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Outcome of immature oocytes collection of 119 cancer patients during ovarian tissue harvesting for fertility preservation

Journal of Assisted Reproduction and Genetics volume 35, pages 851–856 (2018)Cite this article

Abstract

Purpose

Few clinical options for fertility preservation are available to females with cancer, and data about clinical outcomes is limited. Potential supplementary approaches to fertility preservation include retrieval of immature oocytes followed by in vitro maturation (IVM) and storage. The aim of this study was to evaluate post-thawing outcomes of immature oocytes collected both by transvaginal aspiration and from excised ovarian tissue.

Methods

We conducted a retrospective cohort study of patients treated in a single tertiary center. We reviewed the records of 119 cancer patients who underwent ovarian tissue cryopreservation and immature oocyte harvesting for fertility preservation. All embryos and oocytes that were frozen and thawed were included in the study. Post-thawing outcomes were evaluated.

Results

Thirty-five stored embryos from eight patients were thawed. Twenty-nine embryos survived (82% survival rate) and were transferred. Six oocytes were thawed, two oocytes survived, and no oocytes were fertilized. Only one PCOS patient became pregnant, resulting in the normal delivery of a healthy baby.

Conclusions

Although a relatively high number of mature oocytes and embryos can be stored with the combined procedure, the limited rate of pregnancies represents a poor reproductive outcome. Therefore, this approach should be reserved for special groups with limited options.

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References

  1. Cvancarova M, Samuelsen SO, Magelssen H, Fossa SD. Reproduction rates after cancer treatment: experience from the Norwegian radium hospital. J Clin Oncol. 2009;27(3):334–43. https://doi.org/10.1200/JCO.2007.15.3130.

    Article  PubMed  Google Scholar 

  2. Green DM, Whitton JA, Stovall M, Mertens AC, Donaldson SS, Ruymann FB, et al. Pregnancy outcome of female survivors of childhood cancer: a report from the childhood cancer survivor study. Am J Obstet Gynecol. 2002;187(4):1070–80.

    Article  PubMed  Google Scholar 

  3. Magelssen H, Melve KK, Skjaerven R, Fossa SD. Parenthood probability and pregnancy outcome in patients with a cancer diagnosis during adolescence and young adulthood. Hum Reprod. 2008;23(1):178–86. https://doi.org/10.1093/humrep/dem362.

    Article  PubMed  CAS  Google Scholar 

  4. Barton SE, Najita JS, Ginsburg ES, Leisenring WM, Stovall M, Weathers RE, et al. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the childhood cancer survivor study cohort. Lancet Oncol. 2013;14(9):873–81. https://doi.org/10.1016/s1470-2045(13)70251-1.

    Article  PubMed  Google Scholar 

  5. Society for Assisted Reproductive Technology, 2014 Clinic summary report. 2014. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0. Accessed 14/09/2017 2017.

  6. Practice Committees of American Society for Reproductive M, Society for Assisted Reproductive T. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013;99(1):37–43. https://doi.org/10.1016/j.fertnstert.2012.09.028.

    Article  Google Scholar 

  7. Meirow D. Fertility preservation in cancer patients using stored ovarian tissue: clinical aspects. Curr Opin Endocrinol Diabetes Obes. 2008;15(6):536–47. https://doi.org/10.1097/MED.0b013e32831a44a8.

    Article  PubMed  Google Scholar 

  8. Rodriguez-Wallberg KA, Oktay K. Options on fertility preservation in female cancer patients. Cancer Treat Rev. 2012;38(5):354–61. https://doi.org/10.1016/j.ctrv.2011.10.002.

    Article  PubMed  Google Scholar 

  9. Donnez J, Jadoul P, Squifflet J, Van Langendonckt A, Donnez O, Van Eyck AS, et al. Ovarian tissue cryopreservation and transplantation in cancer patients. Best Pract Res Clin Obstet Gynaecol. 2010;24(1):87–100. https://doi.org/10.1016/j.bpobgyn.2009.09.003.

    Article  PubMed  Google Scholar 

  10. Silber S, Kagawa N, Kuwayama M, Gosden R. Duration of fertility after fresh and frozen ovary transplantation. Fertil Steril. 2010;94(6):2191–6. https://doi.org/10.1016/j.fertnstert.2009.12.073.

    Article  PubMed  Google Scholar 

  11. Donnez J, Dolmans MM, Pellicer A, Diaz-Garcia C, Sanchez Serrano M, Schmidt KT, et al. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil Steril. 2013;99(6):1503–13. https://doi.org/10.1016/j.fertnstert.2013.03.030.

    Article  PubMed  Google Scholar 

  12. Donnez J, Silber S, Andersen CY, Demeestere I, Piver P, Meirow D, et al. Children born after autotransplantation of cryopreserved ovarian tissue. A review of 13 live births. Ann Med. 2011;43(6):437–50. https://doi.org/10.3109/07853890.2010.546807.

    Article  PubMed  Google Scholar 

  13. Martinez F. Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives. Fertil Steril. 2017;108(3):407–15.e11. https://doi.org/10.1016/j.fertnstert.2017.05.024.

    Article  PubMed  Google Scholar 

  14. Meirow D, Hardan I, Dor J, Fridman E, Elizur S, Ra'anani H, et al. Searching for evidence of disease and malignant cell contamination in ovarian tissue stored from hematologic cancer patients. Hum Reprod. 2008;23(5):1007–13. https://doi.org/10.1093/humrep/den055.

    Article  PubMed  Google Scholar 

  15. Fasano G, Moffa F, Dechene J, Englert Y, Demeestere I. Vitrification of in vitro matured oocytes collected from antral follicles at the time of ovarian tissue cryopreservation. Reprod Biol Endocrinol. 2011;9:150. https://doi.org/10.1186/1477-7827-9-150.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Hourvitz A, Yerushalmi GM, Maman E, Raanani H, Elizur S, Brengauz M, et al. Combination of ovarian tissue harvesting and immature oocyte collection for fertility preservation increases preservation yield. Reprod BioMed Online. 2015;31(4):497–505. https://doi.org/10.1016/j.rbmo.2015.06.025.

    Article  PubMed  CAS  Google Scholar 

  17. Revel A, Revel-Vilk S, Aizenman E, Porat-Katz A, Safran A, Ben-Meir A, et al. At what age can human oocytes be obtained? Fertil Steril. 2009;92(2):458–63. https://doi.org/10.1016/j.fertnstert.2008.07.013.

    Article  PubMed  Google Scholar 

  18. Prasath EB, Chan ML, Wong WH, Lim CJ, Tharmalingam MD, Hendricks M, et al. First pregnancy and live birth resulting from cryopreserved embryos obtained from in vitro matured oocytes after oophorectomy in an ovarian cancer patient. Hum Reprod. 2014;29(2):276–8. https://doi.org/10.1093/humrep/det420.

    Article  PubMed  CAS  Google Scholar 

  19. Segers I, Mateizel I, Van Moer E, Smitz J, Tournaye H, Verheyen G, et al. In vitro maturation (IVM) of oocytes recovered from ovariectomy specimens in the laboratory: a promising “ex vivo” method of oocyte cryopreservation resulting in the first report of an ongoing pregnancy in Europe. J Assist Reprod Genet. 2015;32(8):1221–31. https://doi.org/10.1007/s10815-015-0528-9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Uzelac PS, Delaney AA, Christensen GL, Bohler HC, Nakajima ST. Live birth following in vitro maturation of oocytes retrieved from extracorporeal ovarian tissue aspiration and embryo cryopreservation for 5 years. Fertil Steril. 2015;104(5):1258–60. https://doi.org/10.1016/j.fertnstert.2015.07.1148.

    Article  PubMed  Google Scholar 

  21. Meirow D, Epstein M, Lewis H, Nugent D, Gosden RG. Administration of cyclophosphamide at different stages of follicular maturation in mice: effects on reproductive performance and fetal malformations. Hum Reprod. 2001;16(4):632–7.

    Article  PubMed  CAS  Google Scholar 

  22. Meirow D, Nugent D. The effects of radiotherapy and chemotherapy on female reproduction. Hum Reprod Update. 2001;7(6):535–43.

    Article  PubMed  CAS  Google Scholar 

  23. Fadini R, Dal Canto MB, Mignini Renzini M, Brambillasca F, Comi R, Fumagalli D, et al. Effect of different gonadotrophin priming on IVM of oocytes from women with normal ovaries: a prospective randomized study. Reprod BioMed Online. 2009;19(3):343–51.

    Article  PubMed  CAS  Google Scholar 

  24. Meirow D, Levron J, Eldar-Geva T, Hardan I, Fridman E, Zalel Y, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005;353(3):318–21. https://doi.org/10.1056/NEJMc055237.

    Article  PubMed  CAS  Google Scholar 

  25. Meirow D, Ra’anani H, Biderman H. Ovarian tissue cryopreservation and transplantation: a realistic, effective technology for fertility preservation. Methods Mol Biol. 2014;1154:455–73. https://doi.org/10.1007/978-1-4939-0659-8_21.

    Article  PubMed  CAS  Google Scholar 

  26. Revel A, Safran A, Benshushan A, Shushan A, Laufer N, Simon A. In vitro maturation and fertilization of oocytes from an intact ovary of a surgically treated patient with endometrial carcinoma: case report. Hum Reprod. 2004;19(7):1608–11.

    Article  PubMed  CAS  Google Scholar 

  27. Shalom-Paz E, Almog B, Shehata F, Huang J, Holzer H, Chian RC, et al. Fertility preservation for breast-cancer patients using IVM followed by oocyte or embryo vitrification. Reprod BioMed Online. 2010;21(4):566–71. https://doi.org/10.1016/j.rbmo.2010.05.003.

    Article  PubMed  Google Scholar 

  28. Yin H, Jiang H, Kristensen SG, Andersen CY. Vitrification of in vitro matured oocytes collected from surplus ovarian medulla tissue resulting from fertility preservation of ovarian cortex tissue. J Assist Reprod Genet. 2016;33(6):741–6. https://doi.org/10.1007/s10815-016-0691-7.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Walls ML, Douglas K, Ryan JP, Tan J, Hart R. In-vitro maturation and cryopreservation of oocytes at the time of oophorectomy. Gynecol Oncol Rep. 2015;13:79–81. https://doi.org/10.1016/j.gore.2015.07.007.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Sonigo C, Simon C, Boubaya M, Benoit A, Sifer C, Sermondade N, et al. What threshold values of antral follicle count and serum AMH levels should be considered for oocyte cryopreservation after in vitro maturation? Hum Reprod. 2016;31(7):1493–500. https://doi.org/10.1093/humrep/dew102.

    Article  PubMed  CAS  Google Scholar 

  31. Chung K, Donnez J, Ginsburg E, Meirow D. Emergency IVF versus ovarian tissue cryopreservation: decision making in fertility preservation for female cancer patients. Fertil Steril. 2013;99(6):1534–42. https://doi.org/10.1016/j.fertnstert.2012.11.057.

    Article  PubMed  Google Scholar 

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Availability of data and materials

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no competing interests.

Funding

No external funding was received for this study.

Author information

Affiliations

  1. IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Alon Kedem, Gil M. Yerushalmi, Masha Brengauz, Hila Raanani, Raoul Orvieto, Ariel Hourvitz & Dror Meirow

Authors
  1. Alon Kedem
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  2. Gil M. Yerushalmi
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  3. Masha Brengauz
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  4. Hila Raanani
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  5. Raoul Orvieto
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  6. Ariel Hourvitz
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  7. Dror Meirow
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Corresponding author

Correspondence to Dror Meirow.

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Cite this article

Kedem, A., Yerushalmi, G., Brengauz, M. et al. Outcome of immature oocytes collection of 119 cancer patients during ovarian tissue harvesting for fertility preservation. J Assist Reprod Genet 35, 851–856 (2018). https://doi.org/10.1007/s10815-018-1153-1

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  • DOI: https://doi.org/10.1007/s10815-018-1153-1

Keywords

  • Fertility preservation
  • Oocyte retrieval
  • In vitro oocyte maturation