In vitro maturation

Thanks to the team of Invitro Clinic “Sofia” on February 20, 2008, the first baby conceived through IVF was born in Bulgaria. The baby is named Danaya and was born from the parents' first IVM experience.

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In vitro maturation (IVM) is a revolutionary infertility treatment designed to provide a safer and cheaper alternative to traditional IVF treatment. In vitro maturation is a relatively new procedure, similar to in vitro fertilization, but there are some significant differences. In classic in vitro fertilization, medications are used to bring the patient's eggs to maturity before they are extracted from the ovary. In vitro maturation, medications are not administered, and the eggs are extracted from the ovary at an immature stage of development and brought to maturity in laboratory conditions (in vitro).

Immature oocytes are extracted from unstimulated or minimally stimulated ovaries under ultrasound control. In vitro maturation is based on the ability of immature eggs from small follicles (4—10 mm) to pass through the final stage of maturationin vitro — under controlled laboratory conditions.

Then, immature eggs mature in the laboratory for 24-48 hours using special culture media to which small amounts of hormones have been added. For fertilization of mature eggs, intracytoplasmic sperm injection (ICSI) is administered. The resulting embryos are transferred to the patient's uterus.

Basic laboratory aspects:

The physiology of egg maturationinvolves two key stages: nuclear maturation (transition to metaphase II) and cytoplasmic maturation (acquisition of competence for fertilization and embryonic development).
In IVM they are used specialized nutrient media, rich in hormones (such as FSH, LH and EGF) and supplements (such as serum and amino acids) that support this process.
It is necessary Precise time controlEggs usually mature between 24 and 48 hours.
The procedure is supported by modern incubation systems, which provide optimal conditions of pH, temperature and gas composition.
Our laboratory uses proprietary IVM protocols based on years of experience and publications in international scientific publications. They are designed to ensure maximum egg maturity and quality in controlled conditions.

In which cases is IVM treatment appropriate?

Women at high risk of ovarian hyperstimulation syndrome (OHSS);
Women with past ovarian hyperstimulation syndrome (OHSS);
Cases with polycystic ovary syndrome (PCOS);
Young, tall and weak women with polycystic ovarian structures;
All cases in which there is a need for treatment by IVF procedure;
Women with certain malignancies in whom chemotherapy should be started without delay;
Diseases, such as active systemic lupus erythematosus and some forms of breast cancer, in which an increase in estrogen levels in the blood is contraindicated;
In the presence of only a male factor of sterility.

Are there any risks?

The risks to a woman's health are greatly reduced, compared to the classic in vitro procedure. Regarding genetic risks, published data indicate that there is no increase in the rate of congenital malformations in children conceived after IVM compared to children conceived through IVF and ICSI procedures.

Are there limits and what are the chances of success?

IVM is still a less applied technique globally and requires an experienced team and precise laboratory conditions. The success rate depends on the age of the woman, the number and quality of the eggs obtained, as well as the exact protocol of the procedure.

Although the percentage of pregnancies is slightly lower compared to standard IVF, IVM offers an extremely important opportunity for a certain group of patients who have no alternative.

Application of IVM method in Bulgaria

Invitro Clinic “Sofia” is the first Bulgarian reproductive clinic that began to study and apply the method of in vitro maturation in Bulgaria. Thanks to the team of Invitro Clinic “Sofia” on February 20, 2008, the first baby conceived through IVF was born in Bulgaria. The baby is named Danaya and was born from a first experience with IVM to parents who have 2 years of sterility and male factor. In comparison, the first IVM baby in England was born in October 2007, and the first IVM baby in Germany was born at the end of 2006. By the time Danaya was born, a total of 300 babies were born in the world using this method. Dr. Yavor Vladimirov reported the Bulgarian experience at the first European IVM Congress, which took place in Monza, Italy at the end of 2008.