Ex vivo Retrieval of Mature Oocytes for Fertility Preservation in a Patient with Bilateral Borderline Ovarian Tumor

Abstract

We report a case of ultrasound-guided ex vivo oocyte retrieval for fertility preservation in a woman with bilateral borderline ovarian tumor, for whom conventional transvaginal oocyte retrieval was deemed unsafe because of the increased risk of malignant cell spillage. Ovarian stimulation with gonadotropins was performed. Surgery was scheduled according to the ovarian response to exogenous gonadotropic stimulation; oophorectomized specimens were obtained by laparoscopy, and oocyte retrieval was performed ∼ 37 hours after the ovulatory trigger. The sum of 20 ovarian follicles were aspirated, and 16 oocytes were obtained. We performed vitrification of 12 metaphase II oocytes and 3 oocytes matured in vitro. Our result emphasizes the viability of ex vivo mature oocyte retrieval after controlled ovarian stimulation for those with high risk of malignant dissemination by conventional approach.

Serous Borderline Ovarian Tumor Diagnosis, Management and Fertility Preservation in Young Women

“…Hence, ovarian tissue cryopreservation is not recommended in post-pubertal women to this day, but its use in young women may be discussed if the majority of ovarian tissue is removed with a poor outcome of ovarian stimulation. Another emerging FP technique is the ex vivo collection of immature oocytes from ovarian tissue after surgery, followed by in vitro maturation of the follicles, before vitrification [ 46 ]. This technique has been described throughout the case series and case reports, and large-scale studies are lacking to confirm its efficacy.…”

Ovarian stimulation for fertility preservation in a woman with borderline serous ovarian tumor causing a large fluctuating subcutaneous fluid collection: a case report

“…In such cases, ovarian tissue cryopreservation runs the risk of re-introducing the can-cer if the tissue is subsequently returned to the patient. There are over 40 reported cases in the medical literature of ovarian stimulation and oocyte collection in women with ovarian cancer [5][6][7][8][9]. Most of these procedures were performed in women with serous borderline tumors, while some were in women with overt malignancies [9].…”

“…Therefore, fertility preservation in patients who were diagnosed with or previously treated for borderline ovarian tumors is likely reasonable [10]. Whereas ovarian stimulation is usually followed by transvaginal or transabdominal oocyte collection, there are some reports of successful ex-vivo oocyte harvesting in patients with borderline ovarian tumor during the oncologic operation [5,6].…”