The definition of IVM is clear-variations need defining.
Oocyte in vitro maturation (IVM) is currently defined as the maturation in vitro of immature cumulus-oocyte complexes collected from antral follicles. This is the original definition as first described by Pincus and Enzmann and then by Edwards many decades ago, and this clear and unambiguous definition has served us well ever since. In an attempt to clarify apparent differences among clinicians, the following revised definition of IVM was recently proposed: 'The retrieval of oocytes from small and intermediate sized follicles in an ovary before the largest follicle has surpassed 13 mm in mean diameter'. As such, this proposed definition should encompass the use of hCG triggering. To change the clear and long-serving definition of IVM to fit varying clinical practices requires a compelling justification based on solid scientific and clinical grounds. We are of the opinion that the proposed revised definition of IVM is counterintuitive as it includes protocols that are intended to mature oocytes in vivo The proposed definitions are cumbersome and indeed further complicate the situation. It is not scientifically rational to base the definition on follicular size, and the definition ignores the vast corporate knowledge acquired from the many decades and >6000 publications in animal research that universally practices IVM as per the existing definition. Furthermore, such a definition can lead to false results in interpreting the follow-up of children conceived using IVM. Hence, we see no rationale to change the existing definition of IVM. However, we agree that variations on IVM require alternative nomenclature-these definitions need to be intuitive and need to clearly distinguish themselves from the existing long-standing definition of IVM. This would help to clarify the recent confusion within the clinical ART community as to what is and what is not, IVM.
Centre for Reproductive Medicine, University Hospital UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium mdv@uzbrussel.be.
Michel
M
De Vos
Follicle Biology Laboratory, Medical School, University Hospital UZ Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Johan
J
Smitz
School of Medicine, Robinson Research Institute and ARC Centre of Excellence for Nanoscale BioPhotonics, The University of Adelaide, 2nd Floor, Medical School South, Frome Road, 5005 Adelaide, Australia.
Jeremy G
JG
Thompson
Discipline of Obstetrics & Gynaecology, School of Women's & Children's Health, University of New South Wales, Level 4, Room 421, Wallace Wurth Building, Botany Street, Sydney, NSW 2052, Australia.
Robert B
RB
Gilchrist
D054885:Cumulus Cells / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D059471:In Vitro Oocyte Maturation Techniques / Q000379:methods*; D054315:Oocyte Retrieval / Q000379:methods*; D009865:Oocytes / Q000502:physiology*
ART; FSH; IVF; cumulus–oocyte complex; definition; follicle; hCG; in vitro maturation