DSSRTN 1

IN-VITRO MATURATION OF OOCYTES
AUTHOR: __________________
PERSONAL INFORMATION: _____________________

Abstract
The present research is based on the In Vitro Maturation (IVM) of Oocytes. The
research is conducted to obtain the insights of the professionals working in fertility
clinics. The opinions of the professionals were recorded on the basis of a questionnaire.
The sample size is taken as 35 which include both doctors and lab technicians who
work together in these clinics. The response that was generated is found to be neutral
to use IVM as an alternate to In Vitro Fertilization (IVF) for fertilizing the Oocytes in
unfertile females. This research is the culmination of detailed literature review and data
analysis. The research does not cover any of the technical procedures and guidelines
that are needed to be followed for carrying out IVM, but is simply conducted on
response based data that has been obtained from the questionnaire. The research is
able to tactfully answer the questions of feasibility, application, knowledge, skills and
experience required to conduct IVM. The research is completely focused on the
outcome of the response and discuses scope for further research of IVM.
Table of Contents
Chapter 1: Introduction......................................................................................................5
1.0 Introduction..................................................................................................................5
1.1 Background of the Research.......................................................................................5
1.2 Research Rationale.....................................................................................................6
1.3 Research Aims............................................................................................................7
1.4 Research Objectives....................................................................................................7
1.5 Research Questions....................................................................................................8
1.6 Significance of the Research.......................................................................................8
1.7 Structure of the Dissertation........................................................................................9
1.8 Summary......................................................................................................................9
Chapter 2: Literature Review...........................................................................................10
2.0 Introduction................................................................................................................10
2.1 Conceptual Framework.............................................................................................10
2.2 Human Reproductive System....................................................................................10
2.3 Procedure of Fertilisation in Female Reproductive System......................................12
2.4 Morphology of Oocytes..............................................................................................13
2.5 Physiology of Oocytes...............................................................................................14
2.6 Types of Maturation process of Oocytes...................................................................15
2.7 Issues in the maturation of Oocytes and Fertilisation with the Sperm......................16
2.8 Techniques involved overcoming the incapability of Oocyte maturation..................17
2.9 Concept of In Vitro Fertilisation.................................................................................18
2.10 History of In Vitro Maturation...................................................................................19

2.11 Advantages of In Vitro Maturation of Oocytes.........................................................19
2.12 Disadvantages and Risks of In Vitro Maturation of Oocytes...................................20
2.13 Alternatives to the In Vitro Maturation of Oocytes...................................................21
2.14 Comparison between IVF and IVM from commercial perspective..........................22
2.15 Linking Literature with current research..................................................................23
2.16 Gaps in Literature....................................................................................................23
2.17 Summary.................................................................................................................24
Chapter 3: Materials and Methods..................................................................................25
3.0 Introduction................................................................................................................25
3.1 Research Outline.......................................................................................................25
3.2 Research Philosophy.................................................................................................25
3.3 Research Approach...................................................................................................26
3.4 Research Design.......................................................................................................27
3.5 Sampling Method and Sample Size..........................................................................27
3.6 Research Strategy.....................................................................................................28
3.7 Data Collection Methods...........................................................................................29
3.8 Data Analysis.............................................................................................................29
3.9 Ethical Considerations...............................................................................................30
3.10 Time Frame.............................................................................................................30
3.11 Summary.................................................................................................................30
Chapter 4: Results...........................................................................................................31
4.0 Survey Questionnaire for the 35 microbiologists and laboratory attendants employed
in the gynaecological research laboratories....................................................................31

4.1 Case Studies.............................................................................................................41
Chapter 5: Discussion......................................................................................................44
5.0 Primary Quantitative Data Analysis...........................................................................44
5.1 Secondary Data Analysis..........................................................................................52
Chapter 6: Conclusion.....................................................................................................53
6.0 Summary....................................................................................................................53
6.1 Conclusion.................................................................................................................53
6.2 Linking Objectives with Findings...............................................................................54
6.3 Recommendations.....................................................................................................55
6.4 Limitations of the Research.......................................................................................56
6.5 Future Scopes of the Research.................................................................................57
References.......................................................................................................................59
Acknowledgement...........................................................................................................65
Bibliography.....................................................................................................................66
Appendices......................................................................................................................73
Appendix 1. Dissertation Structure..................................................................................73
Appendix 2. Conceptual Framework...............................................................................74
Appendix 3. Time Table...................................................................................................75
Appendix 4. Data Analysis...............................................................................................77
4.0 Survey Questionnaire for the 35 microbiologists and laboratory attendants employed
in the gynaecological research laboratories....................................................................77
Appendix 5. Case Study..................................................................................................82
Appendix 6. Survey Questionnaire..................................................................................84

List of Tables
Table 4.1: Working in the gynaecological research field.................................................35
Table 4.2: Current research based on.............................................................................36
Table 4.3: Reasons of infertility of the women................................................................37
Table 4.4: Financial expenditure on the In Vitro Maturation (IVM) methods...................38
Table 4.5: In Vitro Fertilisation is preferred over In Vitro Maturation...............................39
Table 4.6: In Vitro Maturation is encouraged in the medical treatment procedures.......39
Table 4.7: In Vitro Maturation (IVM) is safer than the In Vitro Fertilisation (IVF)............40
Table 4.8: In Vitro Maturation (IVM) must be followed along with the IN Vitro Fertilisation
(IVF).................................................................................................................................40
Table 4.9: Limitations of In Vitro Maturation (IVM) over In Vitro Fertilisation (IVF).........41
Table 4.10: IVM techniques require additional skills and experiences as compared to
IVF...................................................................................................................................41
Table 4.11: Government has active role in implementing the IVM methods..................42
Table 4.12: Role of advertisements in employing the use of the In Vitro Maturation (IVM)
.........................................................................................................................................43
Table 4.13: Any role in the predominance of the IVF over the IVM................................43
Table 4.14: Laboratory conducting the IVM experiments and researches.....................44

List of Figures
Figure 2.3: Female Reproductive System.......................................................................15
Figure 4.1: Working in the gynaecological research field................................................35
Figure 4.2: Current research based on...........................................................................36
Figure 4.3: Reasons of infertility of the women...............................................................37
Figure 4.4: Financial expenditure on the In Vitro Maturation (IVM) methods.................38
Figure 4.5: In Vitro Fertilisation is preferred over In Vitro Maturation.............................80
Figure 4.6: In Vitro Maturation is encouraged in the medical treatment procedures......81
Figure 4.7: In Vitro Maturation (IVM) is safer than the In Vitro Fertilisation (IVF)...........81
Figure 4.8: In Vitro Maturation (IVM) must be followed along with the In Vitro
Fertilisation (IVF).............................................................................................................82
Figure 4.9: Limitations of In Vitro Maturation (IVM) over In Vitro Fertilisation (IVF).......82
Figure 4.10: IVM techniques require additional skills and experiences as compared to
IVF...................................................................................................................................83
Figure 4.11: Government has active role in implementing the IVM methods.................83
Figure: 4.12: Role of advertisements in employing the use of the In Vitro Maturation
(IVM)................................................................................................................................84
Figure: 4.13: Any role in the predominance of the IVF over the IVM..............................84
Figure: 4.14: Laboratory conducting the IVM experiments and researches...................84
Figure 4.15 (a): Maturation Rates of the Oocytes after induction with GH.....................85
Figure 4.15 (b): Maturation Rates of the Oocytes after induction with IGF-I..................85
Figure 4.16: Use of Hormones in Oocyte Maturation......................................................86

Chapter 1: Introduction
1.0 Introduction
According to Thompson and Gilchrist (2013, p.795), the In Vitro Maturation of the
Oocytes constitutes the typical phenomenon in which, the female with the reproductive
impermeability are benefited. In this context, the method of In Vitro Fertilisation (IVM) is
employed for the women, which are exposed to Ovarian Hyperstimulation Syndrome
(OHSS). In this phenomenon, the eggs or the ovaries are collected, before they reach
the maturation stage, within the female reproductive unit. The essential compartments
are functional at this stage, except the fact, that the ability of fertilisation and the
mechanism of oocyte maturation is unsatisfactory within the body of the women.
Therefore, in this research, the different methods and the advantages of IVM have been
discussed.
1.1 Background of the Research
In the modern context of the Human reproductive analysis, it has been evident that the
scope of research and the success of the IVM have been minimal, as compared to the
traditional methods of In Vitro Fertilisation (IVF). As mentioned by Son et al. (2014,
p.145), a complex association of a number of hormones in the human body, contribute
to the overall process of oocyte development and maturation. The IVM techniques are
applied on the patients, after taking into account the family history of the patient and the
natural scenario that have been presented to the patient.
Nowadays, with the increased evidence of Obesity among the females, the incidents of
diagnosis with Polycystic Ovarian Syndrome (PCOS) have assumed a great vitality and
are the scope of research in many countries. Moreover, the exposure to the fertility
inducing hormones and artificial drugs further adds to the complications of developing
Ovarian Hyperstimulation Syndrome (OHSS). This adds to the importance of extensive
research on the IVM techniques in the developed countries of the world (Guzman et al.
2013, p.det034). One advantage of the technique, as compared to the IVF is that, in this
process, the eggs or the oocytes are extracted from the body of the woman, before its
maturation stage is reached. Therefore, in this research, the IVM and its parameters
have been researched.
1.2 Research Rationale
Although the techniques of In Vitro Maturation have been practiced in different parts of
the world, the trends have seen a minimum importance in the modern context, as
compared to the traditional methods of In Vitro Fertilisation (IVF). It has been seen that
the statistics of the obese women have significantly increased around the world, in the
past decade (about 75% of the adults were diagnosed with obesity and overweight in
2010, in the US) (www.niddk.nih.gov, 2010). These consequences have led to the
dependency on the drugs and other hormonal injections, to restore the normal scenario.
The overuse of these drugs and hormones has increased the ratio of Ovarian
Hyperstimulation Syndrome (OHSS) among the women of the reproductive age.
Therefore, these women have been recommended for IVF. However, the risks of IVF
have been elucidated. On the other hand, the designated research on IVM has been
less. Therefore, the research for IVM is an issue in the research. The patients have the
opportunity to preserve their immature oocytes before undergoing cancer

chemotherapy, and are a significant advantage of the IVM (van den Belt-Dusebout,
2016, p.25).
The current research on IVM is an issue for the scientists and the doctors around the
world, to focus on the recent methods of the fertility treatment. The research is an issue
for the doctors, as the Ovarian Hyperstimulation may lead to detrimental effects
including the accumulation of fluid around the heart and the lungs. Other effects may be
pain in the abdomen, vomiting and the rupture of the oocytes, in extreme cases. The
number of deaths from 1984 to 2008 was accounted for both the developing offspring
as well as the mother. The reported number of deaths in this tenure was that for every
100,000 live child births, 6 deaths were accounted for. On the other hand, for every
100,000 live births, 42.5 maternal deaths were accounted (www.nhs.uk, 2010). This
research can shed significant light for the need of developing alternatives to IVF, that
may improve the outcomes of parturition and at the same time ensure the maternal
safety.
1.3 Research Aims
The researcher aims to highlight the importance of adopting IVM as an alternative to
IVF, and its advantages over the IVF procedure. Further, it aims to establish the
advantages that the immature oocyte possesses, after its extraction outside the female
donor.
1.4 Research Objectives
The objectives of the research are:

 To identify the methods that are adopted in the In Vitro Maturation (IVM) of
Oocytes
 To analyse the importance of adopting IVM for the infertile patients as an
alternative to IVF
 To evaluate the potential advantages of the patients and the maturing oocytes in
the IVM procedures
 To recommend the use of IVM and augment its research worldwide
1.5 Research Questions
 What are the methods that are adopted in the In Vitro Maturation (IVM) of
Oocytes?
 What is the importance of adopting IVM, as an alternative to IVF for the infertility
treatment?
 What are the advantages, that are evident on the patients, implementing the IVM
procedure
 What recommendations may be made to augment the research and
implementation of IVM processes worldwide?
1.6 Significance of the Research
The research on the In Vitro Maturation (IVM) of Oocytes is of prime importance in the
modern context, on account of the statistics of the offspring and the maternal deaths
due to the IVF in the recent years. It has been evident that certain chances exist, which
leads to the rejection of the eggs after fertilisation. Moreover, the use of the artificial
drugs in the in vivo maturation of Oocytes prior to the IVF might be substituted by the
use of the IVM. Therefore, these reasons provide the opportunity to signify that the
research of the IVM methods is important in the modern scenario.
1.7 Structure of the Dissertation
(Refer to Appendix 1)
1.8 Summary
From this chapter, it can be ascertained that the levels of research for implementing the
IVM procedures has been less, as compared to the traditional IVF procedures.
Therefore, the research on the management of IVM procedures has been preceded with
further, stating it as a significant alternative to IVF.

Chapter 2: Literature Review
2.0 Introduction
In this chapter, the researcher aims to describe the information that has been provided
in the previous researches, by aligning it to the current research topic. The theoretical
framework, including the introduction of the general concepts of fertilisation,
reproduction, maturation and other techniques has been analysed. The advantages and
the disadvantages of the literature references have been analysed, according to the
current topic. This chapter provides the in-depth idea of the topic that has been
introduced in the previous chapter. This review determines the importance of the In
Vitro Maturation of Oocytes and its relevance in the modern context of the fertilisation
and reproduction of women.
2.1 Conceptual Framework
(Refer to Appendix 2)
2.2 Human Reproductive System
The reproductive system of the human beings constitutes the systems and mechanisms
that lead to the development of the offspring. It is divided into two parts, including the
male reproductive system and the female reproductive system. The male reproductive
system is concerned with the production, maturation, development and the deposition of
the male reproductive units of the male gametes, known as the Sperm. On the other
hand, the female reproductive system is involved in the production, maturation,
fertilisation and development of the female gametes called the ovum or egg (Varga et
al. 2016, p.4). In brief process of the human reproduction, the male gametes and the
female gametes fuse, followed by the development of the zygote that has been a result
of the structure formed after the union of the sperm with the ovum. It has been seen that
the human reproductive system consists of organs and hormones, which are highly
differentiated between the two sexes.
Figure 2.2: Male Reproductive System
(Source: www.bbc.co.uk, 2014)
The organs of the male reproductive system constitute the penis, testis, and scrotum.
On the other hand, the female reproductive organs include the vagina, uterus and the
cervix. However, a number of associated organs exist in the males and the females.
The accessory organs of the female reproductive unit consists of the fallopian tubes,
where the fusion of the sperm and the ovum takes place, the uterus, where the zygote
is implanted, the ovaries, that produces the ovum or the egg (Anderson and Politch,
2015, p.166). The labia majora protects the reproductive organs, and these resemble
the scrotum in males. The production of oily substance prevails in the labia majora,
which are covered with hairs after puberty. The labia minora are present in the interior
cavity of the labia majora. The clitoris and the Bartholin’s Gland are the other accessory
organs of the female reproductive tract. These structures are prepared for receiving the
male penis, after the puberty or the onset of the developmental phase of the females
(www.bbc.co.uk, 2014).
Figure 2.3: Female Reproductive System

(Source: www.bbc.co.uk, 2014)
2.3 Procedure of Fertilisation in Female Reproductive System
The total mechanism of the fertilisation and the development of the zygote is sourced to
the female reproductive unit. The fertilisation begins after the ejaculation of the sperm
from the male penis, into the vagina of the female. As mentioned by Higginson et al.
(2012, p.4541), millions of sperms are released in a single ejaculation. The sperm
travels inside the female reproductive system at higher speed and soon they reach the
fallopian tubes of the female reproductive unit. In the female reproductive unit, the
fusion of the male sperm and the female ovum fertilizes and the zygote is developed.
Soon after the zygote is formed, they get implanted in the placenta, for the absorption of
nutrient from the mother. Here, the cells undergo mitosis and the cellular division and
differentiation begins, assisted by the continuous protection of the zygote. As stated by
Tilly and Sinclair (2013, p.845), gradually, the zygote develops and the organs begin to
develop followed by the formation of the amniotic sac, filled with amniotic fluid, that
protects the baby, from the shocks and disturbances in the external environment.
During this phase, the nutrition, the nourishment and the immunity is transferred from
the mother to the baby, through the umbilical cord. After complete development of the
baby, parturition or the delivery of the baby is accomplished.
A complex network of hormonal systems employs the organised fertilisation and the
zygote development in the females. The Luteinizing Hormone (LH) and the Follicle
Stimulating Hormone (FSH), collectively produces the ovum from the ovaries. The two
hormones, estrogens and progesterone are secreted by the ovary, on account of the
nourishment of the uterus and the placenta, to meet the situations, whenever
fertilisation occurs. The estrogens is found in the three major forms, including estradiol,
that is involved in development of breasts, the estrone, estriol and the inhibin (Wira et
al. 2015, p.226).
2.4 Morphology of Oocytes
Oocytes are the germ cells that collectively form the female gametocyte in their
reproduction. The Oocytes are seen, before the final egg or ovum is produced in the
females. It has been evident that, the immature eggs or ovum are referred to as the
Oocytes. Therefore, as opined by Levi et al. (2013, p.det261), it has been seen that the
development of the matured ovum from the Oocytes in the female body, is referred to
as Oogenesis. A number of hormones are involved in this process and is directly
related to the age and the development of the individual. Before the maturation of the
Oocytes, in the early Oocytes development they are referred to as Germinal Vesicle
(GV), and this stage of development is known as Metaphase I (MI) Stage. After this
stage, the first division of the cells or the first meiotic divisions are seen (Seet et al.
2013, p.924).
The oocyte is protected by different layers that protect their functionality and structure.
The Zona Pellucida protects the Oocyte through its thick extracellular matrix. The Zona
Pellucida is covered by additional specialised layers, known as Granulosa Layer. The
recent studies and microscopic analyses have revealed that, the size of the oocytes is
much larger, as compared to morphology and the size of the male sperms (Wei et al.
2013, p.937).
2.5 Physiology of Oocytes
In the normal stages of the life stages of a female, the ovary is studded with
approximately 6 million to 7 million Oogonial cells. However, it has been studies that all
of these do not participate in the reproduction. Most of these cells die inside the body,
on account of the normal processes of apoptosis, that controls the specificity of the cell
division in the human females (Uzelac et al. 2012, p.88). The gestation period in the
females begin at this stage, and these are followed by the surviving Oogonial cells
undergoes the meiotic cell division. At this juncture, these Oogonial cells are referred to
as the Primary Oocytes. The normal cell division progress, however it is hindered at the
Prophase I, while the diploid state of the Oogonial cells are maintained.
On account of the stimulation by the Follicle Stimulating Hormone (FSH), the primary
follicles continue to increase in size and are accompanied by the formation of Vesicles.
This stage is referred to as the Secondary Follicles. As mentioned by Kiapekou (2004,
p.156), finally, the follicle continues to mature and leads to the formation of Graafian
follicle. At this position, the graafian follicles continue to provide the structure, where the
Oocytes mature and leads to the formation of ovum, thereby secreting the estrogen
hormone, that are involved in reproduction.
2.6 Types of Maturation process of Oocytes
It has been seen that the Oocytes are the primary structures that are not capable of
reproduction, without their maturation, differentiation and development. Two types of
maturation have been evident, especially in the process of development and the
maturation of the Oocytes. These include the Natural maturation and the In Vitro
Maturation (IVM) (Li and Albertini, 2013, p.150). The Oocytes continue to mature and
develop, for their ability to produce the mature egg or ovum. After the sharp decline of
the Meiosis II phase, the maturation commences within the Oocytes, to form the mature
ovum. On the other hand, the ovarian follicles or the Oocytes are transferred out from
the body of the individual and are cultured and matured under artificial conditions in the
laboratory.
In the maturation process, the nutrients are supplemented by the surrounding
Granulosa cells of the body. According to Holubcova et al. (2015, p.1145), in this period,
the Levels of the production of the Luteinizing Hormone continues to increase and in the
final week before its release, the nuclear contents of the Oocyte matures and develops.
On the other hand, the maturation of the Oocytes through IVM is brought about by the
extraction of eggs, before their individual maturation from the body of the woman. These
are placed in the laboratory and incubated at the human body temperature (Coticchio et
al. 2013, p.912).

2.7 Issues in the maturation of Oocytes and Fertilisation with the Sperm
The maturation of the Oocytes are concerned with the continuous modes of maturation
of the cytoplasm and the nucleus. The Gonadotropin further stimulates the meiosis of
the Oocytes that were in the Prophase I stage, before their ovulation (Uzelac et al.
2012, p.78). Furthermore, it has been observed that the germinal breakdown initiates to
establish the current Metaphase II stage from the Germinal Vesicle Breakdown (GVBD).
However, the normal course of the oocyte maturation may not be evident in some
cases, on account of a number of issues. These include the extensive use of the
Human Chorionic Gonadotropin (HCG) hormone to the women, the uncontrolled use of
fertility drugs to induce ovarian stimulation, cause an immense drawback for the
longevity and the efficacy for the natural and effective ovulation (Walls et al. 2015,
p.91).
Infertility is a condition that does not allow the subjected woman to enter into the stage
of fertilisation of the sperm with the ovum. It has been seen that the women that are not
able to provide the platform for the fertilisation are prone to infertility. These may be
accounted for a number of reasons, including the improper or damaged fallopian tube,
problematic Oocyte maturation leading to unsuccessful ovulation, or the conditions of
endometriosis. Apart from the physiological factors, external and other environmental
factors may lead to the consequences of infertility among the women. These include the
consequences of Polycystic Ovarian Syndrome (PCOS), stress, obesity, lifestyle
diseases, multiple previous miscarriages and the age of the women (Shafiee et al.
2014, p.251). It may also be accountable due to the ineffective and inefficient quality of
sperm or the lower sperm count, problems in ejaculation or erection, and orchitis. These
are the most probable factors that prevent the efficient fertilisation of the sperm with the
ovum, thereby yielding the consequences of infertility.
2.8 Techniques involved overcoming the incapability of Oocyte maturation
It has been noted that the inhibition of the Oocyte maturation may lead to the infertility
among the females and it may be improved or treated by the use of the alternative
treatments. These include the method of Intracytoplasmic Sperm Injection (ICSI) and
the In Vitro Fertilisation (IVF) technique. Furthermore, as suggested by Nayot et al.
(2013, p.1441), the alternative use of the Oocyte stimulation drugs and hormones such
as Human Chorionic Gonadotropin (HCG) have been incident in many cases. These
artificial technological applications may provide the women, with the increased ability of
reproducing via the fertilisation of their own eggs.
Although the methods of ICSI have been based on the treatment of the male infertility, it
significantly affects the method of reproduction and fertility, and accounts for the
advantages among the females as well. As stated by Reddy et al. (2014, p.928), this
process is effective in those cases, that have the female partner to account for the fewer
eggs that are exposed for fertilisation. This method is particularly important whenever
the female fallopian tubes have changes in the pH, that hinders the free movement of
sperm, or are affected by infection. It has also been evident that the method proves
fruitful, whenever the fallopian tubes are ineffective to provide the suitable environment
for the sperm to mature. In the method of In Vitro Fertilisation (IVF), the egg is fertilised
outside the body of the women. It has a number of advantages in this context. The
advantages include the ability of the women to have their offsprings by the fertilisation of
their own ovum (Gremeau et al. 2012, p.356). This ensures their individual genetic
makeup for the offspring. The women are able to conceive, even if her fallopian tubes
are blocked. The effective fertilisation is possible for the women that have a lower
reserve for their eggs.
2.9 Concept of In Vitro Fertilisation
The process of In Vitro fertilisation (IVF) is a modern technological implication to induce
the maturation and the fertilisation of the female Oocytes. This is followed by the
providence of fertility opportunity for the females, thereby producing the offsprings in a
natural course. It has been seen that the methods of IVF initially became successfully
implemented in the year 1990. This has been accompanied by the serious increase in
the efficiency and success rates in the following years and has now been used very
frequently in the US and the other countries (Garcia‐Faura et al. 2016, p.238).
In this method, the female immature Oocytes are stimulated to mature, under the action
of artificial hormones including the HCG. The mature oocytes are then collected as eggs
and are placed in the laboratory to fertilise externally and the fertilisation using the male
sperms are performed and transferred into the female tract and these are then
implanted in the placenta (Altamiranda et al. 2016, p.2001). These implantations are
made by the developing and fertilised embryo that restores the general dividing and
differentiating ability. After the desired period of time, the normal offsprings are
produced and the parturition occurs under normal conditions. This provides the
opportunity for the females that are not capable of Oocyte maturation.
2.10 History of In Vitro Maturation
The In Vitro Maturation (IVM) has been adopted as a substitute for the traditional IVF, in
providing the ability for the infertile women to induce pregnancy. It has been reported
that the first concept to induce artificial pregnancy by In Vitro Maturation was adopted in
1935, on the rabbits. However, following its success, the process was adopted in 1965,
on different other animals including cow, monkey, rat and pigs (Bui et al. 2015, p.508).
On account of the further success of the method, the first experiment was conducted on
the human beings in 1991, where the methods of both IVF and IVM were adopted. 1994
experienced the first healthy birth of the offspring, using the IVM methods. The
experiment was applied for the women that had the syndrome of Polycystic Ovary. It
induced a massive success and has been seen that the patients affected with PCOS
were able to undergo pregnancy by inducing their respective Oocyte maturation, using
the methods of IVM (Kupčinskas et al. 201, p.1). This has been a case for the patients
treated with IVF, as in this method, the patient were not stimulated to induce the
maturation of Oocytes. Therefore, in this case, the susceptibility of drug in the female
body has been considerably reduced.
2.11 Advantages of In Vitro Maturation of Oocytes
The In Vitro Maturation (IVM) of Oocytes has been implemented, by using the artificial
technologies. It has been seen that the IVM methods have significant better health on
the female patients. However, it is evident that significant advantages were evident on
the patients that have been subjected to the methods of In Vitro Maturation (IVM).
According to Cui et al. (2015, p.192), the IVM methods are capable of extracting the
Oocytes from the body of the women, that have the inability of maturation. Therefore, in
this method, the female with the problems of maturing the Oocytes have been positively
affected by the method. Another advantage in this procedure is that, the females
undergoing the IVM techniques are not exposed to the use or the administration of the
hormonal drugs or the hormone enhancing synthetics. This poses the safety of the
females in the future course of their lives.
The third advantage that has been recorded in this aspect is that the patients that are
subjected to the IVM may have additional benefits in the cases where the females are
exposed to the diagnosis of cancer (Lindenberg et al. 2013, p.1171). It has been seen
that the method of IVM is based on the extraction of the immature Oocytes even before
they mature. Therefore, in this case, if the subjected women are incident to receive the
Cancer Chemotherapy, the immature Oocyte may be taken out of the body and
preserved. This will not pose the secondary effects of the chemotherapy that would
have otherwise affected the Oocytes.
2.12 Disadvantages and Risks of In Vitro Maturation of Oocytes
Although it has been evident that the procedures of IVM have not been accounted for in
the modern world, however, a number of disadvantages have been evident while
implementing the IVM, it has therefore been seen that the overall methods of removal of
the immature Oocytes have been an area of concern, as the techniques that are
generally used for the extraction of the immature Oocytes from the female ovaries are
crucial, and this involves the incorporation of the advanced and acute skills and
technologies for the extraction procedure. Moreover, after the extraction the immature
Oocytes are preserved under laboratory conditions and this involves huge infrastructure
and technology (Cho et al. 2013, p.5). Furthermore, it has been established that the
fertilisation process may be an important limiting step in this procedure, as the
conditions have to be maintained strictly, to provide the significant success to the
experiments.
As the process is carried out outside the body, under artificial conditions, it is essential
to maintain the body temperature, pH, ion influx and metallic balance in the medium,
where the Oocytes are grown and this requires additional surveillance and skills. These
developing and maturing Oocytes may be subjected to the environmental fluctuations
and the total setup of the method may be wasted. In these contexts, another set of
experiments are required and this involves additional financial support (Segers et al.
2015, p.1230). These are the parameters that pose the risks and the disadvantages for
the adoption of the In Vitro Maturation (IVM), throughout the world, as the countries with
lower economic status may not be able to afford the expenses of the IVM practices. .
2.13 Alternatives to the In Vitro Maturation of Oocytes
A significant alternative to the newer methods of IVM is the method of In Vitro
Fertilisation (IVF) that has been adopted in many countries. The alternatives are
generally used, on account of the lower costs of the procedure. In this procedure, the
mature Oocytes are taken out of the Ovary and are fertilised externally, under strict
laboratory conditions (Shalom-Paz et al. 2012, p.54). This causes lesser surveillance
and expenditure on the experiments. The procedures that are employed in the IVF have
been comparatively simple, as compared to the IVM. In the IVF, the maturation of the
Oocytes in the body of the females are stimulated, using synthetic drugs and hormones,
and the mature Oocytes are produced. The mature Oocytes are then extracted outside
the body of the individual. These are then followed by the culture in the laboratory and
the fertilisation of sperm, under required environments in the laboratory.
After the fertilisation, the zygote cell is transferred to the uterus of the female and they
gradually get implanted in the placenta and continue to grow and divide naturally, finally
leading to the development of the offspring, after continued periods of gestation.
Furthermore, as mentioned by Stein et al. (2014, p.322), it has been noted that the rates
of success of the IVF has been very high, accompanied by the lower costs of the
process. Therefore, nowadays the methods of IVF are still preferred in the US, over the
IVM. There are chances of the fact that the outer layer of the Ovum become harder for
the sperm to penetrate and this method requires the incorporation of the ICSI, adding to
the further expenditure of the IVM.
2.14 Comparison between IVF and IVM from commercial perspective
From the commercial perspective of the IVM and the IVF, it has been seen that the
differences exists in the commercial area of the method that augments the use of the
traditional IVF methodology over the implementation of the IVM methods (Ellenbogen et
al. 2014, p.79). It has been seen that the success rates and the implementation of the
IVF methods have been practiced throughout the world, and this has been the area of
sponsorship and funding, by a number of pharmaceutical companies and organisations.
On the other hand, the IVM, being a newer method has minor sponsorship and fundings
to be implemented at a larger scale worldwide.
Another significant important area of concern over the preference of IVF than the IVM is
the lack of researches and the extensive laboratory procedures. In the method of IVM,
the immature Oocytes are extracted from the ovaries and this involves careful surgery.
Moreover, the laboratory culture of these oocytes is ensured extensive care and skill
(Grynberg et al. 2014, p.238). These require the greater costs for the patients as
compared to the IVF, where the mature oocytes are extracted out of the body and
fertilised. Therefore, the cost is another important factor, which reduces the
implementation of the IVM, in commercial perspectives.
2.15 Linking Literature with current research
In this chapter of the research, the focus has been made on the human reproductive
system, and increased focus has been provided to the female reproductive system. This
has been made in order to provide the brief idea of the differences in the reproductive
systems of the malke and the female reproductive systems and its individual organs.
The anatomy, physiology and the role of the Oocytes and the importance of Oogenesis
have been described as it provides the idea of the different procedures that are
implemented by the human Oocytes to mature and ultimately participate in fertilisation.
The alternatives to the IVM, has been implied in the context on account of the increased
prevalence of the IVF over the IVM. The advantages and the disadvantages as well as
the risks of the IVM have been described, on account of the preferences of the IVF over
the IVM. Therefore, on account of these studies, the understanding of the In Vitro
Maturation has been effective, in the recent studies, and therefore, the following
chapters of the research may be approached with specificity.
2.16 Gaps in Literature
It is analysed from the current research that the methods of the In Vitro Maturation and
In Vitro Fertilisation (IVF) have been the latest techniques that may provide the greater
scopes for the pregnancy and fertilisation in the infertile women and the women that
have difficulties in the Oocyte maturation. The literature provided different insights about
the advantages and disadvantages of the IVM and IVF. Further, the methods of IVM
have been discussed at significant levels. However, the lack of the data has been
evident in huge proportion. It has been seen the effect of the hormones and the surgical
methods of stabilising the maturation of Oocytes after their extraction in the laboratory
have not been reported sufficiently. Moreover, the secondary data did not reveal the
actual causes for the lack of the IVM practices. The impact of the hormones on the
implanted zygote after fertilisation has not been presented conceptually, in the previous
literature.
2.17 Summary
From this chapter, it may be interpreted that the overall methods of improving the
female fertility have been based on the two techniques including the In Vitro Fertilisation
(IVF) and the In Vitro Maturation (IVM). Although it has been seen that the IVF
methodology have been applied in greater frequencies in the different countries,
including the US, however, the application of the IVM have been relatively low. This has
been evident on account of the extensive researches in the academic and scientific
levels. The advantages of the IVM have been elucidated and this may provide useful
information for the researchers to test the methods of IVM at larger frequencies.
Chapter 3: Materials and Methods
3.0 Introduction
This chapter is based on the different tools and the theories that are employed by the
researcher, in order to accomplish the desirables of their research, with regard to a
particular topic of study. This chapter provides the idea of the concepts, theories,
approach and other parameters that are employed by the researcher. The paradigm of
the research, including the outline, philosophy, approach, design, methods of sampling,
strategy of the research, data collection procedures and methods, analysis of the data,
ethical considerations and the time frame, that are applied in the research have been
elaborated in this chapter.
3.1 Research Outline
It is often important for the researcher, to have the conceptual outline of the methods
that are used in the research. The overall structure of the research has been described
in this chapter and tends to provide the necessary frameworks for the research, to
complete the proceedings of the data collection and analysis of the research. The
primary and secondary data have been collected from the various sources and have
been carefully analysed in this research. The reliability of the research and the validity
of the literature of the literature have been based on the data that have been collected.
3.2 Research Philosophy
One of the prime requisites for the researcher in a research is to employ the most
appropriate philosophy in the research. The philosophy of the research allows the
researcher to base the foundation of their research based on a preformed philosophy.
Two philosophies are generally employed in the researches and these include the
Positivism philosophy and the Interpretivism Philosophy. The positivism philosophy is
based on the observations, which lead to the development of the data analysis, using a
statistical method. Moreover, the data is usually collected from the real evidences and
are generally based on the existent theories, to develop a hypothetical conclusion.
On the other hand, the Interpretivist approach largely depends on the method of
collecting the data by using interviews and observations. This philosophy is generally
employed in cases, where very little literature and theories are available on the topic of
the research (Bauer, 2014, p.12). Therefore, in this research, the positivism philosophy
has been applied, as the data for the research has been collected by the researcher
and presented in the form of statistical quantitative forms. This allows the researcher to
obtain the useful data from the surveys and present them suitably for analysis.
3.3 Research Approach
Two types of research approaches are generally employed by the researchers, and
these include the Deductive approach and the Inductive approach. The deductive
approach is used by the researcher, whenever, new logic and theories are adopted by
the researcher that are based on the previous resources available from the previous
researches and the collection of sufficient data, to support the theory. On the other
hand, the inductive approach is used by the researcher, that uses a bottom-up process
in a research that are generally involved in testing the theories, on the basis of the
literature evidences from the previous researches (Tuohy et al. 2013, p.19). In this
research, the researcher has adopted the deductive approach, as the researcher is
involved in the generation of new theories, which are based on the reviewed literature
and the primary quantitative data, from the surveys. Moreover, this approach results in
the comparative study of the theories and the practical implementations of the
procedures in the real world.
3.4 Research Design
Three distinct research designs are generally used in the researches and these include
the explanatory, exploratory and descriptive designs. The research aims sets the tune
for the adoption of the designs of the research. If the objectives and the research
questions are not prepared, the researcher opts for the explanatory and the exploratory
design. On the other hand, the experiments that have a well defined set of objectives
and questions; the researcher adopts the descriptive approach (Bauer, 2014, p.11). In
this design, the positive as well as the negative aspects of the topic are included in the
study. Therefore, as this research is based on the research questions and objectives,
the descriptive design has been used and has been based on the primary and
secondary data extraction, for their individual analysis.
3.5 Sampling Method and Sample Size
The sampling method allows the researcher to adopt a specific sample size for the data
collection in the research. Generally two types of sampling are employed by the
research for the researches and these include the probability sampling and
nonprobability sampling. In this research, the researcher has adopted the simple
random non-probability sampling technique as the method of data extraction. This
sampling method allowed the researcher to maintain the time and the financial
resources in a convenient way. As the lack of time and financial resources was an
important issue, this method was adopted by the researcher as it allowed the
researcher to extract authentic and bulk of the data within a short span of time. The
sample size has been taken to be 35 and this includes the microbiologists and the
laboratory attendants of the infertility research laboratories.
3.6 Research Strategy
The research strategies employ the strategies that are generally adopted by the
researcher to complete the research. A number of strategies are generally used by the
researchers and these include the case study strategy, experimental strategy,
interviews and surveys. These strategies enable the researcher to extract the data, from
the different sources. Surveys may be used by the researcher to obtain the results or
data from a huge population and the experimental strategy is used in the case of
providing new theories and models relevant to the topic. The interviews allow the
researcher to obtain the qualitative data in the form of their facial expressions, using a
considerable amount of time.
In this study, case study strategy and the Survey Questionnaire Strategy has been
adopted by the researcher. This enabled the researcher to collect the secondary
quantitative data from the statistics and results for previous researches and reports.
Survey Questionnaire strategy is also used by the researcher, for the Primary
Quantitative Data from the microbiologists and the laboratory attendants. This allowed
the researcher to extract the quantitative primary data from a large number of
participants within a short span of time and using limited resources.

3.7 Data Collection Methods
The data collection methods are important for the researchers in a research as it
enables the researcher to prepare the overall framework of the research and at the
same time, draw out the approximate resources that are required in order to complete
the data collection procedures. In this research, the data for the research have been
collected by using the survey questionnaire that had a Likert scale answering technique
for the closed ended questions. These questionnaires were provided to the participants
through the online social media. This allowed the research to obtain a huge amount of
primary data, within a very short span of time. Another method of data collection has
been used by the researcher in the form of secondary data analysis from the
government websites and health journals. This allowed the research to obtain the
secondary quantitative data for the research.
3.8 Data Analysis
The data analysis is important in the researchers as it enables the researcher to draw
the useful conclusions and recommendations based on the extracted data in the
research. In this research, the primary quantitative data from the survey questionnaires
have been presented in the form of tables and the response frequency of the questions
have been converted into response percentages and these are provided in the form of
graphs and charts. On the other hand, the secondary quantitative data from the different
secondary sources have been presented and analysed according to the recent years of
their evidence in the world.

3.9 Ethical Considerations
The ethical considerations are important in the context of the researches, especially in
the researches that are based on the primary data sources, which are obtained from the
quantitative surveys. As the analysis of the data in the research is based on the primary
data that have been obtained from the survey questionnaires it presents the authenticity
of the research. Therefore, the ethical considerations in this research were that the
participants were not forced to answer the questionnaire. Confidentially was provided to
the participants that allowed them to answer the questions freely. The data that were
obtained were ethically subjected to be used only for the academic research and not for
other purposes. Finally, the data that have been obtained from the case studies and the
survey questionnaires were kept unaltered and authentic. This allowed the complete
specificity of the analysis that has been based on the data.
3.10 Time Frame
(Refer to Appendix 3 for Time Table)
3.11 Summary
Finally from this chapter, it may be ascertained that the research methodology provided
all the parameters that are adopted in the research, to restore the authenticity of the
research. It may be concluded that the positivism philosophy, the deductive approach,
the case study and survey questionnaire strategy, primary quantitative data, simple
random non-probability sampling technique and secondary quantitative data are
adopted to approach the research and consequently analyse and discuss the results.
Chapter 4: Results
4.0 Survey Questionnaire for the 35 microbiologists and laboratory attendants

employed in the gynaecological research laboratories
(Refer to Appendix for the Survey Questionnaires)
Q1. How long have you been working in the gynaecological research field?
Options Response Response Total
Frequencies Percentages Respondents
Fresher 2 6% 35
Less than 1 10 28% 35
Year
Less than 2 14 40% 35
Years
Less than 3 6 17% 35
Years
More than 5 3 8% 35
Years
Table 4.1: Working in the gynaecological research field
Figure 4.1: Working in the gynaecological research field

Q2. What is your current research based on?
In Vitro Fertilisation 18 51% 35
In Vitro Maturation 10 29% 35
Transplacental Nutrient 2 6% 35
Transfer
Artificial Ovulation 4 11% 35
Human 1 3% 35
Immunoglobulin
Table 4.2: Current research based on
Figure 4.2: Current research based on

Q3. What are the major problems that are noted in research, for the reasons of
infertility of the women?
Oocyte 6 17% 35
Degeneration
Obstructive 10 28% 35
Fallopian Tube
Oocyte Maturation 12 35% 35
Obesity 3 8% 35
Others 4 12% 35
Table 4.3: Reasons of infertility of the women
Figure 4.3: Reasons of infertility of the women

Q4. What is the nature of the financial expenditure on the In Vitro Maturation (IVM)
methods?
High Expenditure 21 60% 35
Moderate 13 37% 35
Expenditure
Free 1 3% 35
Table 4.4: Financial expenditure on the In Vitro Maturation (IVM) methods
Figure 4.4: Financial expenditure on the In Vitro Maturation (IVM) methods

Q5. How far do you agree that the In Vitro Fertilisation (IVF) is preferred over In
Vitro Maturation (IVM)?
Strongly Agree 7 20% 35
Agree 9 26% 35
Neutral 10 28% 35
Disagree 8 23% 35
Strongly 1 3% 35
Disagree
Table 4.5: In Vitro Fertilisation is preferred over In Vitro Maturation
(Refer to Appendix 4 for Graphical Presentation of the data)
Q6. How far do you agree that In Vitro Maturation is encouraged in the medical
treatment procedures?
Agree 6 17% 35
Neutral 3 9% 35
Disagree 14 40% 35
Strongly 7 20% 35
Disagree
Table 4.6: In Vitro Maturation is encouraged in the medical treatment procedures
Q7. How far do you agree that In Vitro Maturation (IVM) is safer than the In Vitro
Fertilisation (IVF)?
Agree 17 48% 35
Neutral 2 6% 35
Disagree 1 3% 35
Strongly 3 9% 35
Disagree
Table 4.7: In Vitro Maturation (IVM) is safer than the In Vitro Fertilisation (IVF)
Q8. How far do you prefer that In Vitro Maturation (IVM) must be followed along
with the In Vitro Fertilisation (IVF)?
Highly Prefer 10 28% 35
Prefer 11 31% 35
Neutral 5 15% 35
Do not Prefer 7 20% 35
Not at all 2 6% 35
Prefer
Table 4.8: In Vitro Maturation (IVM) must be followed along with the IN Vitro
Fertilisation (IVF)
Q9. What are the limitations of In Vitro Maturation (IVM) over In Vitro Fertilisation
(IVF)?
More expenditure 8 23% 35
Complicated 7 20% 35
Technique
Lack of Research 11 32% 35
Less applications 4 11% 35
Lack of 5 14% 35
Sponsorship
Table 4.9: Limitations of In Vitro Maturation (IVM) over In Vitro Fertilisation (IVF)
Q10. How far do you agree that the In Vitro Maturation (IVM) techniques require
additional skills and experiences as compared to the Traditional In Vitro
Agree 14 40% 35
Neutral 5 14% 35
Disagree 3 9% 35
Strongly 1 3% 35
Disagree
Table 4.10: IVM techniques require additional skills and experiences as compared
to IVF
Q11. How far do you agree that the government has active role in implementing
the IVM methods in the different countries?
Agree 17 48% 35
Neutral 3 9% 35
Disagree 1 3% 35
Strongly 1 3% 35
Disagree
Table 4.11: Government has active role in implementing the IVM methods
Q12. What role does the advertisement play in employing the use of the In Vitro
Maturation (IVM), in the modern world?
No Practical 5 14% 35
Role
Partial Role 8 23% 35
Neutral 4 11% 35
Active Role 11 32% 35
Very effective 7 20% 35
Role
Table 4.12: Role of advertisements in employing the use of the In Vitro Maturation
(IVM)
Q13. How far do you agree that, the general awareness of the people have any
role in the predominance of the IVF over the IVM?

Agree 11 31% 35
Neutral 5 14% 35
Disagree 9 26% 35
Strongly 4 11% 35
Disagree
Table 4.13: Any role in the predominance of the IVF over the IVM
Q14. Does your laboratory have the resources to conduct the researches for the
In Vitro Maturation (IVM)?
Yes 6 17% 35
Do not know 2 6% 35
No 23 66% 35
Infrastructure present but 4 11% 35
lack of scientists
Table 4.14: Laboratory conducting the IVM experiments and researches
4.1 Case Studies
Case Study 1
(Refer to Appendix 5 for Graphical Data)

The Growth Hormones (GH) are the hormones, secreted by the endocrine glands of the
body. In this case, the research has been done, that are based on the differences in the
effects of the Growth Hormone, on the development of the Oocytes of the mouse, in
vitro. Therefore, in this context, the experiment was performed, by increasing the levels
of the Growth Hormone (GH) and subjected to the Developing Oocytes of the mouse. It
has been seen that different concentration levels were applied on the maturing Oocytes.
In this case, the concentrations used were 0.1 µg/ml, followed by the 0.2 µg/m. The
concentrations were gradually increased 0.4 µg/ml and consequently doubled to
0.8µg/ml. A control experiment was performed, to relate the effects of the Gh on
maturation of Oocytes and its natural maturation. In the first two concentrations of the
GH, the rates of maturation have seen to increase significantly. However, the increase
in the maturation rates were not seen in the concentrations of 0.4 µg/ml and 0.8 µg/ml.
This experiment was performed to analyse the effects of the IGF-I, on the maturation
rates of the Oocytes of the mouse. In this experiment, the concentrations of the IGF-I,
was gradually increased, and the consequent percentage increase in the rates of
maturation of the Oocytes have been measured. It was observed that different
concentrations were used in this experiment. The initial concentration was kept at 10
ng/ml. The concentration was gradually increased to 50 ng/ml and the relevant
recording was done, on the percentage increase in the maturation rates of the mouse
Oocytes. Further the concentrations the IGF-I was kept at 200 ng/ml and the percent
increase in the maturation rates was recorded. Finally a double concentration of about
400 ng/ml was applied on the developing Oocytes and their consequent recordings
were made according to the percentage increase in the rates of Oocyte maturation.
Again a control experiment was done, to measure the effect of the independent
maturation of the mouse Oocytes, in the absence of the inducing factors including the
IGF-I. Significant rise in the maturation levels were evident in the first two
concentrations. However, it was seen to have a neutral effect on the maturation rates,
whenever the concentrations were further increased in the experiment.
Case Study 2
(Refer to Appendix 5 for Graphical Data)
Four separate groups were made to analyse the effects of the FSH, HCG and FSH +
HCG, on the Oocytes and its values were recorded for both the in vitro and the in vivo
experiments. It was evident that the Rates of the in Vitro Maturation (IVM) rates were
higher in the cases where the HCG and FSH were used in combination. On the other
hand, it was seen that the HCG boosted reaction had the maturation rates of about
57.9%. Further, the maturation rate of about 50.8% was seen in the cases treated with
FSH. However, the lowest rates of maturation were seen in the cases, where the
Oocytes were not treated without any hormones.

Chapter 5: Discussion
5.0 Primary Quantitative Data Analysis
Q1. Discussion
From the table, it may be ascertained that the tenure of the individuals in the
laboratories have been minimum and this has been attributed to the methods of
advanced technologies that are generally adopted in the In Vitro Maturation (IVM)
Techniques. It has been observed that about 40% of the individuals in the laboratory
belonged to the tenure of less than 2 years. Further it has been seen that about 28% of
the microbiologists belonged to the experience of less than a year and about 6% of the
employees belonged to the fresh category of the individuals that do not have the
required experience to carry out the IVM techniques. Only few percentage of the
individuals (about 8%) were more than 5 years old, and this proportion of the
experienced individuals were insufficient to carry out the desired IVM techniques. It
proves that the experience and the skills that are required for the efficient conductance
of the IVM researches were available at very lower rates, as compared to the critical
and acute techniques of the process.
Q2. Discussion
From this survey question, it was noted that different researches have been involved in
the microbiological and gynaecological studies around the world. From the above
question it has been analysed that about 29% of the individuals were engrossed in the
researches on In Vitro Maturation (IVM). About 51% of the individuals were involved in
the In Vitro Fertilisation (IVF) Methods. This proves that the awareness for the
researches and the treatments were inclined towards the adoption of the IVF, as
compared to the IVM. About 11% researched on artificial ovulation in different animals
including human beings. A few proportions (about 3%) were engrossed in the research
on Human Immunoglobulin and its transfer to the developing baby, along the placenta
of the mother. Further, it has been noted that, about 6% of the microbiologists were
involved in different researches based on the Transplacental Nutrient Transfer.
Therefore, it proves that the IVF method has been widely researched and its proportion
is considered to be prevalent at higher rates, as compared to the research rates of IVM.
Q3. Discussion
In the context of the current research, the major reasons for the causes of the infertility
among the women have been described in the table. The analysis if the data in the table
proves that a major proportion of the views (about 35%) supported the fact that the
maximum causes of the ind\fertility among the women in the modern world was based
on Oocyte Maturation. It has been noted that, the women at higher rates had problems,
relating to the Oocyte maturation and it accounted for the convenient treatment
procedures to restore the fertility. On the other hand, about 28% of the cases reported
that the causes of infertility among the women have been based on the obstructions in
the Fallopian Tubes and its consequent researches have been analysed. Therefore, the
Obstructive Fallopian Tube was the second major cause of the infertility in the women.
About 17% of the modern women faced the infertility problems that have been based on
the Oocyte Degeneration and this method required the importance of the In Vitro
Fertilisation (IVF) and the In Vitro Maturation (IVM) methods. These statistics reveal that
Oocyte is one of the dominant factors for the causes of the infertility among the women
and these results in the extensive researches on IVF and IVM. About 12% of the
respondents answered that other causes were responsible for the infertility among the
women in the modern world. A very percentage of the respondents about 8% reported
that the Obesity among the women of young and Middle Ages were one of the factors
that significantly leads to the development of infertility symptoms among the women, in
the modern world.
Q4. Discussion
Data have been further recorded in the form the reviews about the expenditures in the
In Vitro Maturation (IVM) techniques. It has been analysed that a higher percentage of
the respondents (about 60%) reported that the higher expenditures in the In Vitro
Maturation (IVM) methods were responsible for the lack of preference over the In Vitro
fertilisation (IVF). About 37% of the respondents agreed to the fact that the IVM
methods employ moderate expenditure and it revealed that the expenditure on IVM has
been relatively a little higher as compared to the traditional methods of the IVF.
However, only 3 % of the participants agreed to the fact that the methods of IVM were
available without any cost. This may have been referred to a free medical check-up or
treatment that might have been available in the recent past. However, finally, it is
analysed the higher rates of the IVM methods drives its prevalence lower than the
traditional IVF techniques.
Q5. Discussion
The table in this question depicts the responses of the participants to measure the
prevalence of the IVF over the IVM. From the tabulated data, it may be analysed that
about 28% that accounted to the maximum response of the participants were neutral to
the proposition. It may be analysed that these participants believed that both the
developed and the traditional methods of the infertility treatment must be implied. It may
be analysed that these proportion of the participants believed that both the IVM and the
IVF are needed to be mutually coexistent with one another. About 26% of the
participants agreed to the point that the IVF methods are preferred over the IVM
methods, and about 20% strongly supported to the fact that the IVF methods were more
common as compared to the IVM methods. This indicated that the higher expenditures
and the lack of the research is one of the major causes of the preference of the IVF over
IVM. A very lower percentage of the respondents (about 26% in total) agreed to the fact
that IVM is most commonly preferred over the IVF. However, the statistics and the
literature evidences ultimately yield tha fact the traditional IVF methods are preferred
than the IVM methods, in the recent years.
Q6. Discussion
From the above data, it may be analysed that about 20% of the participants strongly
disagreed to the proposition that the In Vitro Maturation is strongly disagreed in the
medical treatment procedures. The major reason for these responses is the higher
costs of the procedures and the lower research and implementation in the medical
infertility treatment. On the other hand, about 40% disagreed to the use of the In Vitro
Maturation (IVM) methods and the accountability has been both due to the increased
costs and the lack of researches. It has been seen that the major scopes for the
treatment of infertility in the medical terms have been sourced to the In Vitro Fertilisation
and the easier methods of the procedure. About 3% remained neutral to the question,
as they were involved in the researches of both the IVF and IVM. Further it has been
noted that about 14% strongly agreed to the statement as they preferred the use of the
improved technologies and the advanced methods of the IVM procedures. About 17%
of the participants partly agreed to the fact the methods of IVM have been in scope for
the treatment of infertility among the women, except for the US.
Q7. Discussion
The safety of the In Vitro Maturation (IVM) has been compared in this question, with the
traditional methods of In Vitro Fertilisation (IVF). In the context of the different
responses, it has been seen that about 34% of the participants strongly agreed to the
fact that the IVM methods are comparatively safer as compared to the IVF. This has
been the result on account of the different synthetic drugs and injections that are
extensively used in the IVF methods, whereas, in the case of IVM, the Oocytes are
taken out even before it matures. This has been agreed by 48% of the participants
because; this method was comparatively safer, due to the fact that the Oocytes and the
developing eggs of the women were considered safe, even if the patient had to undergo
cancer chemotherapy. It was seen that about 6% of the participants remained neutral to
the question and 3% of the participants disagreed to the fact that the IVM was safer as
compared to the advanced IVM techniques. About 9% of the participants strongly
disagreed to the fact and it stated that the IVF was safer as compared to the IVM
techniques. This was the result of the lack of knowledge and the lack of research in their
particular laboratory.
Q8. Discussion
The study discusses the benefits of IVM over IVF. In the study, it has been found that
28% of the responders have voted strongly in favour of IVM over IVF while 31%
responded in a mild preferential manner towards IVM. This shows a shift in perception
and acceptance of the newly developed technique from the old traditional one.
However, 15% of the responders do not have any preference in any of the method and
are comfortable in both. 20% of the responders do not prefer the IVM method over IVM
as this technique has a wide range of applications and is inherently less complex than
IVM. 6% of the responders vehemently oppose the use of IVM over IVF as it is a tried
and tested method and has been in use over the years and the results generated from it
has been the backbone for many of the existing researches. The data analysis clearly
shows a tilt towards use if IVM over IVF, however many strongly disapprove of this and
the reasons have been discussed in the forthcoming questions.
Q9. Discussion
The study showcases the limitations of IVM over IVF. It has been found that 23% of the
responders agree to the fact that IVM is more expensive than IVF. It has also been
observed that 20% prefer IVF over IVM as it involves use more complicated techniques.
A further simplification in procedures can help the researchers in utilizing this method
more commonly and regularly in their research. 32% prefer IVF as there is a lack of
research and findings regarding IVM and the need of finding more data in support of
IVM are need of the hour. It has been observed in the study that 11% of the responders
allege that IVM has lesser fields of application than IVF and this needs to be clarified
using the research data provided in support of IVM technique. The lack of sponsorship
comprised of 14% of the response, caused due lack of knowledge and information
regarding IVM and has been categorized as a limitation for IVM. These limitations need
to be addressed as soon as possible as it can prove to be a more efficient and novel
technique to be used in research.
Q10. Discussion
As understood by the study, additional skills and experience can play a major role in the
use of IVM. It has been reported in the current study that 34% of the responders are in
strong favor of the fact that training needs to be provided for conducting IVM. It is
followed by a 40% response that states that these skills are deemed necessary for
conducting IVM. However, 21% of the response remained unaffected by the lack of
additional skills that are needed for conducting IVM. A weak 9% disagreed with the
notion of additional skills or experience for IVM as they may believe that IVF and IVM
employ the same experimental procedure.. Only 3% of the responders have vehemently
opposed that additional skills and experience is required for performing IVM. This is due
to the fact that the responders may be unlikely to shift from IVF to IVM for their studies
compounded with lack of information and required knowledge. It is very important to
understand that any new technique cannot be accepted as a part of scientific
experimental procedure without any supporting data and without additional skills or
experience it will be nearly impossible to implement IVM in research field.
Q11. Discussion
From the above table, it may be analysed that about 48% of the respondents agreed to
the proposition that the government of the respective countries has effective roles, in
the implementation of the IVM techniques and their prevalence. About 37% of the
participants strongly agreed to the point. It was seen that about 9% of the participants
remained neutral to the proposition and about 3% responses were recorded each for
the participants that disagreed and strongly disagreed to the role of the government in
improving the use of the IVM in the countries.
Q12. Discussion
From the tabulated data, it may be analysed that about 20% of the participants admitted
that the advertisements played very effective role in improving the use of the IVM
procedures in the different countries. About 11% remained neutral to the proposition.
About 32% of the participants agreed that the advertisements play an active role, in
improving the use of the IVM methods in medical treatment of infertility. About 23%
agreed that advertisements had partial roles and about 14% admitted that the
advertisements had no practical role in the improvement of the use of the IVM
techniques in the modern world.
Q13. Discussion
From the above studies, it may be analysed that about 18% of the participants strongly
agreed to the proposition that the general awareness of the individuals are required in
order to increase the prevalence of the IVM, over the IVF. About 31% agreed about the
increased role of the general awareness programmes. About 14% remained neutral and
nearly 26% of the participants disagreed that the the general awareness had no effect
on the increase in the role of the IVM, in the infertility treatment procedures. Finally,
about 11% responded negatively to the proposition, demarcating that the awareness
programmes had no relativity with the increase in the use of the IVM techniques.
Q14. Discussion
From the data tabulated in the table, it may be analysed that about 66% of the research
facilities did not have the requisite technologies to perform the researches on the IVM
methods. About 11% participants reported that their laboratory had the infrastructure for
the IVM researches, but did not have the sufficient experience to handle the desired
protocols of the IVM techniques. About 6% of the participants were ignorant of the
presence of the IVM research facilities and about 17% of the participants had the
provision of the IVM techniques in their laboratories.
5.1 Secondary Data Analysis
Case Study 1: Discussion
The highest frequency of the maturation of the experiments Oocytes were measured in
the first day of the experiment. The next day was followed by the lesser maturation
rates. It was observed that during this period, most of the experiment Oocytes were
denatured and this increased the specificity of the experiment. Finally, it was measured
that the Oocytes without the influence of the Growth Hormone were evident to have
matured at a rate of about 44%. Therefore, it may be analysed that the Growth
Hormones (GH) and the IGF-I are important for the Oocytes to mature.
Case Study 2: Discussion
From the experiment, it may be ascertained that the preservation of the fertility is
possible in this technique. It may further be ensured that hormonal regulations are not
required in the methods of IVM, with the implementation of the advanced laboratory
techniques and instruments. The pregnancy rates have been seen to be minimal from
the experimental study. The experiment yielded the result that women having the
normal ,menstruation timings had the CPR accounting to about 29.9%, with the FSH
stimulation and the 10,000 IU HCG.

Chapter 6: Conclusion
6.0 Summary
Finally, from this chapter, it may be concluded that the importance for the use of the
IVM techniques have not been evident largely on the general people. Therefore, in this
aspect the different aspects of promotions may be incorporated to make these facilities
known to the people. It may be implemented by the financial supports, sponsorships,
research, campaigns and advertisements. Therefore, it is evident that the usefulness of
the techniques are improved only if the people are made aware of the advanced
methods to treat the infertility among the women. The future scopes, including the
responses of the technicians and the microbiologists may provide the importance of the
method, in the modern world.
6.1 Conclusion
This chapter is based on the conclusion that has been derived from all the previous
chapter of the research. It provides the central idea by summarising all the results and
the analysis of the data that have been processed and the supporting literature that has
been reviewed. Further, it provides the useful links that related the objectives of the
research in the first chapter to the data and their analysis in the research. The
limitations of the research have been described, including the ways to overcome the
limitations. Further, the future scopes of the research have been discussed.
From the above researches, literature reviews, data findings and analysis, a number of
conclusions have been drawn. These include the probability of the success rates of the
IVM. As it has been seen that the success rates have been high, although the number
of experiments and researches were low, it still proves a valuable method in the
treatment of the infertility. Moreover, the additional conclusions were the higher
prevalence of the In Vitro Fertilisation (IVF) techniques as compared to the In Vitro
Maturation (IVM) techniques. This has been a result of the huge expenditure that are
accounted in the process of IVM. Further, it has been seen that the researchers have
seen the importance of this technique and have analytically explained that the methods
of IVM are comparatively safer, as compared to the IVF technique. Moreover, this
method may be applied in the case of the patients that desire the safer methods with
stable financial support, as the immature eggs are captured and removed, before the
patient undergoes the methods of cancer chemotherapy.
6.2 Linking Objectives with Findings
Efficient approaches were made, in order to link the objectives of the research, with the
overall progresses and the data analysis of the research. The first objective, to identify
the methods of IVM have been met, as the different parameters of carrying out the
research on the topic have been described in the research. The second objective,
relating to the importance of adopting the In Vitro Maturation (IVM) process, as an
alternative to the In Vitro Fertilisation (IVF) for the infertile women, have been met in the
data analysis as it has been found that the rate of using the IVM method is
comparatively lesser, as compared to the traditional IVF methods.
The third objective, pertaining to the advantages of the IVM over the IVF procedure has
been addressed, as it has been seen that the immature Oocytes are taken out without
any drug stimulation and this results in the safer practices of the IVM methods as
compared to the IVF methods. The fourth objective addressing the recommendations of
implementing the IVM process in the medical infertility treatment has been met in the
final chapter of the research, as a number of conclusions have been provided by the
researcher, to sustain the use of the IVM techniques, at a greater scale, as compared to
the IVF techniques, in the current scenario.
6.3 Recommendations
A number of limitations have been made, after the thorough researches on the topic.
These recommendations have been based on the practical aspects of the In Vitro
Maturation (IVM) and the extensive researches and alternatives to the In Vitro
Fertilisation (IVF).
Increased Sponsorship
Increasing the sponsorship might be a useful step ahead, in order to increase the In
Vitro Maturation (IVM) methods of treatment. If the sponsorships of the different
companies and the pharmaceuticals and gadget industries are ensured on the
implementation of the IVm techniques in the hospitals and laboratories, the use of the
IVM techniques may be improved. This is the reason of the huge expenses on the IVM
techniques and the lower sponsorships in the IVM methods.
Increased Research on the Infertility Treatment Procedures (IVM)
It has been seen that the researches on the In Vitro Maturation techniques have been
significantly lower in the recent years. This has been the results of the poor financial
aids and sponsorships. Therefore, in order to have the increased researches on the
implementation of the IVM methods, the additional sources of financial aid might be
provided by the government of the countries that intend to have the increased use of the
IVM methods. Therefore, it may be inferred that the extensive use of the IVM
techniques require the use of the advanced technologies and these have to be
efficiently financed by the government of the respective countries.
Decrease in the cost of the IVM techniques
The government might employ the additional finances to lower the expenditure of the
general people, as it has been a new technique and it has been less tested, as
compared to the traditional IVF techniques. Moreover, the decrease in the costs of the
IVM, may encourage additional people to have the IVM methods tested, on account of
their infertility treatment.
Increasing the IVM awareness campaigns and advertisements
The government of the different countries might adopt a number of ways to inform the
general population about the new improved methods of infertility treatment. These may
provide the general awareness to the people of the different countries about the method
and the advantages that are evident in the following method. This awareness may be
improvised by the administration of the local and national campaigns that may be
financed by the government of the respective countries. Furthermore, the
advertisements of the IVM methods may be provided to the general people, by the
incorporation of the advertisements through the online media, newspapers, magazines
and the televisions.
6.4 Limitations of the Research
A number of limitations have been encountered in order to complete the effective
researches on the In Vitro Maturation (IVM) methods. These include the lack of financial
support for the research. Lack of financial support constrained the scope of the research
because the researcher could not delve into those case studies and literary sources,
which involved subscribing to their online site for membership. As a result, the amount
of data gathered was quite narrow as well as restricted to only a constricted sphere of
IVM. However, the lack of the financial support and time, restrained the parameters of
primary qualitative doctors. Moreover, huge time frame was also a limiting factor, as a
considerable amount of time would have been required to implement the laboratory
procedures of the IVM and compare them with that of the IVF, to obtain efficient
information and contrast between the two procedures.
These factors were efficiently mitigated. Some of the limitations of the financial
resources were overcomed with the help of the financial support from the educational
institutions and the pharmaceutical company of the areas. Moreover, the time limitation
was overcome by the implementation of a time saving approach for the collection of
data. The secondary data was collected from the previous reviewed literature and from
the government health statistics reports and magazines. In this research, the time
limitation was resolved by employing the extraction of the data by using the primary
quantitative data, by using online survey questionnaires for the microbiologists of the
infertility research laboratories.
6.5 Future Scopes of the Research
It is important for the researchers to keep in mind, that the research must be conducted
in such a way, that it adds up its importance in the future prospects. The researches
must provide the opportunity for the other researchers and the community to have the
beneficial aspects of the research that are being conducted. A number of future scopes
may be provided by the current research. This research contains the authentic primary
quantitative data, about the different parameters of the IVM techniques and its
advantages and disadvantages. These data may provide useful secondary quantitative
data, for the researchers to implement them in their future researches.
The recommendations in these researches may provide useful insights for the readers
and the researchers to understand the usefulness of the In Vitro Maturation (IVM)
techniques and their according advantages and disadvantages in the infertility treatment
fields, as compared to the In Vitro Fertilization (IVF) techniques.
This research further provides the opportunity to the other researchers to obtain the
significant and authentic knowledge of the different techniques and aspects of the In
Vitro Maturation (IVM). This knowledge and information about the IVM, may allow the
researchers to analyse and compare the efficiency and the aspects of the alternatives to
this process in the medical and infertility field. Moreover, the parameters for the
research may be used by the future researchers to conduct their researches, which are
based on different aspects of separate fields of study.

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Acknowledgement
I would like to thank my teachers who have supported and guided me throughout the
project and without whose valuable inputs the research would have been a fallacy. I
would also like to thank my institution and the management who have been generous
enough to provide me with the tools and resources and knowledge to conduct the
research. I would like to thank my parents for their constant support and motivation.
Finally I would like to thank god almighty for blessing me with such an opportunity and
filling my life with so many supportive and encouraging people.

Bibliography
Altamiranda, E.A.G., Kaiser, G.G., Ríos, G.L., Leunda, M.R. and Odeón, A.C., (2016).
Interaction of bovine viral diarrhea virus with bovine cumulus–oocyte complex during
IVM: Detection in permissive cells. Theriogenology, 86(8), pp.1999-2003.
Anderson, D.J. and Politch, J.A., (2015). Role of Seminal Plasma in Human Female
Reproductive Failure: Immunomodulation, Inflammation, and Infections. In The Male
Role in Pregnancy Loss and Embryo Implantation Failure, pp. 159-169.
Bauer, G.R., (2014). Incorporating intersectionality theory into population health
research methodology: Challenges and the potential to advance health equity. Social
Science & Medicine, 110, pp.10-17.
Bui, T.T.M., Karata, A., Ferré, P., Tran, M.T. and Funahashi, T.W.H., (2015). Animal
Reproduction AR-131 Supplementation of vascular endothelial growth factor (VEGF)
increases the maturation of porcine COCs derived from small follicles. Sustainable
Animal Agriculture for Developing Countries, p.508.
Cho, H., Mirkhani, S., Cher, C.Y., Abraham, J.A. and Mitra, S., (2013). Quantitative
evaluation of soft error injection techniques for robust system design. In Design
Automation Conference (DAC), 2013 50th ACM/EDAC/IEEE, pp. 1-10.
Coticchio, G., Dal-Canto, M., Guglielmo, M.C., Mignini-Renzini, M. and Fadini, R.,
(2013). Human oocyte maturation in vitro. International Journal of Developmental
Biology, 56(10-11-12), pp.909-918.
Cui, J., Kessinger, C.W., McCarthy, J.R., Sosnovik, D.E., Libby, P., Thadhani, R.I. and
Jaffer, F.A., (2015). In vivo nanoparticle assessment of pathological endothelium

predicts the development of inflow stenosis in murine arteriovenous fistula.
Arteriosclerosis, thrombosis, and vascular biology, 35(1), pp.189-196.
Ellenbogen, A., Shavit, T. and Shalom-Paz, E., (2014). IVM results are comparable and
may have advantages over standard IVF. Facts Views Vis Obgyn, 6(2), pp.77-80.
Garcia‐Faura, A., Gracia, A., Valladares, E., Moens, V. and Lopez ‐Teijon, M., (2016).
P22. 03: Fetal speech movement response comparing the intravaginal emission of
music and maternal speech. Ultrasound in Obstetrics & Gynecology, 48(S1), pp.238-
238.
Gremeau, A.S., Andreadis, N., Fatum, M., Craig, J., Turner, K., Mcveigh, E. and Child,
T., (2012). In vitro maturation or in vitro fertilization for women with polycystic ovaries? A
case–control study of 194 treatment cycles. Fertility and sterility, 98(2), pp.355-360.
Grynberg, M., Le Parco, S., El Hachem, H., Sonigo, C., Sifer, C. and Frydman, N.,
(2014). A history of ABVD (Adriamycin/Bleomycin/Vinblastine/Dacarbazine) therapy for
Hodgkin lymphoma alters the number of oocyte cryopreserved after in vitro maturation
in candidates for urgent fertility preservation. In HUMAN REPRODUCTION Vol. 29, pp.
238-239.
Guzman, L., Ortega-Hrepich, C., Polyzos, N.P., Anckaert, E., Verheyen, G., Coucke,
W., Devroey, P., Tournaye, H., Smitz, J. and De Vos, M., (2013). A prediction model to
select PCOS patients suitable for IVM treatment based on anti-Müllerian hormone and
antral follicle count. Human Reproduction, p.det034.
Higginson, D.M., Miller, K.B., Segraves, K.A. and Pitnick, S., (2012). Female
reproductive tract form drives the evolution of complex sperm morphology. Proceedings
of the National Academy of Sciences, 109(12), pp.4538-4543.

Holubcova, Z., Blayney, M., Elder, K. and Schuh, M., (2015). Error-prone chromosome-
mediated spindle assembly favors chromosome segregation defects in human oocytes.
Science, 348(6239), pp.1143-1147.
Kiapekou, E., Loutradis, D., Drakakis, P., Zapanti, E., Mastorakos, G. and Antsaklis, A.,
(2004). Effects of GH and IGF-I on the in vitro maturation of mouse oocytes. Hormones
(Athens, Greece), 4(3), pp.155-160.
Kupčinskas, T., Stadalienė, I., Šarkūnas, M., Riškevičienė, V., Várady, M., Höglund, J.
and Petkevičius, S., (2015). Prevalence of anthelmintic resistance on Lithuanian sheep
farms assessed by in vitro methods. Acta Veterinaria Scandinavica, 57(1), p.1.
Levi, M., Ghetler, Y., Shulman, A. and Shalgi, R., (2013). Morphological and molecular
markers are correlated with maturation-competence of human oocytes. Human
Reproduction, p.det261.
Li, R. and Albertini, D.F., (2013). The road to maturation: somatic cell interaction and
self-organization of the mammalian oocyte. Nature Reviews Molecular Cell Biology,
14(3), pp.141-152.
Lindenberg, S., (2013). New approach in patients with polycystic ovaries, lessons for
everyone. Fertility and sterility, 99(5), pp.1170-1172.
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Appendices
Appendix 1. Dissertation Structure
Figure 1.1: Dissertation Structure
(Source: Researcher)
Appendix 2. Conceptual Framework
Appendix 3. Time Table
Main activities and Week Week Week Week Week Week Week
stages 1 2 to 9 9 to 15 15 to 20 23 23 to 26
20 25
Selection of the Ø
topic
Collection of data Ø
Planning the Ø Ø
proper layout
Reviewing Ø
literature
Development of Ø
research plan
Selecting research Ø Ø Ø
technique
Gathering Ø Ø
Secondary and
Primary data
Data analysis Ø Ø
Interpretation of Ø
findings
Conclusion Ø
preparation
Project rough Ø
overdraft
Final submission Ø
Figure: Gantt Chart
Appendix 4. Data Analysis
4.0 Survey Questionnaire for the 35 microbiologists and laboratory attendants

employed in the gynaecological research laboratories
Figure 4.5: In Vitro Fertilisation is preferred over In Vitro Maturation
Figure 4.6: In Vitro Maturation is encouraged in the medical treatment procedures

Figure 4.7: In Vitro Maturation (IVM) is safer than the In Vitro Fertilisation (IVF)
Figure 4.8: In Vitro Maturation (IVM) must be followed along with the In Vitro
Fertilisation (IVF)
Figure 4.9: Limitations of In Vitro Maturation (IVM) over In Vitro Fertilisation (IVF)
Figure 4.10: IVM techniques require additional skills and experiences as

compared to IVF
Figure 4.11: Government has active role in implementing the IVM methods
Figure: 4.12: Role of advertisements in employing the use of the In Vitro

Maturation (IVM)
Figure: 4.13: Any role in the predominance of the IVF over the IVM
Figure: 4.14: Laboratory conducting the IVM experiments and researches

Appendix 5. Case Study
Case Study 1
Figure 4.15 (a): Maturation Rates of the Oocytes after induction with GH
(Source: Kiapekou et al. 2004, p. 157)
Figure 4.15 (b): Maturation Rates of the Oocytes after induction with IGF-I
(Source: Kiapekou et al. 2004, p. 156)
Case Study 2
Figure 4.16: Use of Hormones in Oocyte Maturation

(Source: Uzelac et al. 2012, p.82)
Appendix 6. Survey Questionnaire
Survey Questionnaire
Quantitative data analysis
Name:
Location:
Contact No.: Email ID:
Dear participant,
You are sincerely required to complete the questionnaire to the best of your knowledge
and belief. Your responses are extremely important for this survey and of great help. I
assure you that your personal details and response will be confidential.
Your participation is solemnly solicited.
Q1. How long have you been working in the gynaecological research field?
 Fresher
 Less than 1 Year
 Less than 2 Years
 Less than 3 Years
 More than 5 Years
Q2. What is your current research based on?
 In Vitro Fertilisation
 In Vitro Maturation
 Transplacental Nutrient Transfer

 Artificial Ovulation
 Human Immunoglobulin
Q3. What are the major problems that are noted in research, for the reasons of
infertility of the women?
 Oocyte Degeneration
 Obstructive Fallopian Tube
 Oocyte Maturation
 Obesity
 Others
Q4. What is the nature of the financial expenditure on the In Vitro Maturation (IVM)
methods?
 High Expenditure
 Moderate Expenditure
 Free
Q5. How far do you agree that the In Vitro Fertilisation (IVF) is preferred over In
Vitro Maturation (IVM)?
 Strongly Agree
 Agree
 Neutral
 Disagree
 Strongly Disagree
Q6. How far do you agree that In Vitro Maturation is encouraged in the medical
treatment procedures?
 Strongly Agree
 Agree
 Neutral
 Disagree
Q7. How far do you agree that In Vitro Maturation (IVM) is safer than the In Vitro
 Strongly Agree
 Agree
 Neutral
 Disagree
Q8. How far do you prefer that In Vitro Maturation (IVM) must be followed along
with the In Vitro Fertilisation (IVF)?
 Highly Prefer
 Prefer
 Neutral
 Do not Prefer
 Not at all Prefer
Q9. What are the limitations of In Vitro Maturation (IVM) over In Vitro Fertilisation
(IVF)?
 More expenditure
 Complicated Technique
 Lack of Research
 Less applications
 Lack of Sponsorship
Q10. How far do you agree that the In Vitro Maturation (IVM) techniques require
additional skills and experiences as compared to the Traditional In Vitro
 Strongly Agree
 Agree
 Neutral
 Disagree
Q11. How far do you agree that the government has active role in implementing
the IVM methods in the different countries?
 Strongly Agree
 Agree
 Neutral
 Disagree
Q12. What role does the advertisements play in employing the use of the In Vitro
Maturation (IVM), in the modern world?
 No Practical Role
 Partial Role
 Neutral
 Active Role
 Very effective Role
Q13. How far do you agree that, the general awareness of the people have any
role in the predominance of the IVF over the IVM?
 Strongly Agree
 Agree
 Neutral
 Disagree
Q14. Does your laboratory have the resources to conduct the researches for the
In Vitro Maturation (IVM)?
 Yes
 Do not know
 No
 Infrastructure present but lack of scientists

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IN-VITRO MATURATION OF OOCYTES

PERSONAL INFORMATION: _____________________

research is conducted to obtain the insights of the professionals working in fertility

experience required to conduct IVM. The research is completely focused on the

1.1 Background of the Research.......................................................................................5

1.2 Research Rationale.....................................................................................................6

1.3 Research Aims............................................................................................................7

1.4 Research Objectives....................................................................................................7

1.5 Research Questions....................................................................................................8

1.6 Significance of the Research.......................................................................................8

1.7 Structure of the Dissertation........................................................................................9

Chapter 2: Literature Review...........................................................................................10

2.1 Conceptual Framework.............................................................................................10

2.2 Human Reproductive System....................................................................................10

2.3 Procedure of Fertilisation in Female Reproductive System......................................12

2.4 Morphology of Oocytes..............................................................................................13

2.5 Physiology of Oocytes...............................................................................................14

2.6 Types of Maturation process of Oocytes...................................................................15

2.8 Techniques involved overcoming the incapability of Oocyte maturation..................17

2.9 Concept of In Vitro Fertilisation.................................................................................18

2.10 History of In Vitro Maturation...................................................................................19

2.12 Disadvantages and Risks of In Vitro Maturation of Oocytes...................................20

2.13 Alternatives to the In Vitro Maturation of Oocytes...................................................21

2.14 Comparison between IVF and IVM from commercial perspective..........................22

2.15 Linking Literature with current research..................................................................23

2.16 Gaps in Literature....................................................................................................23

Chapter 3: Materials and Methods..................................................................................25

3.1 Research Outline.......................................................................................................25

3.2 Research Philosophy.................................................................................................25

3.3 Research Approach...................................................................................................26

3.4 Research Design.......................................................................................................27

3.5 Sampling Method and Sample Size..........................................................................27

3.6 Research Strategy.....................................................................................................28

3.7 Data Collection Methods...........................................................................................29

3.8 Data Analysis.............................................................................................................29

3.9 Ethical Considerations...............................................................................................30

3.10 Time Frame.............................................................................................................30

in the gynaecological research laboratories....................................................................31

5.0 Primary Quantitative Data Analysis...........................................................................44

5.1 Secondary Data Analysis..........................................................................................52

6.2 Linking Objectives with Findings...............................................................................54

6.4 Limitations of the Research.......................................................................................56

6.5 Future Scopes of the Research.................................................................................57

Appendix 1. Dissertation Structure..................................................................................73

Appendix 2. Conceptual Framework...............................................................................74

Appendix 3. Time Table...................................................................................................75

Appendix 4. Data Analysis...............................................................................................77

in the gynaecological research laboratories....................................................................77

Appendix 5. Case Study..................................................................................................82

Appendix 6. Survey Questionnaire..................................................................................84

Table 4.1: Working in the gynaecological research field.................................................35

Table 4.2: Current research based on.............................................................................36

Table 4.3: Reasons of infertility of the women................................................................37

Table 4.4: Financial expenditure on the In Vitro Maturation (IVM) methods...................38

Table 4.5: In Vitro Fertilisation is preferred over In Vitro Maturation...............................39

Table 4.6: In Vitro Maturation is encouraged in the medical treatment procedures.......39

Table 4.14: Laboratory conducting the IVM experiments and researches.....................44

Figure 2.3: Female Reproductive System.......................................................................15

Figure 4.1: Working in the gynaecological research field................................................35

Figure 4.2: Current research based on...........................................................................36

Figure 4.3: Reasons of infertility of the women...............................................................37

Figure 4.4: Financial expenditure on the In Vitro Maturation (IVM) methods.................38