title: Live birth using vitrified--warmed oocytes in invasive ovarian cancer: case report and literature review.
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.
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain. Electronic address: manalv@dexeus.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Alvarez
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Solé
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Devesa
authors.affiliation: Service of Oncological Gynaecology, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Fábregas
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Boada
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Tur
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Buenaventura
authors.initials: B
authors.lastname: Coroleu
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain; Center of Regenerative Medicine (CMR [B]), Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Veiga
authors.affiliation: Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
authors.forename: Pedro N
authors.initials: PN
authors.lastname: Barri
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D059247:Fertility Preservation / Q000941:ethics / Q000379:methods*; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth; D009865:Oocytes; D010051:Ovarian Neoplasms / Q000601:surgery*; D010062:Ovulation Induction; D011247:Pregnancy; D016896:Treatment Outcome; D058989:Vitrification
keywords: fertility preservation; fertility-sparing surgery; heterotopic pregnancy; ivf in cancer patients; oocyte vitrification; ovarian cancer