Oocyte retrieval and cryopreservation for unmarried female cancer patients

Abstract

OBJECTIVE: Aggressive chemotherapy and radiotherapy have greatly enhanced the life expectancy of young cancer patients, but these treatments cause massive destruction of the ovarian reserve resulting in infertility or sterility. However, oocyte cryopreservation can preserve their fertility of these patients after cancer treatment. We applied a minimal ovarian stimulation protocol using clomiphene citrate (CC) to retrieve mature oocytes, and the cryotop vitrification method to cryopreserve them. DESIGN: Prospective clinical study. MATERIALS AND METHODS: Sixty-four unmarried hematopoietic defect patients with informed consent who underwent the CC cycle from January, 2007 to March, 2010. Fifty mg CC was administered from cycle day 3 and 75 IU HMG was administered every other day from day 8 until the leading follicle developed to 18 mm in diameter. Administration of CC was then stopped, and 300 g GnRH-agonist was given as a maturation trigger. Oocytes were retrieved from 30 to 36 hrs following the administration of the GnRH-agonist using a 22 gauge needle with local anesthesia. The retrieved oocytes were denuded before vitrification. The cryotop method was used to vitrify the oocytes (Kuwayama 2005). RESULTS: The type of cancers included acute and chronic leukemia, malignant lymphoma, aplastic anemia, and myelodysplastic syndrome. The mean age of the patients was 27.2 (± 5.1, S.D.). The mean number of retrieved oocytes per cycles was 4.2, and the mean number of morphologically normal cryopreserved oocytes per cycle was 3.4. The mean numbers of oocyte retrieval cycles per patient was 1.7. The mean number of retrieved oocytes per patient was 7.1, and the mean number of morphologically normal cryopreserved oocytes per patient was 5.6. No patients had any adverse side effects. CONCLUSION: Our data showed that the minimal ovarian stimulation protocol using CC for oocyte retrieval with a 22 gauge needle and with anesthesia was a safe, simple, effective method of preserving fertility for unmarried cancer patients.