CAPA - IVM in Ovulatory Infertile Women

• Screening for eligibility and randomization

• This trial will be conducted at My Duc Hospital, Ho Chi Minh City, Viet Nam.
• Eligibility screening will be performed on the first visit.
• Patients meeting the inclusion criteria will be invited to participate in the study. Patients will be provided with study information and consent forms. The investigator will collect signed consent forms from all participants.
• Oocyte retrieval:

On days 2-4 of the menstrual cycle, after patients have consented to CAPA-IVM, they will undergo oocyte aspiration anytime thereafter but no later than day 6 of the cycle.

Cycle programming with oral contraceptives or progestogens, nor ovarian stimulation with rFSH or hMG preparations nor the use GnRH analogues are allowed. The use of oral contraceptives will be considered from the second cohort of patients onwards in case the timing/scheduling of the oocyte retrieval needs to be optimized. No hCG or GnRH agonist preparations will be administered for triggering ovarian maturation prior to oocyte retrieval.

• Capacitation in vitro maturation The follicular aspirates are collected and filtered through a cell strainer. After collection, COCs are washed and transferred to a four-well dish, containing CAPA medium. Following 24 hours of incubation in CAPA media, COCs complexes are cultured in IVM medium for 30 hours. Following IVM culture, oocytes are mechanically and enzymatically denuded from their cumulus layers under a stereomicroscope and oocyte maturation is assessed under the inverted microscope
• Fertilization:

ICSI will be used to fertilize mature oocytes. Embryos will be cryopreserved at the cleavage-stage embryo (day 3) if the patient has less than 4 embryos. Patients with 4 or more embryos will be counseled on blastocyst culture (day 5) according to the IVFMD protocol. All viable embryos will be cryopreserved.

Inclusion criteria

• Ageing from 18 to 37.
• Women without PCOS:

• Having regular periods: >24 days and <35 days.
• And not having clinical hyperandrogenism or biochemical hyperandrogenism.
• And not presenting with peripheral distribution of polycystic ovaries on ultrasound.
• Antral follicle count 15 ≤AFC ≤ 24 and Anti-Mullerian Hormone 2,1 ≤ AMH ≤ 5 ng/mL)
• Having indication for ART
• First ART cycle.
• No ovarian stimulation 3 months prior to study entry
• Agree to have all embryos frozen on day 3 or day 5.
• Agree to transfer no more than 02 cleavage-stage embryos or 01 blastocyst-stage embryo in a subsequent embryo transfer.
• Agree to participate in the study (Agree to undergo CAPA-IVM).

Exclusion criteria

• Donor oocyte cycles.
• Uterine abnormalities (adenomyosis, leiomyoma (≥5 cm), bicornuate uterus, intrauterine adhesion).
• Prior ovarian surgery.
• Surgically extracted sperm (by PESA, TESE or micro TESE).