Article

Obstetric outcomes following vitrification of in vitro and in vivo matured oocytes

McGill Reproductive Center, McGill University Health Centre, Montreal, Quebec, Canada.
Fertility and sterility (Impact Factor: 4.59). 07/2008; 91(6):2391-8. DOI: 10.1016/j.fertnstert.2008.04.014
Source: PubMed

ABSTRACT To evaluate obstetric outcomes with oocyte vitrification after ovarian stimulation (OS) and in vitro maturation (IVM) of immature oocytes.
A prospective trial from October 2003 to April 2007.
University-based medical center.
OS group: 38 patients undergoing intrauterine insemination who overresponded to OS. IVM group: 20 patients who had previous unsuccessful intrauterine insemination.
Mature oocyte retrieval following OS. Immature oocyte retrieval and IVM. Oocyte vitrification, thawing, insemination, and transfer of the resulting embryos.
Live-birth rates and obstetric outcomes.
The OS group was superior to the IVM group in terms of oocyte survival (81.4 +/- 22.6% vs. 67.5 +/- 26.1%), fertilization rate (75.6 +/- 22.5% vs. 64.2 +/- 19.9%), and cumulative embryo score (38.4 +/- 22.3 vs. 20.0 +/- 13.8). However, the differences in the implantation rate per embryo (19.1 +/- 25.8% vs. 9.6 +/- 24.1%), clinical pregnancy rate per cycle started (44.7%, vs. 20.0%), and live-birth rate per cycle started (39.5% vs. 20.0%) were not statistically significant. Twenty healthy babies were born in the OS group and four in the IVM group.
Pregnancies achieved with vitrification of oocytes after OS and IVM treatments do not appear to be associated with adverse pregnancy outcomes. Vitrification of IVM oocytes represents a novel option for fertility preservation.

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Available from: Lucy Gilbert, Aug 28, 2015
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    • "Assisted reproduction may be used in order to optimize the chances of fertility preservation and pregnancy through embryo, ovarian tissue and/or oocyte cryopreservation. Other options which can be considered include the combination of immature egg retrieval followed by in-vitro maturation (IVM) and oocyte vitrification (Huang et al., 2007), or combination of ovarian tissue freezing with retrieval of immature eggs followed by IVM and oocyte vitrification (Huang et al., 2008, 2010) since IVM and oocyte vitrification can also lead to live births (Chian et al., 2009). "
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    ABSTRACT: This article reports the live birth of a healthy newborn using vitrified–warmed oocytes in a young patient with invasiven2x2h mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after insemination of warmed oocytes. Eighteen days after the transfer, she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. As far s is known, this is the first live birth reported through vitrified–warmed oocytes in a patient with invasive ovarian cancer. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, controversial issues are discussed.
    Reproductive biomedicine online 06/2014; 28(6). DOI:10.1016/j.rbmo.2014.02.010 · 2.98 Impact Factor
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    • "The development of oocyte cryopreservation has made rapid progress since the introduction of vitrification techniques, and rates of fertilization, development and implantation have improved significantly, with survival rates of more than 85% and pregnancy rates of over 40% [23-25]. It has been further demonstrated that vitrification is superior to conventional slow freezing procedures in terms of meiotic spindle maintenance and recovery during and after the freezing process [26-28]. "
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    ABSTRACT: Background Oocyte in vitro maturation (IVM) and cryopreservation at the time of routine ovarian tissue freezing may be offered to cancer patients as an additional option for fertility preservation. This study aimed to investigate the developmental capacity of oocytes isolated from unstimulated ovaries. Methods Immature oocytes (n = 63) from seven consenting premenopausal patients were analysed. Oocytes were collected during routine laparoscopic examination with biopsy of an ovary (cystic adnexal mass, n = 3; cervical adenocarcinoma, n = 2) or oophorectomy (sex reassignment surgery, n = 2) without previous stimulation of the ovaries. The stage of the patient’s menstrual cycle was not considered. Oocytes in all visible antral follicles were aspirated from ovaries, cultured in IVM medium and vitrified at the MII stage before being kept in liquid nitrogen for at least one month. After warming, oocytes were subjected to parthenogenetic activation by chemical stimulus. Their further development was recorded at intervals of 24 hours for up to 6 days of culture. Results 61.9% of oocytes matured in vitro within 48 hours. The survival rate after vitrification and warming was 61.5%. A total of 75% of surviving oocytes were able to respond to artificial activation, 44.4% of the parthenotes developed to early embryonic stage. However, only 1 in 18 (5.6%) of the resulting embryos reached blastocyst stage. Conclusions Oocytes matured in vitro from unstimulated ovaries seem to have limited developmental potential after cryopreservation and artificial activation. Although the outcome of IVM for non-stimulated oocytes is poor, it is currently the only chance besides cryopreservation of ovarian tissue for women for whom ovarian stimulation is not possible due to life circumstances. Based on our preliminary results, we suggest that the use of cryopreserved ovaries for fertility preservation in women with cancer warrants further investigation.
    Journal of Ovarian Research 04/2013; 6(1):30. DOI:10.1186/1757-2215-6-30 · 2.43 Impact Factor
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    • "Assisted reproduction may be used in order to optimize the chances of fertility preservation and pregnancy through embryo, ovarian tissue and/or oocyte cryopreservation. Other options which can be considered include the combination of immature egg retrieval followed by in-vitro maturation (IVM) and oocyte vitrification (Huang et al., 2007), or combination of ovarian tissue freezing with retrieval of immature eggs followed by IVM and oocyte vitrification (Huang et al., 2008, 2010) since IVM and oocyte vitrification can also lead to live births (Chian et al., 2009). "
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    ABSTRACT: Abstract Improvements in early diagnosis and treatment strategies in cancer patients have enabled younger women with cancer to survive. In addition to the stressful event of the diagnosis, patients with malignant diseases face the potential loss of the opportunity to have children. Preservation of fertility has become a challenging issue and it is still surrounded by controversies. On the basis of available evidence, a group of experts reached a consensus regarding the options for trying to preserve fertility in women with cancer: among established methods, in postpubertal women, oocyte cryopreservation is the preferred option, whereas ovarian tissue cryopreservation is the only possibility for prepubertal girls. Combining several strategies on an individual basis may improve the chances of success. Realistic information should be provided before any intervention is initiated. Counseling should offer support for patients and provide better care by understanding emotional needs, psychological predictors of distress and methods of coping. Early referral to the fertility specialist is essential as fertility preservation (FP) may improve quality of life in these patients. The information summarized here is intended to help specialists involved in the treatment of cancer and reproductive medicine to improve their understanding of procedures available for FP in young cancer patients.
    Gynecological Endocrinology 01/2013; 29(4). DOI:10.3109/09513590.2012.743019 · 1.14 Impact Factor
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