Twenty-first century oocyte cryopreservation—in vitro maturation of immature oocytes from ovarian tissue cryopreservation in cancer patients: A systematic review

Abstract

Objectives: Our review aimed to consolidate the latest update on the application of in vitro maturation among immature oocyte harvest in combination with ovarian tissue cryopreservation known as ovarian tissue oocyte–in vitro maturation. Methods: A thorough search for relevant studies was conducted via PubMed, Google Scholar, EMBASE, and clinical.gov databases up to December 2020. The primary outcome was the oocyte maturation rate, which measured the number of immature oocytes (geminal vesicle stage) that progressed to mature oocytes (meiosis II stage) following in vitro maturation. The secondary outcomes were the fertilization rate following intracytoplasmic sperm injection/in vitro fertilization of these oocytes for the embryo cryopreservation cohort. Our review included pre-pubertal girls and women with cancer who underwent ovarian tissue oocyte–in vitro maturation as fertility preservation. Results: The primary search identified 207 studies. Twelve manuscripts were selected for inclusion in our review following duplication assessment, title and abstract screening, and full-text evaluation tailored to our inclusion criteria. All the population belonged to a cancer group and underwent concurrent ovarian tissue oocyte–in vitro maturation. A total of 5724 immature oocytes were obtained following ovarian tissue cryopreservation. Approximately 33.84% of the immature oocytes successfully matured via in vitro maturation, which were cryopreserved as oocytes or fertilized as embryos and subsequently stored for future use. Conclusion: Our review proposed the potential application of ovarian tissue oocyte–in vitro maturation in increasing the number of mature oocytes. The acceptable improvement in oocyte maturation rate following in vitro maturation indicates that improving oocyte outcomes is an excellent cost-effective strategy for fertility preservation among women with cancer.

Fertility preservation in pediatric leukemia and lymphoma: A report from the Children's Oncology Group

“…33 While reimplantation of ovarian tissue in survivors of leukemia has been successful without reintroducing disease 34 and methods exist to screen for minimal residual disease in ovarian tissue, 35 currently there is no standard way to screen the tissue for malignant cells, and reimplanting this tissue carries and remains controversial. There have been promising advances with in vitro maturation of immature oocytes, which may allow for fertilization via intracytoplasmic sperm injection (ICSI) and bypass the need for reimplantation of tissue, 36,37 but this technology is still developing and is not yet standardized.…”

Risk reduction for small cell cancer of the ovary, hypercalcemic type in prepubertal patient: A clinical and bioethical perspective

“…For this case, maintenance of the patient’s fertility options was the primary hesitation for performing RRBSO, particularly given her young age and inability to independently consent for the procedure. Advancements in ovarian tissue cryopreservation for prepubertal patients in the context of fertility preservation are underway, and in patients with BSO or concern that possible residual disease would preclude ovarian tissue reimplantation, techniques such as in vitro maturation and in vitro ovarian follicle maturation may be potential solutions in the future ( Mohd Faizal et al, 2022 , Medicine PCotASfR, 2021 ). Pediatric assent to procedures is essential when possible, and in this case, during discussion with the ethics consult team, our patient demonstrated age-appropriate understanding of her sister’s condition and her own upcoming surgery.…”

Restoring Ovarian Fertility and Hormone Function: Recent Advancements, Ongoing Efforts and Future Applications

“…These recovered COCs may contain oocytes that are developed enough to undergo IVM. A recent systematic review of 12 studies where oocyte cryopreservation was performed with the COCs obtained during ovary tissue processing for OTC found that only 33% of recovered oocytes were able to be matured using current IVM technologies in a mixed population of pediatric and adult patients [ 34 ]. While there were some differences in the IVM protocols across centers, this is a reduced rate of maturation compared to adult-only IVF populations, where rates of mature metaphase II (MII) eggs resulting from IVM of recovered oocytes is approximately 70% [ 35 ].…”