Foad Azem1, Avivit Brener2, Gustavo Malinger3, Adi Reches4, Ariel Many5, Yariv Yogev5, Yael Lebenthal2. 1. Institution of Reproduction and IVF, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. Electronic address: azemf@tlvmc.gov.il. 2. Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. 3. Unit for Maternal Ultrasound, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. 4. Institution of Reproduction and IVF, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. 5. Obstetrics and Gynecology Department, Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.
Abstract
OBJECTIVE: To report the first successful oocyte cryopreservation in a prepubertal girl. DESIGN: Case report and review of the literature. SETTING: Tertiary medical center. PATIENT(S): A 7-year-old prepubertal girl with Turner syndrome mosaicism (45,X[37]/47,XXX[15]) who underwent a novel fertility preservation procedure after fertility preservation counseling and informed decision of the parents. INTERVENTION(S): Controlled ovarian hyperstimulation with daily administration of 100 IU recombinant human follicle-stimulating and 50 IU recombinant human luteinizing hormone per milliliter, injection of 250 μg human chorionic gonadotropin was given 36 hours before the follicular aspiration procedure, and oocytes retrieved by a transabdominal ultrasound guided approach. MAIN OUTCOME MEASURE(S): Mature oocyte cryopreservation. RESULT(S): The first cryopreservation cycle with use of a gonadotropin-releasing hormone agonist trigger failed to yield oocytes. The second cycle with human chorionic gonadotropin trigger was successful. Six oocytes were retrieved, and all were mature metaphase 2. The patient was discharged in good condition with no complications. CONCLUSION(S): This novel procedure bypasses the timely physiologic progression of pubertal maturation of the hypothalamic-pituitary-ovarian axis to directly target the ovaries and achieve mature ovarian follicles. This innovative approach offers a new treatment modality for prepubertal girls who need fertility preservation such as in Turner syndrome or in cases that ovarian tissue cryopreservation is contraindicated.
OBJECTIVE: To report the first successful oocyte cryopreservation in a prepubertal girl. DESIGN: Case report and review of the literature. SETTING: Tertiary medical center. PATIENT(S): A 7-year-old prepubertal girl with Turner syndrome mosaicism (45,X[37]/47,XXX[15]) who underwent a novel fertility preservation procedure after fertility preservation counseling and informed decision of the parents. INTERVENTION(S): Controlled ovarian hyperstimulation with daily administration of 100 IU recombinant human follicle-stimulating and 50 IU recombinant human luteinizing hormone per milliliter, injection of 250 μg human chorionic gonadotropin was given 36 hours before the follicular aspiration procedure, and oocytes retrieved by a transabdominal ultrasound guided approach. MAIN OUTCOME MEASURE(S): Mature oocyte cryopreservation. RESULT(S): The first cryopreservation cycle with use of a gonadotropin-releasing hormone agonist trigger failed to yield oocytes. The second cycle with human chorionic gonadotropin trigger was successful. Six oocytes were retrieved, and all were mature metaphase 2. The patient was discharged in good condition with no complications. CONCLUSION(S): This novel procedure bypasses the timely physiologic progression of pubertal maturation of the hypothalamic-pituitary-ovarian axis to directly target the ovaries and achieve mature ovarian follicles. This innovative approach offers a new treatment modality for prepubertal girls who need fertility preservation such as in Turner syndrome or in cases that ovarian tissue cryopreservation is contraindicated.
Authors: Sarina N Hanfling; Toral Parikh; Allison Mayhew; Erin Robinson; James Graham; Veronica Gomez-Lobo; Jacqueline Y Maher Journal: F S Rep Date: 2021-04-08
Authors: Atsuko Kusuhara; Elnur Babayev; Luhan T Zhou; Vijay P Singh; Jennifer L Gerton; Francesca E Duncan Journal: Front Cell Dev Biol Date: 2021-06-16