Live birth after the transfer of human embryos developed from cryopreserved oocytes harvested before cancer treatment

Objective To report a birth of a healthy boy after long-term cryopreservation of oocytes by vitrification. Design Clinical application. Setting IVF Center. Patient A 17 year-old female with secondary pulmonary hypertension caused by transposition of great vessels visited our center in 2002, and she wished oocytes cryopreservation to avoid possible sterility after the following category X medication treatment. Intervention(s) Vitrified oocytes on Electron Microscope (EM) grids were warmed after 5 years of storage. Surviving MII oocytes were microinjected for fertilization and two embryos were transferred into a gestational carrier day 5 after microinjection. Main Outcome Measure(s) Survival, fertilization, cleavage, clinical pregnancy and delivery. Result(s) Eleven out of fourteen oocytes (78.6%) survived warming. Eight Metaphase II (MII) oocytes and 3 in vitro matured oocytes were microinjected; all 11 oocytes (100%) fertilized and 2 embryos were transferred on day 5. A healthy baby boy weighing 3,600 g was delivered at 38 weeks of gestation. Live-birth rates per warmed oocyte and per injected oocyte were 7.1% and 9.1% respectively. Conclusion(s)Cryopreservation after vitrification with EM grids maintained the developmental competence of oocytes after long-term storage and resulted in a successful live birth.Keywords Human oocyte cryopreservation . Vitrification . Electron microscope grid . Ethylene glycol . Clinical outcome Since the first successful pregnancy from frozen human oocyte was reported 20 years ago [1], remarkable technological progress has been made in the area of cryopreservation of human oocytes. The recent increased interest in vitrification has resulted in improved efficiency and pregnancy outcomes [2][3][4][5][6][7][8][9][10][11][12][13]. Being able to protect and prolong the reproductive capacity by way of oocyte cryopreservation potentially opens the door for many thousands of women who are at a risk of losing ovarian function from radiation, chemotherapy and surgery.Over the last decade, multiple clinics have reported IVF successes after transfer of embryos derived from frozen/ thawed oocytes [5,[14][15][16][17][18][19][20]. The authors have recently reported that oocytes from young fertile women retain their reproductive potential after 6 months of vitrification cryopreservation [20] and the pregnancy and implantation rates are comparable to that of frozen embryos. There is evidence that children born from frozen embryos have no significantly increased risk of congenital abnormalities [21][22][23], however, no such data are available concerning children born from vitrified oocytes after long-term storage.Here, we report the healthy outcome of a now 2 year old boy who was born after vitrification of oocytes that were stored for 5 years.Capsule Documentation of a pregnancy after long-term storage of vitrified oocytes.

Section: Discussionmentioning

confidence: 80%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Successful live birth from vitrified oocytes after 5 years of cryopreservation

Kim

Hong

2010

“…A large meta-analysis, however, has outlined lower ongoing pregnancy rates (>20 weeks of gestation) when warmed oocytes were in use [26], and this finding was proposed to stem from studies heterogeneity. As opposed to donors and infertile subjects, for oncologic patients, data is currently limited to several case reports and small series [27][28][29][30][31][32]. In the meantime, while information on outcomes for this population is awaited, experience drawn from infertile patients/oocyte recipients can be used when consulting cancer patients seeking fertility preservation.…”

Section: Ovarian Response In Coh Cyclesmentioning

confidence: 99%

IVF for fertility preservation in breast cancer patients—efficacy and safety issues

Shapira

Raanani

Meirow

2015

Background Potential risks on future fertility have become a dominant issue in consultation and management of newly diagnosed young cancer patients. Several fertility preservation strategies are currently available. Of those, ovarian stimulation followed by IVF and embryo cryopreservation is the most established one and is especially applicable in reproductive aged breast cancer patients. Aim The aim of this study is to provide a comprehensive review on ovarian stimulation and IVF for fertility preservation in newly diagnosed breast cancer patients. Methods Review of relevant literature is available through PubMed and Google scholar. Results The use of IVF for fertility preservation in breast cancer patients raises dilemmas regarding efficacy and safety of controlled ovarian stimulation. Among these are the suggested role of malignancy and BRCA mutation in reducing ovarian response to stimulation, strategies designated to protect against hyper-estrogenic state associated with stimulation (co-treatment with tamoxifen or letrozole), and possible adjustments to accommodate oncologic-related time constraints. Conclusion Ovarian stimulation followed by IVF forms an important fertility preservation strategy for newly diagnosed young breast cancer patients, though live born rates following thawed embryo transfer in these patients are still lacking. Recent advances in controlled ovarian stimulation protocols provide practical options for some of the challenges that breast cancer patients present.

“…Various studies have looked at the fertility outcomes in oncology patients [27,32]. Robertson et al [27] demonstrated a high embryo yield and pregnancy rate in patients with cancer and autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

Fifteen year follow-up of embryos cryopreserved in cancer patients for fertility preservation

Barcroft

Dayoub

Thong

2013

Purpose Determine the outcome of embryo cryopreservation in female oncology patients Methods The outcomes of IVF/ICSI cycles in oncology patients over 15 years in a University Teaching Hospital. Results Forty-two oncology patients (mean 31.9±3.9 years) underwent embryo cryopreservation treatment (n=33 IVF, n=6 ICSI). Controlled ovarian stimulation with GnRH antagonist protocol (n=34; 81 %) yielded fewer oocytes than GnRH agonist protocol (n=8; 19 %) (9.4±6.3 vs. 15.3±8.9; p=0.04) respectively. There was no significant difference in mean (±SD) duration of ovarian stimulation (11.6±2.6 vs.10.6±2.7), median gonadotrophin dose (1950( vs. 1670, median day 5-6 oestradiol level (1124 vs.1129 pmol/l) or embryo yield (6.2±4.1 vs. 8.8± 4.3; p=0.07) between GnRH antagonist and agonist treatment cycles respectively. Thirty-nine patients cryopreserved embryos and three had their cycle cancelled. During this study period, of those who cryopreserved embryos, 5 patients underwent 9 frozen-thaw cycles (13 %), resulting in 2 live births (1 twin, 1 singleton, live birth rate 22 %). Six patients died (15 %), 3 conceived naturally (8 %) and 2 couples separated (5 %). Fourteen patients discarded their embryos (36 %). Twenty-two patients' (56 %) have embryos remaining in storage. Conclusions This study demonstrates that embryo cryopreservation in female oncology patients gives a satisfactory live birth rate. However, there are concerns regarding costeffectiveness, resulting from high disposal/non-usage of embryos, and further studies are required.