24 Oct 07

Britain's first IVM babies

The first babies in the UK to be conceived by IVM – IVF without fertility drugs – have been born thanks to a collaboration between Oxford University researchers and the NHS. The revolutionary fertility treatment could provide a safer and cheaper alternative to conventional IVF.

The twins, a boy and a girl, were born on 18 October at the John Radcliffe Hospital, Oxford. They were conceived thanks to the Oxford Fertility Unit, a private company whose consultants are all Oxford University researchers and honorary clinicians at the Oxford Radcliffe Hospitals.

IVM (In Vitro Maturation) is a safer, faster and cheaper alternative to standard IVF which does not involve injecting fertility drugs prior to egg collection. Instead, eggs are collected from the ovaries whilst still immature, and allowed to mature in a Petri dish before being fertilised and implanted into the womb.

Around 400 babies have been born from IVM worldwide, compared to about two million IVF babies. The safety of IVM over IVF is crucial for women with polycystic ovaries, who account for 30–40 per cent of all women seeking fertility treatment. A dangerous side-effect of the fertility drugs used in IVF is severe ovarian hyperstimulation syndrome (OHSS), which occurs in 1 in 10 cycles of women with polycystic ovaries.Severe  OHSS usually results in a week or more in hospital. In its most severe form, it can cause fluid to collect in lungs, abdominal cavity, and tissues.

So far only a handful of centres worldwide have used IVM. In January 2007 the Oxford Fertility Unit became the first unit in the UK to be licensed by the HFEA (Human Fertilisation and Embryology Authority) to offer the treatment.

The programme is led by Mr Tim Child, Senior Fellow in Reproductive Medicine at the University of Oxford and Consultant Gynaecologist at the Oxford Fertility Clinic. ‘The main advantage of IVM over IVF is improved safety for women,” he says. 'Women with polycystic ovaries account for up to 40 per cent of all women needing fertility treatment. Those women have a one in ten chance of severe ovarian hyperstimulation syndrome, which is a serious condition. IVM completely takes away that risk.

‘In standard IVF treatment a woman undergoes two weeks of injections of a drug called gonadotrophin to stimulate egg production prior to retrieval. She also has to sniff a drug for three weeks before that to suppress egg production. As well as the OHSS risk, this is time-consuming and uncomfortable.

'It is also expensive, as the cost of drugs is often largely met by the patients. With IVM the cost is therefore reduced, meaning it has the potential to become a more accessible form of fertility treatment than IVF.'

In IVM, immature eggs (oocytes) are extracted directly from the ovaries, under the guidance of ultrasound, and then allowed to mature in vitro for 24–48 hours. The eggs that have successfully matured after this time are fertilised by injecting one sperm into an egg. Two to three days after fertilisation, the embryos are transferred to the mother's womb.

‘After years of research and development into IVM, and after many months of working with the twins’ parents, it has been hugely exciting to see them born,” says Mr Child. “They are beautiful babies and the whole family is doing well.'

To begin with, the Oxford Fertility Unit is only offering IVM to the one in three women presenting with polycystic ovaries. However, it is thought possible that in the long term the procedure might be a safer, cheaper alternative to IVF for all women.