Future potential of in vitro maturation including fertility preservation

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In several mammalian species, oocytes from small antral follicles after in vitro maturation (IVM) are successfully used for procreation. Humans are the exception, mainly because of limited access to immature oocytes and because oocyte maturation is uniquely regulated in women. With the introduction of cryopreservation of the ovarian cortex for fertility preservation, immature oocytes from small antral follicles in the medulla are now available for developing IVM on the basis of actual human studies. This review presents recent findings in favor of developing human IVM, including the oocyte diameter, follicle size from which the immature oocytes are collected, necessary level of follicle-stimulating hormone and luteinizing hormone to accelerate IVM, and secretion of factors from the cumulus-oocyte complex that affect the way oocyte maturation takes place. Furthermore, on the basis of studies in human granulosa cells and follicle fluid collected during the final maturation of follicles in vivo, a number of signal transduction pathways and hormone levels active during physiological conditions have been identified, providing new candidates and ways to improve the current IVM platform. Furthermore, it is suggested that the small droplet of culture medium in which IVM is performed mimics the hormonal milieu within a follicle created by the somatic cells and oocyte in vivo and may be used to advance oocyte nuclear and cytoplasmic maturation. Collectively, we envision that a continued research effort will develop a human IVM platform equally effective as for other mammalian species.

OriginalsprogEngelsk
TidsskriftFertility and Sterility
Vol/bind119
Udgave nummer4
Sider (fra-til)550-559
Antal sider10
ISSN0015-0282
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Supported by the University Hospital of Copenhagen , Rigshospitalet , the Independent Research Fund Denmark (grant number 0134-00448; 2096-00060B), and the Interregional European Union–sponsored ReproUnion network.

Publisher Copyright:
© 2023 The Authors

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