Wednesday, December 22, 2010

IVM= Invitro Maturation

Recently this fall I had a woman come in who was undergoing IVM. She orginally heard of the procedure in Canada where she had been living. I had not had a couple undergo this procedure but basically it is IVF without the drugs instead is done with the use of hormones similar to what the body makes. The RE's will utilize HCG made in a lab but similar to the hormone circulating in every pregnant woman. This hormone is similar to LH which drives the follicles to develop. LH causes maturity and the dominant follicle usually releases quite a bit of it. HCG causes immature eggs to stimulate towards final maturation.

Last night I had the opportunity to listen to Dr. Karol Chacho MD one of the first doctor's in the US to utilize IVF in Chicago, talk about this procedure. He was very excited about the procedure with less risks to women, less overstimulation of the ovaries, less risks of cancer. Several centers around the US he stated are jumping on this bandwagon. Ovarian hyperstimulation causes the ovaries to enlarge and often rupture, these large ovaries leave blood thick and can hypercoagulate causing clogged arteries or a clot in the brain or legs.

He also strongly reccommended patients get pretreated with acupuncture and Chinese Herbs before IVM to improve their success rate.

Key Signs for Ovulation

There are 3 key signs I tell the women I work with in my practice to look for when they are getting ready to ovulate: 1. Cervical Fluid, 2. Position of the Cervix and 3. Drop in Temperature followed by a 3 degree rise in Temperature.
If all goes well the timing of these will be in close sync. The Cervical Fluid(CF) might start out as creamy and thicker perhaps around day 8 or 9 as early as day 10 clear, stretchy fluid the kind sperm need to live and swim may begin to form and can last up to 4 days, this might be the consistency of egg white although it could be milky as well. The position of the cervix when you are ovulating will be higher, softer, more open and feel wet whereas at infertile times it will be lower and harder like the tip of your nose and dry. These two signs normally are about two days before the LH surge. So this is optimum time to try and conceive. However once the LH surge occurs you can also try as there may be one more follicle that often releases. Usually with this LH surge we see a peak in temperature rising at least 3 degrees higher because the lutenizing hormone secretes progesterone which keeps the temps hopefully high enough for a possible embryo to implant and grow.
The book the Garden of Fertility is such a wonderful book for women to monitor their cycle based on their basal body temperatures. The process is called Fertiltiy Awareness and really allows a woman to understand how her body works. It also gives her a sense of control. Did you know your mate is more attracted to a woman when she is ovulating, the book talks about this.