A healthy female born after ICSI of a cryopreserved oocyte and cryopreserved spermatozoa banked prior to radiotherapy in a patient with a seminoma: a case report

Abstract

Objective: Banking of semen specimen prior to radio/chemotherapy allows patients to preserve future fertility. Oocyte cryopreservation may be an alternative, specially now that certain efficacy of the technique has been demonstrated. There are very few publications about the use of thawed sperm from patients who have undergone chemo/radiotherapy and then gone on to perform ART with cryopreserved oocytes. To the best of our knowledge this is the first case of ICSI with cryopreserved oocytes and banked spermatozoa due to a seminoma. The objective of this report is to inform the birth of a healthy baby after the application of this technique Design: Case report. Materials and Methods: A 30-year-old male with diagnosis of seminoma was referred to our institute for semen banking before radiotherapy. Six vials of sperm were banked. After oncologic treatment was done, his partner, a 23-year-old woman, underwent controlled ovarian hyperstimulation with gonadotrophin therapy (rFSH 200 IU/day) with leuprolide acetate (0.5 mg/day) desensitization from the previous midluteal phase. 17 oocytes were retrieved, one was at the VG stage, two were inseminated by ICSI, obtaining two embryos; 14 MII oocytes were frozen according to the protocol previously published (Fertil Steril., 1997, 69, 555–557). The woman presented moderate ovarian hyperstimulation syndrome and the cryopreservation of the embryos was indicated for a future transfer. Results: After endometrial preparation, good quality embryos were thawed and transferred; this process led to a single pregnancy; the woman suffered from eclampsia during the 28th week of gestation and cesarean surgery was performed. A preterm female of 1000 grams was born and died two weeks after the delivery. One year and a half later a second procedure was started; all the frozen oocytes and one vial of semen were thawed. 8 out of 14 oocytes survived and were microinjected; two became fertilized and one cleaved embryo of good quality was transferred. Pregnancy was achieved and delivery was performed by cesarean surgery at 36 weeks of gestation, a healthy female was born with a birth weight of 2800 grams. Conclusion: Oocyte cryopreservation is a useful tool when oocyte recruitment is high and there is no intention to store supernumerary embryos; in young women at risk of ovarian hyperstimulation this procedure offers a solution because gametes can be used or not, so no legal nor ethics conflicts may occur. This technique combined with banked sperm from an oncologic patient is a novel procedure for couples in need of differed parenthood