Single vs. Group CAPA-IVM Culture of Cumulus-oocyte Complexes
Condition: IVF; PCOS; IVM
Study type: Interventional

Summary: 
      Oocyte in vitro maturation (IVM) is a minimal-stimulation ART with reduced hormone-related
      side effects and risks for the patients. However, the approach is not widely used because of
      an efficiency gap compared to conventional ART. In order to further optimize and adapt the
      CAPA-IVM system in the IVM clinic, this pilot study aims to check the feasibility of applying
      a single COC CAPA-IVM strategy versus the group COC culture CAPA-IVM
    

Detailed description: 
      Oocyte in vitro maturation (IVM) is a minimal-stimulation ART with reduced hormone-related
      side effects and risks for the patients. However, the approach is not widely used because of
      an efficiency gap compared to conventional ART.

      Oocytes retrieved for IVM procedures derive from a heterogeneous pool with variable cellular
      and molecular characteristics that indicate its immature status. Thus, in vitro systems that
      permit and enhance acquisition and synchronization of meiotic competence (ability to resume
      meiosis in response to an ovulatory stimulus) and developmental competence (ability to be
      fertilized and support early embryo development) before the meiotic trigger are crucial for
      the optimization of human IVM systems.

      A novel two-step IVM culture system (named CAPA-IVM) involving a pre-maturation culture with
      C-type natriuretic peptide (CNP) and a maturation step in presence of Amphiregulin (AREG),
      both more physiological compounds improving oocyte competence, have been introduced in
      previous clinical studies. So far these pilot studies proved to increase the rates of oocyte
      maturation, good quality embryos on day 3, good quality blastocyst, and as a result a higher
      embryo yield. CAPA-IVM blastocysts have shown similar rates of methylation and gene
      expression at gDMRs compared to COS embryos; and the expression of ma-jor epigenetic
      regulators was similar between both groups. Furthermore, an improvement in pregnancy rates
      strengthens the clinical relevance of the use of CAPA-IVM strategy.

      In order to further optimize and adapt the CAPA-IVM system in the IVM clinic, this pilot
      study aims to check the feasibility of applying a single COC CAPA-IVM strategy versus the
      group COC culture CAPA-IVM. A single COC culture would permit to perform a non-invasive
      molecular analysis per matured oocyte, in order to identify quality genes ex-pressed in
      cumulus cells post-IVM (cumulus biomarkers), which could be subsequently used to identify the
      embryo(s) with highest potential of implantation.
    

Intervention name(s): The way of Cumulus-oocyte complexes (COC) culture
Intervention type(s): Other
Intervention description(s): Cumulus-oocyte complexes (COC) will be cultured in CAPA-IVM standard conditions: 24 hrs capacitation followed by 30h maturation. The first group will be culture in pools (group culture). The second group will be culture individually in 20µl droplets.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: CAPA-IVM; Single culture; Group culture