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<p>With increasing rates of delayed childbearing and the use of assisted reproductive technologies (ARTs), concerns regarding the safety of associated treatments have intensified. This is particularly relevant for women with polycystic ovary syndrome (PCOS), recently renamed polyendocrine metabolic ovarian syndrome (PMOS), who are at increased risk of ovarian hyperstimulation syndrome (OHSS) during standard in vitro fertilization (IVF). In vitro maturation (IVM) reduces or avoids ovarian stimulation, providing an important strategy for reducing OHSS risk. However, its overall reproductive efficacy remains debated. This review synthesizes current evidence comparing IVM with contemporary IVF protocols, focusing on safety, cumulative live birth rates (CLBRs), and clinical indications. According to data from a Cochrane review, IVM is associated with a markedly lower risk of moderate-to-severe OHSS than IVF in women with PCOS (OR 0.08, 95% CI 0.01–0.67). However, IVM raises the risk of miscarriage per clinical pregnancy (OR 1.66, 95% CI 1.02–2.70). Current evidence suggests lower or uncertain CLBRs, depending on protocol, comparator, and cycle horizon. We outline practical indications for IVM, including for women with high ovarian reserve, those in whom stimulation is contraindicated or undesirable, and those with selected endocrine disorders associated with poor suitability for conventional stimulation. We also discuss key protocol variables that may influence performance, including priming strategies and newer biphasic prematuration systems designed to improve oocyte competence. Finally, we review emerging applications of artificial intelligence in ART, particularly for ovarian response prediction and image-based assessment of gametes or embryos, while emphasizing the need for IVM-specific validation. Overall, IVM should be regarded as a specialized, lower-burden option for carefully selected patients, rather than a universal replacement for IVF.</p>

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In vitro maturation in women with polycystic ovary syndrome: current advances and emerging roles of artificial intelligence

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月25日

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  • Thu Minh Phung,
  • Hao Chi Nguyen,
  • Dang Ngoc Ho,
  • Thuan Minh Hoang Thach,
  • Thao Phuong Nguyen,
  • Van Nguyet Thanh Nguyen,
  • Tam Duc Lam,
  • Tin Hoang Nguyen

摘要

With increasing rates of delayed childbearing and the use of assisted reproductive technologies (ARTs), concerns regarding the safety of associated treatments have intensified. This is particularly relevant for women with polycystic ovary syndrome (PCOS), recently renamed polyendocrine metabolic ovarian syndrome (PMOS), who are at increased risk of ovarian hyperstimulation syndrome (OHSS) during standard in vitro fertilization (IVF). In vitro maturation (IVM) reduces or avoids ovarian stimulation, providing an important strategy for reducing OHSS risk. However, its overall reproductive efficacy remains debated. This review synthesizes current evidence comparing IVM with contemporary IVF protocols, focusing on safety, cumulative live birth rates (CLBRs), and clinical indications. According to data from a Cochrane review, IVM is associated with a markedly lower risk of moderate-to-severe OHSS than IVF in women with PCOS (OR 0.08, 95% CI 0.01–0.67). However, IVM raises the risk of miscarriage per clinical pregnancy (OR 1.66, 95% CI 1.02–2.70). Current evidence suggests lower or uncertain CLBRs, depending on protocol, comparator, and cycle horizon. We outline practical indications for IVM, including for women with high ovarian reserve, those in whom stimulation is contraindicated or undesirable, and those with selected endocrine disorders associated with poor suitability for conventional stimulation. We also discuss key protocol variables that may influence performance, including priming strategies and newer biphasic prematuration systems designed to improve oocyte competence. Finally, we review emerging applications of artificial intelligence in ART, particularly for ovarian response prediction and image-based assessment of gametes or embryos, while emphasizing the need for IVM-specific validation. Overall, IVM should be regarded as a specialized, lower-burden option for carefully selected patients, rather than a universal replacement for IVF.