Nigel Pereira1, Andrea G Hubschmann2, Jovana P Lekovich3, Glenn L Schattman3, Zev Rosenwaks3. 1. Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York. Electronic address: nip9060@med.cornell.edu. 2. Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York. 3. Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York.
Abstract
OBJECTIVE: To report a case of ex vivo oocyte retrieval from oophorectomized specimens in a BRCA1 mutation carrier undergoing surgical staging for ovarian cancer. DESIGN: Video case report and literature review. SETTING: University-affiliated center. PATIENT(S): A 37-year-old single woman, gravida 0, with a known BRCA1 mutation, presented to her oncologist with a complex right ovarian mass and elevated CA-125 level. Ovarian cancer was suspected, and the patient consented to complete surgical staging. Although she desired to cryopreserve oocytes for fertility preservation, conventional oocyte retrieval was deemed unsafe because follicular puncture would compromise the integrity of the ovarian capsule, thereby increasing the risk of malignant cell spillage and cancer upstaging. INTERVENTION(S): Luteal-phase ovarian stimulation with gonadotropins and letrozole was performed. Surgical staging was initiated 34 hours after the administration of the ovulatory trigger. MAIN OUTCOME MEASURE(S): Ex vivo retrieval of oocytes from bilateral oophorectomized specimens under direct visualization at the time of surgical staging. RESULT(S): Seven mature oocytes were retrieved and vitrified. Concomitant surgical staging was completed. CONCLUSION(S): The present case highlights the feasibility of ex vivo or extracorporeal retrieval of mature oocytes from oophorectomized specimens in patients with ovarian cancer. By avoiding follicular puncture within the pelvic cavity, it minimizes the risk of malignant cell spillage and cancer upstaging.
OBJECTIVE: To report a case of ex vivo oocyte retrieval from oophorectomized specimens in a BRCA1 mutation carrier undergoing surgical staging for ovarian cancer. DESIGN: Video case report and literature review. SETTING: University-affiliated center. PATIENT(S): A 37-year-old single woman, gravida 0, with a known BRCA1 mutation, presented to her oncologist with a complex right ovarian mass and elevated CA-125 level. Ovarian cancer was suspected, and the patient consented to complete surgical staging. Although she desired to cryopreserve oocytes for fertility preservation, conventional oocyte retrieval was deemed unsafe because follicular puncture would compromise the integrity of the ovarian capsule, thereby increasing the risk of malignant cell spillage and cancer upstaging. INTERVENTION(S): Luteal-phase ovarian stimulation with gonadotropins and letrozole was performed. Surgical staging was initiated 34 hours after the administration of the ovulatory trigger. MAIN OUTCOME MEASURE(S): Ex vivo retrieval of oocytes from bilateral oophorectomized specimens under direct visualization at the time of surgical staging. RESULT(S): Seven mature oocytes were retrieved and vitrified. Concomitant surgical staging was completed. CONCLUSION(S): The present case highlights the feasibility of ex vivo or extracorporeal retrieval of mature oocytes from oophorectomized specimens in patients with ovarian cancer. By avoiding follicular puncture within the pelvic cavity, it minimizes the risk of malignant cell spillage and cancer upstaging.
Authors: Enrique Perez de la Blanca; Maria Fuensanta Fernandez-Perez; Elena Del Mar Martin-Diaz; Manuel Lozano; Marta Garcia-Sanchez; Carolina Monedero Journal: J Reprod Infertil Date: 2018 Jul-Sep
Authors: Mahmoud Salama; M Lambertini; M S Christianson; Y Jayasinghe; A Anazodo; M De Vos; F Amant; C Stern; L Appiah; T L Woodard; R A Anderson; L M Westphal; R E Leach; K A Rodriguez-Wallberg; P Patrizio; Teresa K Woodruff Journal: J Assist Reprod Genet Date: 2022-01-15 Impact factor: 3.357