Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial

Vuong, Lan N; Ho, Vu N A; Ho, Tuong Vinh; Dang, Vinh Q.; Phung, Tuan H; Giang, Nhu H.; Le, Anh H; Pham, Toan D; Wang, Rui; Norman, Robert J.; Smitz, Johan; Gilchrist, Robert B.; Mol, Ben Willem J.

doi:10.1136/bmjopen-2018-023413

Cited by 22 publications

(7 citation statements)

References 18 publications

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“…Further investigations in larger patient populations are warranted in order to determine whether live birth rates with CAPA-IVM are improved compared with standard IVM. To this end, a large randomized clinical trial is currently underway to compare the efficacy and safety of CAPA-IVM versus conventional COS in women with a high antral follicle count (NCT03405701) [25].…”

Section: Discussionmentioning

confidence: 99%

“…After 24 h, COCs were washed and transferred into IVM medium (Origio, Denmark) containing 5 ng/mL insulin, 10 nM estradiol, 100 ng/mL human recombinant amphiregulin, and 100 mIU/mL rFSH, and incubated under oil for 30 h at 37°C, 6% carbon dioxide in air. Laboratory checks for oocyte maturation were performed after denuding of oocytes at 30 h of IVM for both IVM groups, as previously described [25].…”

Section: Study Schedule and Proceduresmentioning

confidence: 99%

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Live births after oocyte in vitro maturation with a prematuration step in women with polycystic ovary syndrome

Vuong

et al. 2020

J Assist Reprod Genet

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Purpose Standard oocyte in vitro maturation (IVM) usually results in lower pregnancy rates than in vitro fertilization (IVF). IVM preceded by a prematuration step improves the acquisition of oocyte developmental competence and can enhance embryo quality (EQ). This study evaluated the effectiveness of a biphasic culture system incorporating prematuration and IVM steps (CAPA-IVM) versus standard IVM in women with polycystic ovarian morphology (PCOM). Methods Eighty women (age < 38 years, ≥ 25 follicles of 2-9 mm in both ovaries, no major uterine abnormalities) were randomized to undergo CAPA-IVM (n = 40) or standard IVM (n = 40). CAPA-IVM uses two steps: a 24-h prematuration step with C-type natriuretic peptide-supplemented medium, then 30 h of culture in IVM media supplemented with follicle-stimulating hormone and amphiregulin. Standard IVM was performed using routine protocols. Results A significantly higher proportion of oocytes reached metaphase II at 30 h after CAPA-IVM versus standard IVM (63.6 vs 49.0; p < 0.001) and the number of good quality embryos per cumulus-oocyte complex tended to be higher (18.9 vs 12.7; p = 0.11). Clinical pregnancy rate per embryo transfer was 63.2% in the CAPA-IVM versus 38.5% in the standard IVM group (p = 0.04). Live birth rate per embryo transfer was not statistically different between the CAPA-IVM and standard IVM groups (50.0 vs 33.3% [p = 0.17]). No malformations were reported and birth weight was similar in the two treatment groups. Conclusions Use of the CAPA-IVM system significantly improved maturation and clinical pregnancy rates versus standard IVM in patients with PCOM. Furthermore, live births after CAPA-IVM are reported for the first time.

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Section: Discussionmentioning

confidence: 99%

Section: Study Schedule and Proceduresmentioning

confidence: 99%

Live births after oocyte in vitro maturation with a prematuration step in women with polycystic ovary syndrome

Vuong

et al. 2020

J Assist Reprod Genet

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“…[22][23][24] The postulated high success rate of ICSI from previous data resulted in its increased rate of use in other populations, for whom c-IVF might have been a viable option, particularly in couples with non-male factor infertility, 25,26 unexplained infertility, 27 poor responders, 28 and women of advanced age. 29 Moreover, ICSI might exhibit a role in IVF cycles using preimplantation genetic testing, 30 in vitro maturation, 31,32 or previously cryopreserved oocytes. 20 The increased use of ICSI in the absence of any indication is also likely being encouraged by the availability of insurance coverage, laboratory efficiencies, and/or perceived competition among clinics within the country.…”

Section: Current Practice Of Intracytoplasmic Sperm Injectionmentioning

confidence: 99%

Is Intracytoplasmic Sperm Injection the Solution for all in Unexplained Infertility?

Zheng

Nguyen²,

et al. 2020

Semin Reprod Med

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Intracytoplasmic sperm injection (ICSI) was first introduced as a supplemental method to conventional in vitro fertilization (c-IVF) for couples with severe male factor infertility to overcome the poor fertilization rate, while its indications expanded in current clinical practice and gained worldwide popularity. However, ICSI is invasive and crosses all natural barriers, raising several unresolved concerns regarding procedure-dependent and procedure-independent risks, as well as the characteristic of being labor-intensive and more expensive than c-IVF. This review is aimed to draw readers' attention, to the widespread use of ICSI worldwide, with its effectiveness in different indications of infertility, especially in those with unexplained infertility, as well as the cost-effectiveness of the ICSI-for-all strategy. Also, we covered current evidence on the short- and long-term safety of children born thanks to ICSI-aided conception. Further well-designed, adequately powered, and randomized controlled clinical trials are absolutely needed to arrive at a consensus on the use of ICSI over c-IVF in different populations.

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“…These results suggest that the gap in livebirth rates between IVM and conventional IVF can be closed by pre-IVM systems such as CAPA-IVM. Currently, a large RCT in Vietnam comparing the effectiveness and safety of CAPA-IVM with controlled ovarian hyperstimulation/IVF is underway (Clinical trial number: NCT03405701) [21].…”

Section: Introductionmentioning

confidence: 99%

“…Although much is known about how cAMP-mediated pre-IVM improves oocyte quality [5], CNP signals somewhat differently and the mechanisms underpinning the improvement in the oocyte developmental competence from CNP pre-IVM require further investigation. This is particularly important given CAPA-IVM is already in clinical use [21] and is likely to be taken up more widely. The quality and developmental competence of an oocyte are reflected in its ability to undergo meiosis, be fertilized, and give rise to a healthy offspring [22].…”

Section: Introductionmentioning

confidence: 99%

Capacitation IVM improves cumulus function and oocyte quality in minimally stimulated mice

Zhao

Liao

Krysta

et al. 2019

J Assist Reprod Genet

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Purpose Oocyte in vitro maturation (IVM) is a patient-friendly reproductive technology but lower success rates than IVF have limited its uptake. Capacitation-IVM (CAPA-IVM) is an innovative new IVM system currently undergoing clinical evaluation. This study aimed to determine temporal effects of the pre-IVM phase of CAPA-IVM on cumulus function and oocyte developmental competence in mildly-stimulated mice. Methods Immature cumulus oocyte complexes (COCs) derived from mildly stimulated (23 h PMSG) 28-day-old mice underwent pre-IVM for 0-24 h in medium containing c-type natriuretic peptide (CNP), E 2 , FSH and insulin, prior to IVM (CAPA-IVM). The effect of pre-IVM duration on cumulus cell function and embryo development post-CAPA-IVM/IVF was assessed.Results Day 6 blastocyst rate increased incrementally with increasing pre-IVM duration: 40.6 ± 2.0%, 45.8 ± 1.2%, 52.2 ± 3.5%, 53.3 ± 5.9%, and 59.9 ± 2.5% for 0, 2, 6, 12, and 24 h pre-IVM, respectively (P < 0.01). DNA content/COC, a measure of cumulus cell proliferation, was significantly higher with 24 h pre-IVM group compared to 0, 2, or 6 h pre-IVM (P < 0.001). Pre-IVM for 24 h significantly increased cumulus expansion and mRNA expression of matrix genes Has2 and Tnfaip6 and Areg relative to no pre-IVM control (P < 0.01). Cumulus-oocyte gap-junctional communication (GJC) was maintained throughout 24 h pre-IVM (P < 0.0001), and GJC loss was slowed during the subsequent IVM phase, whilst meiotic resumption was accelerated (P < 0.05). Pre-IVM increased COC ATP and ADP content (P < 0.05), but not AMP, ATP/ADP, and energy charge. Conclusion The pre-IVM phase of CAPA-IVM improves the quality of IVM oocytes in a temporally dependent manner and significantly influences cumulus cell function including increased cell proliferation, cumulus expansion, and prolonged cumulusoocyte GJC.

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Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial

Cited by 22 publications

References 18 publications

Live births after oocyte in vitro maturation with a prematuration step in women with polycystic ovary syndrome

Live births after oocyte in vitro maturation with a prematuration step in women with polycystic ovary syndrome

Is Intracytoplasmic Sperm Injection the Solution for all in Unexplained Infertility?

Capacitation IVM improves cumulus function and oocyte quality in minimally stimulated mice

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