cycle can not safely proceed and the physician changes the treatment direction by immediately applying that program’s IVM protocol to the cycle. If aspiration occurred before follicle selection takes place, then the risk of OHSS was eliminated. …