The First Successful Capacitation In Vitro Maturation of Oocyte in Indonesia: A Promising Strategy to Enhance IVF Accessibility for Infertile Couples

Abstract

Background: The identification of c-type natriuretic peptide (CNP) as a key upstream regulator of cyclic GMP (cGMP) levels has paved the way for innovative in vitro maturation (IVM) techniques, the so-called biphasic CAPA-IVM (capacitation IVM) approach. This method uses CNP to prevent early meiosis progression and has demonstrated enhanced oocyte maturation rates. This report highlights the successful use of the CAPA-IVM method in Indonesia.

Case Presentation: Immature cumulus-oocyte complexes (COCs) were successfully retrieved from an infertile woman aged 37 years without prior ovarian stimulation. The obtained COCs were incubated in CAPA medium for 24 hr and then transferred to a maturation medium containing amphiregulin, insulin, human serum albumin, and recombinant FSH. After 30 hr, all immature oocytes reached the metaphase II (MII) stage, as evidenced by the first polar body extrusion and confirmed through spindle formation. While the proper selection of infertile woman eligible to undergo CAPA-IVM is emphasized, this innovative approach has the potential to significantly decrease IVF costs. This could be achieved by eliminating the need for ovarian stimulation and its related cost and complications.

Conclusion: The CAPA-IVM system could represent a major step toward making IVF more affordable and accessible, particularly in resource-limited settings such as Indonesia, where IVF treatment is not covered by government-funded healthcare or health insurance.