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The brutal reality of IVF -

In-vitro fertilization (IVF) remains the dominant fertility treatment, but it comes at a high physical, emotional, and financial cost. Women endure weeks of intense hormone injections, bloating, mood swings, and fatigue. The process is exhausting, yet many feel it’s their only hope of conceiving.

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Boosting egg production -

When a woman undergoes IVF, she takes daily hormone injections for about 10–14 days to encourage her ovaries to produce more eggs than usual. This gives doctors a better chance of finding healthy eggs. Regular ultrasounds track progress, ensuring the eggs are developing properly before retrieval.

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Collecting the eggs -

Once the eggs are ready, a doctor retrieves them using a thin needle while the patient is under mild sedation. The eggs are immediately placed in a special lab dish, where they’ll wait to meet the sperm.

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Fertilization in the lab -

Sperm (either from a partner or a donor) is introduced to the eggs in a controlled lab environment. Sometimes a single sperm is directly injected into an egg (a process called intracytoplasmic sperm injection, or ICSI) to improve the chances of fertilization. The fertilized eggs then start developing into embryos.

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Choosing the best embryo -

After a few days, the lab monitors the growing embryos and selects the healthiest one(s). Only the best embryos are chosen for transfer, increasing the chances of pregnancy. Any extra embryos can be frozen for future attempts if needed.

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Transferring the embryo -

A tiny catheter is used to place one or more embryos into the woman’s uterus. Now, it’s a waiting game to see if the embryo implants and pregnancy begins.

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The two-week wait -

After the transfer, the woman takes hormone support and waits about two weeks before taking a pregnancy test. This can be the most nerve-wracking part, but if the embryo implants successfully, a new journey into pregnancy begins.

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The hormone-fueled rollercoaster -

IVF forces the body to produce multiple eggs at once through powerful hormonal drugs. While effective, these medications cause severe bloating, nausea, headaches, and even ovarian hyperstimulation syndrome (OHSS)—a condition that, in extreme cases, leads to hospitalization. Women often feel drained and overwhelmed.

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The mental and emotional toll -

IVF is not just a physical challenge—it’s an emotional and mental one, too. The uncertainty of success, combined with the hormonal upheaval, makes it an incredibly stressful process. Many women abandon treatment not due to cost, but because of sheer emotional exhaustion.

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The lack of alternatives -

For decades, women had to choose between minimal intervention or the full intensity of IVF. The absence of middle-ground options has forced many into physically grueling treatments, even when their cases may not necessarily require such extreme intervention.

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Enter the new contender -

In-vitro maturation (IVM) offers a less aggressive fertility treatment alternative. Instead of forcing eggs to mature inside the body using excessive hormone injections, IVM retrieves immature eggs and matures them in a laboratory, which reduces discomfort and health risks for patients.

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Behind the science -

IVM works by collecting eggs at an earlier stage of development and allowing them to mature outside the body. Unlike IVF, which relies on high doses of hormones, IVM requires little-to-no hormonal stimulation.

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The early days of IVM -

The first IVM baby was born in 1991 in South Korea, but the technique struggled to gain popularity due to lower success rates compared to IVF. Over time, however, scientific advancements have improved IVM’s effectiveness and it is a more viable option today.

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A revolution in fertility treatment -

Researchers are refining IVM techniques to make egg maturation outside the body more successful and reliable. If perfected, IVM could transform fertility treatments—reducing costs, side effects, and the emotional toll on patients seeking to conceive.

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The promise of lab-grown ovaries -

Biotech companies around the world are working on lab-generated ovarian environments that mimic natural conditions and improve IVM success rates. These advancements could revolutionize fertility care and allow eggs to mature in the safest, most effective way possible outside the human body.

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A milestone moment -

Recently, the first baby was born using Fertilo, a specialized stem cell-based medium that enhances egg maturation outside the body. This breakthrough suggests that IVM could soon become a mainstream fertility treatment with significantly fewer side effects than IVF.

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Global expansion -

IVM is gaining traction in Vietnam, Australia, Mexico, Peru, and Argentina. Fertility clinics in these countries are refining protocols to boost success rates. Meanwhile, US patients still face regulatory hurdles that prevent widespread access to this promising alternative.

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The FDA’s cautious approach -

The Food and Drug Administration (FDA) is slow to approve IVM treatments like Fertilo, requiring extensive clinical trials before commercialization. While these regulations ensure safety, they also delay access to an option that could significantly ease the burden of fertility treatments.

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A gentler fertility journey -

Unlike IVF, IVM requires fewer hormone injections—often just one or two days of medication instead of two weeks. This reduction significantly lowers side effects like nausea, bloating, and mood swings, which could make fertility treatments less painful and more tolerable for women.

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Financial relief -

IVF is prohibitively expensive, often exceeding US$15,000 per cycle. IVM could substantially reduce costs by requiring fewer medications, fewer clinic visits, and less monitoring. This affordability could make fertility treatments accessible to a much wider range of patients.

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A solution for remote patients -

IVF requires frequent doctor visits for monitoring, which certainly makes it difficult for people in rural areas to receive treatment. IVM’s simpler process reduces the need for constant clinic visits, and so it is a more accessible option for those who live far from fertility clinics.

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The challenge of egg maturation -

Unlike sperm, human eggs are delicate and require highly controlled conditions to mature properly. IVM's biggest hurdle is replicating the natural ovarian environment in a lab to ensure that eggs develop just as effectively as they would inside the body.

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Lower success rates -

Historically, IVM has had lower birth rates than IVF. But new scientific techniques are improving success rates. For some patients, IVM could be just as effective as IVF, but with fewer side effects and a significantly lower financial burden.

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A safer route for egg donors -

Egg donors often endure multiple hormone-stimulated retrieval cycles that expose them to various ovarian dangers. But IVM offers a safer alternative that minimizes hormone exposure, reducing the long-term health risks associated with traditional IVF donation cycles.

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A viable choice for diverse groups -

Many diverse communities could benefit from IVM, including women with blocked fallopian tubes, LGBTQ+ individuals, single parents, and young women freezing their eggs.

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A lifeline for cancer patients -

Cancer patients undergoing chemotherapy often have limited time to preserve their fertility. Fortunately, IVM's quicker timeline allows them to freeze eggs more efficiently, which makes it an ideal solution before undergoing cancer treatments that could permanently damage reproductive health.

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Vietnam’s success -

Vietnamese fertility clinics are leading the way in IVM, particularly for patients with polycystic ovary syndrome and those with high ovarian reserves. Their success rates, averaging 35% live birth per cycle, suggest that IVM could soon rival IVF in effectiveness.

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Beyond IVM -

Aside from IVM, other fertility advancements that have been developed include oral medications to replace injections and even at-home cycle monitoring to reduce doctor visits. These innovations aim to streamline fertility care and reduce the stress or discomfort that patients experience.

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A hopeful future -

If advancements continue, fertility treatments may no longer require women to endure extreme conditions in order to fall pregnant. A future where conception is less grueling and more accessible is becoming an increasingly real possibility.

Sources: (The Atlantic) (Reproductive Biology and Endocrinology) (National Institutes of Health) (Britannica) (American Society for Reproductive Medicine) (Mayo Clinic)

See also: Infections during pregnancy that can put your baby at risk

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