Dados do Trabalho

Title

Ex vivo mature oocyte retrieval resulting in healthy singleton pregnancy and live birth.

Objective

To report the first pregnancy (surrogate) and live birth from the intracytoplasmic sperm injection (ICSI) of ex vivo retrieved mature oocytes, in a woman with bilateral ovarian carcinoma.

Methods

Case report.

Results

A 34-year-old nulliparous woman with bilateral ovarian tumor, with a risk of malignancy at 96.1%, according to IOTA-ADNEX. Controlled ovarian stimulation was performed with corifolitropin alfa 150 mcg, complemented by follitropin beta 100 IU/day from day 5 to day 7, and followed by follitropin beta 200 IU/day, the latter from the day 8 onwards, in a GnRH antagonist cycle. A single dose of choriogonadotropin alfa 250 mcg was used as trigger on stimulation day 12. Surgery was programmed to occur ~36 hours after the trigger. Follicular aspiration was proceeded in the operating room, guided by ultrasound applied directly to oophorectomized specimens, yielding 12 metaphase II oocytes, which were vitrified. After remission of the disease, the patient returned, counting on her 33-year-old sister for surrogacy. ICSI with donor sperm was performed in the 12 vitrified-thawed oocytes, resulting in the normal development of 9 cleavage-stage embryos, two of which were chosen for transfer to the surrogate mother, according to KIDScore D3. Surplus embryos were cryopreserved. A positive pregnancy test was achieved 12 days after embryo transfer, evolving to a normal healthy singleton pregnancy, an uneventful prenatal follow-up, and the live birth of a healthy 46,XX baby.

Conclusion

Ex vivo retrieval and cryopreservation of mature oocytes is a viable and efficacious approach for fertility preservation in women with ovarian cancer, mitigating the risk of tumor cells spillage into the pelvis. This is the first report of pregnancy and live birth resulting from ICSI of ex vivo retrieved mature oocytes.

Keywords

Oncofertility care, Fertility preservation, Ex vivo oocyte retrieval, Cryopreservation, Ovarian cancer