In vitro maturation (IVM) of human oocytes is an emerging treatment option for women with polycystic ovary/polycystic ovary syndrome (PCO/PCOS) in addition to the standard in vitro fertilization (IVF) treatment. There has been significant improvements in pregnancy rates with IVM over the last two decades. This article reviews the place of IVM for women with PCO/PCOS, placing an emphasis on the predictors of successful pregnancy, optimization of culture media, IVM protocols, pregnancy rates, and neonatal outcomes following IVM treatment.
A 31-year-old woman presented to the emergency department with sudden onset left upper quadrant pain radiating to the left shoulder. Urine β-hCG test was positive. Transvaginal sonography was suggestive of ruptured ectopic pregnancy with a large amount of free fluid in the pouch of Douglas. The patient was then taken for emergency laparoscopy. On laparoscopy, hemoperitoneum was noted but both the fallopian tubes and ovaries were normal. On further exploration, bleeding was noted from the spleen so laparotomy was performed and emergency splenectomy was carried out by a surgeon. The histopathology report of the spleen confirmed a splenic ectopic pregnancy. On postoperative follow-up, the patient's quantitative serum β-hCG started rising again, which raised suspicion of another pregnancy. After serial β-hCG and ultrasound, a failed intrauterine pregnancy was diagnosed. Suction evacuation was performed, with histopathology confirming products of conception.
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