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

Abstract

CaseA 28 year old unmarried woman underwent a unilateral salpingo‐oophorectomy and was suspected of having a malignant tumor in the remaining ovary. After consultation with the patient and her family, it was decided to cryopreserve the unfertilized oocytes. In order to reduce the risk of puncturing or rupturing the tumor when performing the oocyte retrieval from the ovary that was affected by the malignant tumor, it was chosen to use direct laparotomic oocyte retrieval during surgery, instead of conventional transvaginal retrieval. In order to further reduce the risk of tumor rupture, an ultrasound was used in the laparotomy field to precisely puncture only the follicle and thus avoid the tumor. A total of 11 oocytes was retrieved and 10 of them were cryopreserved in the MII phase.OutcomeBy using an ultrasound at the same time as the oocyte retrieval, it was possible to avoid the ovarian tumor site. Furthermore, by checking and puncturing the follicles, it became possible to retrieve oocytes from the healthy parts of the ovary with greater precision. The combined use of an ultrasound with oocyte retrieval can be considered to be an effective method because it can be performed relatively easily.ConclusionThe authors believe that not only macroscopic, but also ultrasonic, methods are useful to reduce the risk of tumor rupture.

Successful pregnancy using immature oocytes retrieved from resected borderline ovarian tumor: a case report and literature review

“…Previous reports stated that the average number of mature oocytes retrieved following oophorectomy in the presence of ovarian tumors with OTO-COS was 11.6 (ranging from 8 to 15 per case) [ 27 – 31 ], whereas for OTO-IVM, it averaged 3.6 (with a range of 3 to 4 per case) [ 7 , 8 , 32 ]. One reason for the higher oocyte retrieval numbers with OTO-COS is that the follicles at the time of retrieval are larger, making it easier to identify the puncture site both visually and with ultrasound guidance [ 28 ]. However, ovarian stimulation could potentially lead to ovarian enlargement, increasing the risk of torsion or rupture pre-surgery and complicating the operative procedure [ 33 , 34 ].…”