In vitro maturation of germinal vesicle oocytes recovered after premature luteinizing hormone surge: description of a novel approach to fertility preservation.
OBJECTIVE
To report a novel approach to fertility preservation by in vitro maturation and embryo cryopreservation after LH surge and ovulation.


METHODS
Case report.


METHODS
Two university-based reproductive endocrinology clinics.


METHODS
Forty-year-old woman with breast cancer seeking fertility preservation before chemotherapy.


METHODS
The plan was ovarian stimulation and retrieval of mature oocytes, followed by IVF; however, premature LH surge and ovulation occurred before oocyte retrieval. Because no mature oocyte was recovered, follicles <10 mm in diameter were also aspirated.


METHODS
Recovery of immature oocytes after ovulation, in vitro maturation of these oocytes, and fertilization and vitrification of generated embryos.


RESULTS
Four immature oocytes were recovered, and two matured in vitro. After fertilization with intracytoplasmic sperm injection, embryos progressed to the four-cell stage on day 2 and were vitrified for future use.


CONCLUSIONS
This case illustrates that under time constraints, immature oocytes can be recovered after ovulation and used to generate embryos for fertility preservation.
Oktay
Kutluk
K
Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Infertility, Weill Medical College, Cornell University, New York, New York 10021, USA. koktay@fertilitypreservation.org
Demirtas
Ezgi
E
Son
Weon-Young
WY
Lostritto
Kathy
K
Chian
Ri-Cheng
RC
Tan
Seang Lin
SL
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D018929:Cell Culture Techniques; D015925:Cryopreservation; D004334:Drug Administration Schedule; D046149:Embryo Culture Techniques; D005260:Female; D005298:Fertility / Q000187:drug effects; D005300:Fertility Agents, Female / Q000008:administration & dosage; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy*; D000077289:Letrozole; D007986:Luteinizing Hormone / Q000097:blood*; D009570:Nitriles / Q000008:administration & dosage; D054315:Oocyte Retrieval; D010060:Ovulation; D010062:Ovulation Induction / Q000379:methods; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage
D000970:Antineoplastic Agents; D005300:Fertility Agents, Female; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone