Mature oocyte retrieval during laparotomic debulking surgery following random-start controlled ovarian stimulation for fertility preservation in a patient with suspected ovarian cancer

Abstract

Herein, we report a case of successful mature oocyte retrieval during laparotomy after random-start controlled ovarian stimulation (COS) in a 21-year-old nulliparous woman with suspected recurrent ovarian immature teratoma. The patient had been diagnosed with stage IIIC immature teratoma two years earlier following a staging operation, including right oophorectomy and left ovarian cystectomy. And she had subsequently undergone four rounds of postoperative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. Approximately two years after the initial surgery, she was strongly suspected of having recurrent ovarian immature teratoma on radiologic follow-up. We performed random-start COS and in vivo oocyte retrieval during laparotomic debulking surgery including left oophorectomy. Eight mature oocytes were successfully retrieved and vitrified for fertility preservation. The final pathologic diagnosis was mature cystic teratoma of the ovary and peritoneal implants consistent with gliomatosis peritonei. This is the first case report in which random-start COS and in vivo oocyte retrieval were performed.

Ultrasound‐guided laparotomic oocyte retrieval during surgery for fertility preservation in a case of tumor recurrence after a unilateral salpingo‐oophorectomy

“…In recent years, surgeons have deployed direct laparotomic oocyte retrieval from the ovary during surgery instead of conventional transvaginal oocyte retrieval in order to reduce the risk of intraperitoneal contamination by cancer cells during the oocyte retrieval from an ovary that is affected with malignant tumors . In the present case, a malignant tumor was suspected in the remaining ovary after a unilateral salpingo‐oophorectomy.…”

“…With respect to oocyte retrieval during surgery, whether the oocytes should be retrieved inside the body before the oophorectomy or outside the body after the oophorectomy is not known. Four out of the past six cases that have been published in the literature that involved oocyte retrieval during surgery had the retrieval performed outside of the body after the oophorectomy, while the remaining two cases had the retrieval performed inside the body prior to the oophorectomy . (Table ).…”

“…In recent years, there have been successive reports of patients undergoing laparotomic oocyte retrieval during surgery. Particularly in those suspected of ovarian malignancies bilaterally or in the event where there is a possibility of losing both ovaries, malignancy is suspected in the remaining ovary after a unilateral oophorectomy . In this article, the case of a patient with a potentially malignant tumor in the remaining ovary following a unilateral salpingo‐oophorectomy and who underwent ultrasound‐guided laparotomic oocyte retrieval during resection of the remaining ovary is reported.…”

In vitro maturation and cryopreservation of oocytes retrieved from intra-operative aspiration during second enucleation for ovarian tumor: A case report

“…On the other hand, few studies have reported the intra-operative retrieval of immature oocytes in vivo from stimulated ovaries (Kim et al, 2015). One study did attempt to collect immature oocytes by aspirating normal ovaries during cesarean section (Pongsuthirak, 2014).…”

The Effects of Cancer Therapy on Women’s Fertility: What do We Know Now?

“…Data on controlled hormonal stimulation for cryopreservation of unfertilized or fertilized oocytes are rare and derive from case reports [26] or from patients with borderline tumors (BOT) [27].…”