IVF Treatment

IVM: an alternative to IVF

What is IVM?

In Vitro Maturation (IVM) is an alternative to traditional In Vitro Fertilisation (IVF) that uses only a small fraction of the medications needed for IVF. It’s a fertility treatment in which immature eggs are retrieved from the ovaries and matured in the laboratory instead of inside a woman’s body. Once matured, the eggs are then fertilised using the IVF process.

Unlike traditional IVF, which involves up to two weeks of daily hormone injections to stimulate the ovaries, IVM reduces this stimulation by approximately 80 per cent. A person can start a low-dose hormone injection on Friday, have two more daily hormone injections on Saturday and Sundaythen have the immature eggs collected on Tuesday. The result is a shorter cycle, a less invasive approach and a reduction in side effects.  IVM is suitable for women with a high egg count (high AMH blood test or high antral follicle count on an ultrasound scan). With the right patient group, pregnancy rates are equivalent to traditional IVF

City Fertility offers an enhanced version of IVM, called CAPA-IVM.

CAPA-IVM Treatment Procedure at City Fertility

What is CAPA-IVM?

CAPA-IVM is an IVM procedure that has been used around the world for over ten years. It was first developed by Belgian researchers along with Australian scientist Professor Robert Gilchrist from UNSW’s School of Clinical Medicine. City Fertility Professor William Ledger has collaborated with UNSW on CAPA-IVM, to implement this treatment. Our Sydney CBD clinic is the only private clinic licensed by the Australian TGA to perform CAPA-IVM.

What is the difference between IVM and CAPA-IVM?

CAPA-IVM has an added step in the maturation process. The difference is in the method of culturing the unfertilised eggs in order to mature them. The first culture is for 24 hours and deliberately slows down maturation, allowing the egg to ‘catch up’, then the second culture finalises the maturation process.

This approach has been shown to be superior to routine IVM in clinical trials, with a better maturation rate, fertilisation, embryo development and pregnancy and livebirth rate.

 

The CAPA-IVM process

Like IVF, treatment begins with hormonal injections to stimulate the ovaries to produce multiple eggs. However, there are two key differences –

  • You may only have three low-dose injections of Follicle Stimulating Hormone (FSH) over three days and
  • There is no hCG trigger injection. This approach eliminates the risk of ovarian hyperstimulation syndrome.

Immature eggs are retrieved from the ovaries under a general anaesthetic and then matured in our laboratory using a special incubation medium that allows the eggs to slowly mature over two days. When eggs are removed from the body, they tend to mature too quickly. CAPA-IVM is designed to slow this maturation, switching off the progression of the egg for 24 hours. This slower maturation allows the eggs to develop in a healthier way and be more fertile when injected with sperm using ICSI.

Once matured, the eggs are either frozen for future use or fertilised in an incubator outside the body, with the resulting embryos frozen. CAPA-IVM cycles are

When are the eggs removed in CAPA-IVM?

When using IVM and our version of CAPA-IVM, immature eggs can be collected at any time of the monthly cycle.

This shorter, less invasive approach not only reduces the physical and emotional burden for patients but also lowers the risk of side effects, including Ovarian Hyperstimulation Syndrome (OHSS).

It’s important to know that CAPA-IVM is not for everyone, and your fertility specialist will determine if this is the best treatment for you.

Who can benefit from CAPA-IVM?

It may be considered for:

  • People with Polycystic Ovary Syndrome (PCOS). PCOS is a disorder of the endocrine system, where hormones can interfere with the development of eggs and ovulation.
  • People who are at risk of OHSS (Ovarian Hyperstimulation Syndrome). OHSS can develop in 1% of cases of IVF. The ovaries become enlarged, and fluid accumulates in the abdomen. It is caused by the hormonal medication used as the ‘trigger’ in conventional IVF. This injection is not used in IVM.
  • Women with a high ovarian reserve
  • As part of fertility preservation, when there has been a cancer diagnosis and immature eggs can be removed before cancer treatment and
  • Where there is a strong fear of needles.

IVM is not suitable for older patients (over 37) or those with a lower egg count.

What’s the difference between IVF and IVM / our preferred CAPA-IVM?

There are two main differences between IVF and CAPA-IVM.

  1. How the eggs mature: With CAPA-IVM, immature eggs are retrieved from the ovaries and matured in the laboratory instead of in a woman’s body. The immature eggs are carefully monitored and grown in the laboratory until they are ready to be fertilised.
  2. Fertility Medication: CAPA-IVM requires many fewer hormone injections compared to IVF. Less ovarian stimulation is required because the eggs are matured outside of the body. This reduces some of the side effects of fertility medications, particularly the risk of ovarian hyperstimulation.

 

How successful is CAPA-IVM compared to IVF?

Over 1,000 babies have been born with CAPA-IVM. Overseas, randomised controlled trials have shown that, unlike older methods for maturing eggs in the lab, pregnancy and live birth rates per embryo transfer are equivalent to conventional IVF with careful patient selection.

While conventional IVF is effective for many, it can carry risks, particularly for women with a high egg count or polycystic ovary syndrome (PCOS). These women are more susceptible to ovarian hyperstimulation syndrome (OHSS), a potentially serious complication caused by fertility medications, particularly the hCG ‘trigger’. CAPA-IVM offers a safer alternative by completely avoiding the use of a hCG trigger. It’s also significantly faster, requiring less than a week of treatment compared to the typical 2–3 weeks of conventional IVF. This makes it an ideal option in time-sensitive situations, such as when fertility preservation is needed before urgent cancer treatment.

The first birth in Australia after CAPA-IVM was reported in 2023. Unlike other forms of IVM, which are currently in the research phase. CAPA-IVM is approved by the Australian TGA for clinical use and is supported by reassuring data on the health of children born after CAPA-IVM.

FAQ

Is CAPA-IVM available at all City Fertility Clinics?

CAPA-IVM is offered at our Sydney CBD clinic.  The clinic is the only private clinic in Australia with a licence to perform CAPA IVM from the Australian TGA.

Is IVM available at any City Fertility Clinics?

IVM is offered at our Perth Clinics at Applecross and Claremont.

Can I choose CAPA-IVM over IVF even if I don’t have PCOS?

Yes, people can choose CAPA-IVM over IVF, but only if they have a higher-than-average egg count. We use two tests to give us this information. AMH (Anti-Müllerian Hormone) test, which is a blood test used to estimate your ovarian reserve or how many eggs you may have. The second is called AFC (Antral Follicle Count), which is done by ultrasound, giving further insight into your egg count.

Patient suitability is the most important determinant of success with this new technique. Your fertility specialist will advise whether it is a suitable approach for you.

Does CAPA-IVM use stem cells

CAPA-IVM does not involve using stem cells derived from other patients in the maturation process. A specialised culture media is used to improve the quality and development of the eggs.

 

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