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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    • "Fully open systems include the unprotected OPS (Vajta et al., 1998a); tools using the Cryotop principle (i.e. the original Cryotop) (Hamawaki et al., 1999), Cryotech (Gutnisky et al., 2013), Cryolock (Garcia et al., 2011), Cryoleaf (Chian et al., 2009), Vitri-Inga (Almodin et al., 2010) with unsealed protective straws; and the Cryoloop stored in cryotubes. By applying these systems, samples contact liquid nitrogen directly during cooling, and are not safely protected from further contact and potential cross-contamination during storage. "
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    ABSTRACT: Vitrification is now the dominant approach for cryopreservation of human oocytes and embryos; however, serious disagreement persists, particularly about biosafety issues. Techniques are categorized as either ‘open’ or ‘closed’ according to occurrence of direct contact between the medium and liquid nitrogen during cryopreservation. Advocates of closed systems emphasize the potential danger of disease transmission mediated through liquid nitrogen, and praise the safety of their approach; those who use the open systems refer to the lack of evidence of disease transmission and regard their systems as more consistent and efficient. The purpose of this review is to clarify whether open and closed systems are really open and closed; if closed systems are safe and free of any danger of contamination; if closed systems are equally efficient as open ones for cryopreservation of human embryos and oocytes by considering overall outcome; and finally, if ethical and legal concerns are sound when risks and benefits are considered in a broader sense. On the basis of these answers, implementation of rational measures to lower the theoretical danger of disease transmission are proposed while maintaining the achievements in cryopreservation that have contributed substantially to the advancement in assisted reproduction techniques during the past decade.
    Full-text · Article · Jan 2015 · Reproductive biomedicine online
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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.
    Full-text · Article · Jun 2014 · Reproductive biomedicine online
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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.
    Full-text · Article · Apr 2013 · Journal of Ovarian Research
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