J Korean Med Sci.  2024 Jan;39(1):e14. 10.3346/jkms.2024.39.e14.

A Successful Live Birth From a Vitrified Oocyte for Fertility Preservation of a Patient With Borderline Ovarian Tumor Undergoing Bilateral Ovarian Surgery: A Case Report

• Choi YJ
• Hong YH
• Paik H
• Kim SK
• Lee JR
• Suh CS

• KMID: 2550788
• DOI: http://doi.org/10.3346/jkms.2024.39.e14

Abstract

This article reports the live birth of a healthy newborn using vitrified-warmed oocytes from fertility preservation before ovarian surgery. The patient in our case underwent two cycles of controlled ovarian stimulation before laparoscopic bilateral ovarian cystectomy for endometriosis, and a total of 23 mature oocytes were vitrified. After surgery, her pathologic reports revealed a serous borderline tumor and endometrioma. Fifteen months after her second surgery of laparoscopic right salpingo-oophorectomy and left ovarian cystectomy owing to recurrence, she had been married by then, and three of the frozen oocytes were thawed for intracytoplasmic sperm injection. These oocytes were cryopreserved for 2.5 years. All three were fertilized, and two grade-A cleavage-stage embryos were transferred. A singleton pregnancy was achieved, resulting in the delivery of a healthy baby boy at 39.3 weeks of gestation. Oocyte cryopreservation is an effective method for fertility preservation prior to ovarian surgery when ovarian function decline is predictable.

Keyword

Borderline Ovarian Tumor; Fertility Preservation; Intracytoplasmic Sperm Injection; Oocyte Cryopreservation; Pregnancy

Figure

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  Fig. 1 The patient’s transvaginal-ultrasonography image of (A) the quadrilocular right ovarian cyst measuring up to 7 cm and (B) the normal-looking left ovary.

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  Fig. 2 Intra-operative findings of the first operation (laparoscopic bilateral ovarian cystectomy) (A) of the right ovary and (B) of the left ovary with incidental cystic finding.

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  Fig. 3 Pathology sections of (A) right ovarian cyst, which is consistent with serous borderline tumor (100×) (B) right ovarian cyst, serous borderline tumor at higher magnification (400×) (C) left ovarian cyst, consistent with endometrioma (100×).

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  Fig. 4 Intra-operative findings of the second operation (laparoscopic right salpingo-oophorectomy and left ovarian cystectomy) (A) of the right ovary and (B) of the left ovary.

Reference

1. Alvarez M, Solé M, Devesa M, Fábregas R, Boada M, Tur R, et al. Live birth using vitrified--warmed oocytes in invasive ovarian cancer: case report and literature review. Reprod Biomed Online. 2014; 28(6):663–668. PMID: 24745835.

2. Kim MK, Lee DR, Han JE, Kim YS, Lee WS, Won HJ, et al. Live birth with vitrified-warmed oocytes of a chronic myeloid leukemia patient nine years after allogenic bone marrow transplantation. J Assist Reprod Genet. 2011; 28(12):1167–1170. PMID: 22116648.

3. Perrin J, Saïas-Magnan J, Broussais F, Bouabdallah R, D’Ercole C, Courbiere B. First French live-birth after oocyte vitrification performed before chemotherapy for fertility preservation. J Assist Reprod Genet. 2016; 33(5):663–666. PMID: 26861964.

4. Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Mature oocyte cryopreservation: a guideline. Fertil Steril. 2013; 99(1):37–43. PMID: 23083924.

5. Cobo A, Meseguer M, Remohí J, Pellicer A. Use of cryo-banked oocytes in an ovum donation programme: a prospective, randomized, controlled, clinical trial. Hum Reprod. 2010; 25(9):2239–2246. PMID: 20591872.

6. Quinn GP, Vadaparampil ST, Lee JH, Jacobsen PB, Bepler G, Lancaster J, et al. Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol. 2009; 27(35):5952–5957. PMID: 19826115.

7. Kim SJ, Kim SK, Lee JR, Suh CS, Kim SH. Oocyte cryopreservation for fertility preservation in women with ovarian endometriosis. Reprod Biomed Online. 2020; 40(6):827–834. PMID: 32295746.

8. Noyes N, Labella PA, Grifo J, Knopman JM. Oocyte cryopreservation: a feasible fertility preservation option for reproductive age cancer survivors. J Assist Reprod Genet. 2010; 27(8):495–499. PMID: 20480389.

9. Noyes N, Porcu E, Borini A. Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod Biomed Online. 2009; 18(6):769–776. PMID: 19490780.

10. Khiat S, Provansal M, Bottin P, Saias-Magnan J, Metzler-Guillemain C, Courbiere B. Fertility preservation after fertility-sparing surgery in women with borderline ovarian tumours. Eur J Obstet Gynecol Reprod Biol. 2020; 253:65–70. PMID: 32784054.

11. Cobo A, Giles J, Paolelli S, Pellicer A, Remohí J, García-Velasco JA. Oocyte vitrification for fertility preservation in women with endometriosis: an observational study. Fertil Steril. 2020; 113(4):836–844. PMID: 32145929.

12. Mangili G, Somigliana E, Giorgione V, Martinelli F, Filippi F, Petrella MC, et al. Fertility preservation in women with borderline ovarian tumours. Cancer Treat Rev. 2016; 49:13–24. PMID: 27428850.

13. Chang HJ, Han SH, Lee JR, Jee BC, Lee BI, Suh CS, et al. Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertil Steril. 2010; 94(1):343–349. PMID: 19345350.

14. Cobo A, García-Velasco J, Domingo J, Pellicer A, Remohí J. Elective and onco-fertility preservation: factors related to IVF outcomes. Hum Reprod. 2018; 33(12):2222–2231. PMID: 30383235.

15. Daraï E, Fauvet R, Uzan C, Gouy S, Duvillard P, Morice P. Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options. Hum Reprod Update. 2013; 19(2):151–166. PMID: 23242913.

16. Cakmak H, Rosen MP. Random-start ovarian stimulation in patients with cancer. Curr Opin Obstet Gynecol. 2015; 27(3):215–221. PMID: 25919235.