IVM With Low Cost Priming, Enhanced Oocyte Recovery, and Delayed Transfer
IVM With Low Cost Priming, Enhanced Oocyte Recovery, and Delayed Transfer
A protocol was developed to improve pregnancy results after IVM compared to results from
 studies in the literature. Differences from most published protocols include the use of the
 Steiner-Tan needle to optimize oocyte environment during oocyte retrieval, use of oral
 medications and very low doses of FSH, and delayed embryo transfer during subsequent warmed
 cryo-preserved embryo transfer. Eligible patient have a PCO pattern in their ovaries during
 transvaginal ultrasound.
All participants are candidates for IVF having PCOS or having PCO patterns in their ovaries
 who wish to undertake IVM for the potential advantages that it holds. All cycles are
 proceeded by oral contraceptive use for cycle scheduling purposes. Priming is done with oral
 letrozole with the addition of 25-75 IU daily starting after 2 days of letrozole. HCG is
 given when several follicle have diameters 8 mm or greater and no follicles have diameters
 greater than 13 mm. Oocyte retrieval is done approximately 38 hours later. A Steiner-Tan
 needle is used for oocyte retrieval in a manner that minimizes the amount of time that an
 oocyte is out of the ovary and not in a controlled laboratory environment. Oocytes are
 assessed for maturity for up to 48 hours post retrieval. If mature, oocytes are injected with
 sperm using ICSI. Embryos are grown to blastocysts and all blastocyst are vitrified. Warmed
 cryo-preserved blastocyst are transferred using routine IVF protocols during a subsequent
 cycle.
Inclusion Criteria:

 -  PCO pattern with > 25 antral follicles

 -  AMH > 3.5

 Exclusion Criteria:

 -  BMI > 35

 -  body morphology making transvaginal retrieval difficult or impossible

 -  complicating medical condition making pregnancy or IVF relatively contra-indicated