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In vitro maturation of oocytes as a promising treatment option for infertile couples: a transdisciplinary study

Mar 20,06. OMNI. 2. Background. In-vitro maturation (IVM)Immature eggs are retrieved from ovary and mature in laboratory.Once eggs are matured, in vitro fertilization (IVF) is then performed.. Mar 20,06. OMNI. 3. Background. In vitro maturation (IVM) of oocytes vs. conventional in vitro fertiliza

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In vitro maturation of oocytes as a promising treatment option for infertile couples: a transdisciplinary study

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    1. In vitro maturation of oocytes as a promising treatment option for infertile couples: a transdisciplinary study Beum Soo An, Junling Chen Xi-Kuan Chen, Jack Huang Se-Hyung Park, Qiuying Yang

    2. Mar 20,06 OMNI 2 Background In-vitro maturation (IVM) Immature eggs are retrieved from ovary and mature in laboratory. Once eggs are matured, in vitro fertilization (IVF) is then performed.

    3. Mar 20,06 OMNI 3 Background In vitro maturation (IVM) of oocytes vs. conventional in vitro fertilization (IVF) Proposed advantages of IVM: Simplify treatment and reduces cost Avoids potential side effects-weight gain, bloating, breast tenderness, nausea, mood swings, and OHSS Fear of potential risk of malignancy associated with repeated cycles of ovarian stimulation.

    4. Mar 20,06 OMNI 4 Overall Objective To assess biological, clinical, psychological and economical impact of in vitro maturation (IVM) of eggs

    5. Mar 20,06 OMNI 5 3 Pillars

    6. Pillar I: Biological assessment of IVM

    7. Mar 20,06 OMNI 7 Biological approach for IVM group Objectives To compare life cycles and occurrences of disease from IVF and IVM treated offspring To compare gene profile in maternal placenta of IVM and IVF derived embryos

    8. Mar 20,06 OMNI 8 Hypotheses IVM or IVF offspring have no difference in life cycles and occurrences of diseases. Maternal placentas from IVM or IVF embryos do not have different gene profile.

    9. Mar 20,06 OMNI 9 Research design Using animal models (mouse or rat), we will compare life cycles and occurrences of diseases after IVF or IVM We will analyze gene profile in the maternal placenta using microarray after IVF or IVM embryo injection, and confirm this by real time PCR and western blot in the different gestational stages

    10. Pillar II: Clinical, psychological, economical impact of IVM

    11. Mar 20,06 OMNI 11 Objectives To evaluate: Efficacy of IVM-pregnancy and live birth rates. Safety of IVM-complication rates Cost of health service Psychological impact on infertile couples

    12. Mar 20,06 OMNI 12 Hypotheses IVM treatment will result in comparable clinical efficacy as standard IVF (i.e. pregnancy and live birth). IVM decreases the risk of maternal complications and does not increase the risk of fetal, neonatal and long term complications. IVM is more cost effective than IVF IVM reduces psychological stress of infertile couples

    13. Mar 20,06 OMNI 13 Research Design Multicenter prospective randomized control trial comparing IVM to IVF Cohort study-follow up babies from IVM vs. IVF and spontaneous pregnancy -1 year Health economic analysis Psychological assessment using validated structured questionnaire Focus group discussion-clinicians, nurses, clients

    14. Mar 20,06 OMNI 14 Outcomes Efficacy of IVM vs. IVF: Fertilization Implantation Pregnancy Live birth Safety of IVM vs. IVF: Maternal complications (i.e. OHSS, miscarriage) Fetal complications (i.e. congenital anomalies) Newborn (Gestational age, birth weight, APGAR) Follow up of IVM vs. IVF vs. spontaneous pregnancy babies as a cohort Cost-effectiveness of IVM vs. IVF Impact of IVM and IVF treatment on psychological well being of infertile couples.

    15. Pillar III: IVF and pregnancy complication and birth outcomes: a population based study

    16. Mar 20,06 OMNI 16 Objective To assess the effects of IVF and IVM on pregnancy complications and perinatal outcomes

    17. Mar 20,06 OMNI 17 Methods-subjects A population-based retrospective cohort 2004-2008 Niday Perinatal Database, Ontario 120 000 births in Ontario every year 900-1000 births with assistant reproduction technology

    18. Mar 20,06 OMNI 18 Methods-exposure and control Exposure: IVF and IVM Control: spontaneous pregnancy Frequency matched by: Year of birth Postal code of residence Plurality Parity Maternal age

    19. Mar 20,06 OMNI 19 Outcome Pregnancy complications: Gestational hypertension Preeclampsia Eclampsia Gestational diabetes Obstetric complications Placenta previa Placenta abruption

    20. Mar 20,06 OMNI 20 Methods-outcomes Birth outcomes: Birth defects Apgar score Gestational age: Preterm birth Birth weight: LBW, SGA Mortality Fetal death (=20 gestational weeks) Early neonatal death Late neonatal death

    21. Mar 20,06 OMNI 21 Methods-confounders Aboriginal status First language of mother Maternal age Parity Initiation time of prenatal care Maternal smoking Reproductive history Induction during labor C-section

    22. Mar 20,06 OMNI 22 Timetable and Budget Timetable Preparation and coordination (6 months) Implementation (4 years) Report writing (6 months) Budget

    23. Mar 20,06 OMNI 23 Research Team Biologists Clinicians Psychologists Ethicists Epidemiologists Lawyers

    24. Mar 20,06 OMNI 24 Interaction and integration

    25. Mar 20,06 OMNI 25 STIRRHS Mentors Dr. Raymond Lambert Dr. Marcel Melancon Dr. Roger Pierson Dr. Peter Leung (UBC) Dr. Seang Lin Tan (McGill) Dr. Mark Walker (U Ottawa) Dr. Shi Wu Wen (U Ottawa) Acknowledgement

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