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Despite promise, IVM efficiency remains below conventional IVF because molecular and metabolic determinants of oocyte maturation are not fully understood. This review covers advances in biphasic or simulated physiological oocyte maturation (SPOM), culture media optimization, and cumulus–oocyte communication. It also discusses biochemical meiosis regulation, metabolic and gene-expression links to oocyte quality, and translational clinical use in PCOS and oncofertility, alongside persistent limitations in reproducing in vivo conditions, while highlighting emerging microfluidic and 3D culture strategies.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/advances-mechanisms-and-clinical-perspectives-for-the-in-vitro-maturation-of-human-oocytes/461879/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/advances-mechanisms-and-clinical-perspectives-for-the-in-vitro-maturation-of-human-oocytes/461879.png","ImageObject",300,407,{"name":92,"@type":93},"Eliana","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is in vitro maturation (IVM) considered a valuable alternative to conventional IVF?","Question",{"text":113,"@type":114},"IVM bypasses the need for full ovarian stimulation, potentially offering safer options for patients such as those with PCOS, resistant ovary syndrome, or fertility preservation needs before cancer treatment.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What are the main reasons IVM efficiency remains lower than conventional IVF?",{"text":118,"@type":114},"IVM outcomes are constrained by incomplete understanding of molecular and metabolic mechanisms driving oocyte maturation, along with challenges in optimizing culture conditions and laboratory manipulation.",{"name":120,"@type":111,"acceptedAnswer":121},"How does SPOM (Stimulated Physiological Oocyte Maturation) aim to improve IVM results?",{"text":122,"@type":114},"SPOM uses a pre-IVM incubation with cAMP modulators to capacitate the oocyte before meiotic maturation induction, with evidence suggesting improved translational outcomes.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},461879,1790816419,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},4398048949847,"https://ap-avatar.wpscdn.com/avatar/400002536579ef2da7f?_k=1778318612642679267","Review  \nAdvances, Mechanisms, and Clinical Perspectives for the In Vitro Maturation of Human Oocytes  \nMarta Gargallo-Alonso 1,2, Helen M. Picton 3 and Clara Malo 1,2, *  \nAcademic Editors: Jan Tesarik and Apostolos Kaponis  \nReceived: 11 November 2025  \nRevised: 29 November 2025  \nAccepted: 18 December 2025  \nPublished: 19 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Tissue Microenvironment (TME) Lab, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain; [mgargallo@unizar.es](mgargallo@unizar.es)  \n2 Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain  \n3 Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds LS2 9JT, UK; [h.m.picton@leeds.ac.uk](h.m.picton@leeds.ac.uk)  \n* Correspondence: claramalo@unizar.es  \nAbstract  \nThe in vitro maturation (IVM) of human oocytes represents a valuable assisted reproductive technology that bypasses the need for full ovarian stimulation, offering safer alternatives for patients with polycystic ovary syndrome (PCOS), resistant ovary syndrome, or those requiring fertility preservation before oncological treatment. Despite its potential, IVM efficiency remains lower than that of conventional in vitro fertilization (IVF) due to incomplete understanding of the molecular and metabolic mechanisms underpinning oocyte maturation. This review summarizes recent advances in IVM, including biphasic or simulated physiological oocyte maturation (SPOM) systems, optimization of culture media through hormones, growth factors, and antioxidants, and the influence of cumulus–oocyte communication on developmental competence. We also discuss the biochemical regulation of meiosis, metabolic interactions, and gene expression patterns associated with oocyte quality. Furthermore, we examine the translational and clinical applications of IVM inhuman fertility treatment, highlighting its efficacy in PCOS and oncofertility cases, and the limitations that persist in replicating in vivo conditions. Emerging technologies such as microfluidic and three-dimensional culture systems show promise in enhancing oocyte competence and embryo yield. Continued research into the molecular mechanisms governing oocyte maturation will be key to improving IVM outcomes and integrating this approach as a mainstream option in reproductive medicine.  \nKeywords: in vitro maturation (IVM); oocyte; assisted reproduction; folliculogenesis; biphasic IVM; SPOM; cumulus–oocyte complex; oxidative stress; oocyte competence; PCOS; fertility preservation  \n1. Introduction  \nAccording to the World Health Organization (WHO), approximately 48 million couples worldwide face infertility issues, representing a significant public health challenge [1] . Many turn to assisted reproductive treatments, where ovarian stimulation is a key component [2] . Controlled ovarian stimulation allows for the retrieval of multiple oocytes for in vitro fertilization (IVF) or fertility preservation, a demand growing for social or medical reasons, such as delayed motherhood or oncology treatments [3] . However, a challenge remains: around 15–20% of oocytes retrieved after stimulation do not reach maturity and are unsuitable for fertilization [4,5] .  \nIn this context, in vitro maturation (IVM) of immature oocytes has emerged asa promising approach to maximize the number of available oocytes, particularly when ovarian stimulation is unsuitable or poses risks, as in women with polycystic ovary syndrome (PCOS) [6,7] . IVM involves collecting immature oocytes and maturing them outside the body under controlled laboratory conditions before fertilization. While IVM is routinely used in domestic animal embryo production, such as cattle [8,9], its appl","cbCaimFPsoFY0HmB","https://ap.wps.com/l/cbCaimFPsoFY0HmB","pdf",1143563,22,"English","# Abstract\n# Keywords\n# 1. Introduction\n## Assisted reproduction and infertility burden\n## Limitations of ovarian stimulation and immature oocytes\n## Rationale for IVM and key barriers\n## Optimization strategies and SPOM pre-IVM incubation","[{\"question\":\"Why is in vitro maturation (IVM) considered a valuable alternative to conventional IVF?\",\"answer\":\"IVM bypasses the need for full ovarian stimulation, potentially offering safer options for patients such as those with PCOS, resistant ovary syndrome, or fertility preservation needs before cancer treatment.\"},{\"question\":\"What are the main reasons IVM efficiency remains lower than conventional IVF?\",\"answer\":\"IVM outcomes are constrained by incomplete understanding of molecular and metabolic mechanisms driving oocyte maturation, along with challenges in optimizing culture conditions and laboratory manipulation.\"},{\"question\":\"How does SPOM (Stimulated Physiological Oocyte Maturation) aim to improve IVM results?\",\"answer\":\"SPOM uses a pre-IVM incubation with cAMP modulators to capacitate the oocyte before meiotic maturation induction, with evidence suggesting improved translational outcomes.\"}]","Advances, Mechanisms, and Clinical Perspectives for the In Vitro Maturation of Human Oocytes | PDF",1790762653,55]