In-vitro maturation (IVM) and vitrification of oocytes retrieved at the luteal phase in cancer patients facing urgent gonadotoxic treatment

Abstract

To describe successful in-vitro maturation (IVM) and vitrification of oocytes retrieved at the luteal phase. Three cancer patients aged 21, 30 and 40 years, facing urgent gonadotoxic treatment, who were unable to undergo hormonal ovarian stimulation for fertility preservation. Women had regular menstrual cycles and basal serum FSH, LH and estradiol levels within normal range. None had a male partner. They were first seen at our clinic during the luteal phase of the menstrual cycle and were to undergo gonadotoxic treatment imminently. They expressed their desire to cryopreserve as many oocytes as possible during this short period of time. Treatment results are summarized in Table 1. In two women, we were able to perform luteal phase collection followed by a follicular phase collection in the following menstrual cycle. Case number 3 wished to use donor sperm following follicular-phase retrieval in order to fertilize her oocytes, therefore intracytoplasmic sperm injection (ICSI) was performed. Only the oocytes that were matured at the day of collection cleaved. Therefore, 5 MII stage oocytes were vitrified following the luteal phase retrieval and additional two embryos were vitrified following the follicular phase retrieval.Table 1In-vitro maturation (IVM) and vitrification of oocytes retrieved from three cancer patients, facing urgent gonadotoxic treatment, who were unable to undergo hormonal ovarian stimulation for fertility preservationWoman ageCycle day at oocyte retrievalOocytes retrieved (no.)MII stage oocytes at retrieval day (no.)MII stage oocytes after 24 hours (no.)MII stage oocytes after 48 hours (no.)MII stage oocytes vitrified (no.)Case 1213070235Case 2 (luteal collection)302350303Case 2 (follicular phase collection)102137616Case 3 (luteal collection)401570235Case 3 (follicular phase l collection)1152202 embryos∗∗Oocytes were fertilized with donor sperm. Open table in a new tab ∗Oocytes were fertilized with donor sperm. Our result suggests that in vitro maturation of immature oocytes retrieved during the luteal phase is feasible. This option can be considered for fertility preservation in women facing imminente gonadotoxic treatment who are not able to undergo hormonal ovarian stimulation. Moreover, aspiration of oocytes at the luteal phase may not impair the ability to retrieve oocytes during the following follicular phase. Therefore, in women facing gonadotoxic treatment more than one procedure of oocyte retrieval may be performed in a short time period.