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Oocyte cryopreservation with in vitro maturation for fertility preservation in girls at risk for ovarian insufficiency

  • Fertility Preservation
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To assess the feasibility and outcomes of oocyte cryopreservation with in vitro maturation (IVM) in post-pubertal girls undergoing fertility preservation (FP) for primary ovarian insufficiency (POI) risk.

Methods

Ovarian stimulation was performed with an antagonist protocol or progesterone priming. Ultrasound monitoring was performed transabdominally. Oocytes were retrieved transvaginally under IV sedation. Immature oocytes were subjected to IVM for up to 36 h. All MII oocytes were vitrified. The main outcome measure was the total number of mature oocytes cryopreserved. The secondary outcome was the increase in the mature oocyte yield after IVM.

Results

Indications for FP included mosaic Turner syndrome (mTS; n = 10), malignancy (n = 3), and POI risk (n = 2). The mean ± SD age, antral follicle count (AFC), and AMH levels were 14.2 ± 1.4 years, 8 ± 5.2 and 1.3 ± 1.3 ng/mL. In girls with mTS, the ovarian reserve was low for age (AFC 7.4 ± 4.7 and AMH 1.4 ± 1.6 ng/mL). Oocyte cryopreservation was possible in all girls with a range of 1–27 mature oocytes obtained, even in those who were previously exposed to chemotherapy or with low ovarian reserve, and no surgical complications were encountered. After IVM, the median mature oocyte yield increased significantly from 7.5 to 10.5 (p = 0.001).

Conclusions

Oocyte cryopreservation appears to be feasible and safe in girls as young as 12 years of age at risk for POI The utility of IVM increases the yield of cryopreserved mature oocytes. Prior exposure to chemotherapy or low ovarian reserve should not be an automatic reason to exclude these girls from FP consideration.

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Acknowledgements

We thank Giuliano Bedoschi, M.D., Ph.D. for data clarification, and Anastasia Yedynak, clinical coordinator, for technical assistance. No compensation was received for their contributions.

Funding

K.O. is funded by NIH HD R01HD053112. Foundation Alfonso Martín Escudero (Madrid, Spain) provided grant support for S.G. research fellowship position.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, CT, 310 Cedar Street, FMB Room 224. New Haven, CT, USA

    Sonia Gayete-Lafuente & Kutluk H. Oktay

  2. Innovation Institute for Fertility Preservation, NY and CT, USA

    Volkan Turan & Kutluk H. Oktay

  3. Istanbul Health and Technology University School of Medicine, Istanbul, Turkey

    Volkan Turan

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  1. Sonia Gayete-Lafuente
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Contributions

K.O. conceived the idea, directed the study, and wrote the manuscript; S.G. collected data and wrote the manuscript. V.T. collected data and wrote portions of the manuscript. S.G. and K.O. had full access to all data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Kutluk H. Oktay.

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Sonia Gayete-Lafuente and Volkan Turan had equal contributions.

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Gayete-Lafuente, S., Turan, V. & Oktay, K.H. Oocyte cryopreservation with in vitro maturation for fertility preservation in girls at risk for ovarian insufficiency. J Assist Reprod Genet 40, 2777–2785 (2023). https://doi.org/10.1007/s10815-023-02932-7

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