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

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. CONCLUSION: CAPA-IVM system enabled all retrieved immature oocytes to reach the MII stage without prior ovarian stimulation. This finding supports its feasibility as a simplified IVF approach with the potential to reduce treatment costs, particularly in resource-limited settings. However, further clinical evaluation is required to confirm its effectiveness.