JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):156
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263933

P-144. In Vitro Maturation of Oocytes: Potential and Challenges for Clinical Application in Assisted Reproduction

Beatriz C Pitta¹, Gabriela Passananti Lopes¹, Julia Roverso Correa Silveira¹, Gabriel Monteiro Pinheiro¹

¹ Universidade Santo Amaro - São Paulo - SP - Brasil

Objective: In vitro maturation (IVM) is an assisted reproductive technology initially developed in animal models and adapted for human use in 1944. It involves the retrieval of immature oocytes, usually at the germinal vesicle stage, from unstimulated or minimally stimulated antral follicles, which are then matured in the laboratory until reaching metaphase II. IVM offers several advantages, such as reduced hormonal exposure, decreased risk of ovarian hyperstimulation syndrome (OHSS), lower costs, and shorter treatment time. It is particularly indicated for patients with polycystic ovary syndrome (PCOS) and in fertility preservation for oncological patients. This study aimed to critically review the potential and challenges of IVM, focusing on its biological basis, current clinical applications, and technological innovations aimed at improving reproductive outcomes
Methods: This is a qualitative narrative review based on scientific articles published between 1963 and 2025, with an emphasis on developments in the last decade (2015–2025). The literature search was conducted in PubMed, SciELO, Google Scholar, and Cochrane databases using the following keywords: "In vitro maturation" OR "IVM" AND "human oocytes", "assisted reproduction", "polycystic ovary syndrome", and "fertility preservation". Studies addressing biological, clinical, and technological aspects of IVM were included. Selection was guided by relevance, methodological rigor, and the timeliness of the data presented.
Results: The analysis of the scientific literature revealed that, although IVM is a promising alternative to conventional assisted reproductive techniques such as in vitro fertilization (IVF), it still faces significant clinical limitations. IVM is associated with lower fertilization, embryo development, and live birth rates, primarily due to the difficulty in replicating the in vivo follicular microenvironment during in vitro culture. Several studies emphasized the importance of oocyte-cumulus cell communication as a key factor in determining oocyte competence—an interaction often disrupted during IVM. In this context, innovative strategies have been proposed to overcome these limitations, including pre-maturation protocols (pre-IVM and CAPA-IVM), the use of molecular signaling agents such as cAMP, cGMP, and growth factors, as well as co-culture with granulosa cells. Additionally, the application of bioengineered three-dimensional systems has emerged as a promising approach to more accurately mimic the ovarian environment. These advancements have shown particularly favorable outcomes in specific patient groups, such as those with PCOS and women undergoing fertility preservation in the context of cancer, suggesting a potential expansion of the technique.
Conclusion: In vitro maturation of oocytes is an alternative technique with growing relevance in assisted reproduction, especially in clinical scenarios where conventional hormonal stimulation is contraindicated. Although current success rates remain lower than those of conventional IVF, recent advancements indicate significant improvements in IVM outcomes. The implementation of pre-maturation protocols, incorporation of molecular signaling agents, and use of bioengineering technologies have contributed to the optimization of oocyte quality and improved reproductive results. However, the reviewed literature also underscores the need for further large-scale studies to validate these approaches and establish standardized protocols. Therefore, while IVM still faces important challenges for full clinical integration, its potential is evident, positioning it as a viable and expanding option in contemporary reproductive medicine.