Lockdown Uptick: Did the Sars-Cov-2 Pandemic Generate an Increase in Planned Oocyte Cryopreservation (Poc)?

Abstract

transabdominally with lower-than-expected AFC for her AMH. She elected to have her ovaries released robotically from the abdominal wall by gynecologic oncology at the time of debulking surgery for her recurrent rectal cancer. The released ovaries were sutured bilaterally to the pelvic side wall peritoneum to ensure ovarian stability. The patient proceeded with ovarian stimulation five weeks following her ovarian transposition release procedure using straight start with antagonist protocol and 250 IU of Gonal-F to start.RESULTS: Transvaginal ultrasound following surgery demonstrated excellent visualization of the ovaries in the pelvis. AFC was 18 at the beginning of ovarian stimulation. Ovarian stimulation required 11 days and the patient required a total of 2750 IU of Gonal-F and 450 IU of Menopur. She was triggered with Lupron and 1000 IU of hCG with 18 follicles between 12 mm to 21 mm. A total of 15 oocytes were retrieved, 12 were MII and cryopreserved. The remaining three oocytes included one MI, one germinal vesicle, and one empty cumulus. The patient did well post operatively and did not have any complications.CONCLUSIONS: One concern with release of the ovarian pedicles during transposition reversal is hypermobility of the ovaries precluding safe transvaginal oocyte retrieval. We demonstrate that this procedure can be done safely with attention to suturing of the ovaries to the pelvic side wall at the time of reversal that resulted in a good outcome for this patient.IMPACT STATEMENT: This is the first case of transvaginal oocyte retrieval following ovarian transposition and reversal to be reported in the literature and demonstrate the feasibility and safety of this procedure.