Live birth using vitrified–warmed oocytes in invasive ovarian cancer: case report and literature review

• Published in: Reproductive biomedicine online Vol. 28; no. 6; pp. 663 - 668
• Main Authors: Alvarez, Manuel, Solé, Miquel, Devesa, Marta, Fábregas, Rafael, Boada, Montserrat, Tur, Rosa, Coroleu, Buenaventura, Veiga, Anna, Barri, Pedro N
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2014
• Subjects: Adult; Embryo Transfer; Female; fertility preservation; Fertility Preservation - ethics; Fertility Preservation - methods; fertility-sparing surgery; Fertilization in Vitro - methods; heterotopic pregnancy; Humans; Infant, Newborn; ivf in cancer patients; Live Birth; Obstetrics and Gynecology; oocyte vitrification; Oocytes; ovarian cancer; Ovarian Neoplasms - surgery; Ovulation Induction; Pregnancy; Treatment Outcome; Vitrification; ivf in cancer patients; fertility-sparing surgery; fertility preservation; oocyte vitrification; heterotopic pregnancy; ovarian cancer
• ISSN: 1472-6483; 1472-6491
• DOI: 10.1016/j.rbmo.2014.02.010

Abstract This article reports the live birth of a healthy newborn using vitrified–warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after insemination of warmed oocytes. Eighteen days after the transfer, she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. As far as is known, this is the first live birth reported through vitrified–warmed oocytes in a patient with invasive ovarian cancer. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, controversial issues are discussed. Fertility preservation is a proven possibility in some cancer patients according to their age, disease and time available until the beginning of their oncological treatment. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, no live birth has been reported. We report the live birth of a healthy newborn through vitrified–warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after the insemination of the warmed oocytes. Eighteen days after the transfer she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. To our knowledge, this is the first live birth reported using vitrified–warmed oocytes in invasive ovarian cancer. Controversial issues are reviewed and discussed.