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In vitro maturation of germinal vesicle oocytes recovered after premature luteinizing hormone surge: description of a novel approach to fertility preservation.

Oktay K, Demirtas E, Son WY, Lostritto K, Chian RC, Tan SL

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

OBJECTIVE: To report a novel approach to fertility preservation by in vitro maturation and embryo cryopreservation after LH surge and ovulation. DESIGN: Case report. SETTING: Two university-based reproductive endocrinology clinics. PATIENT(S): Forty-year-old woman with breast cancer seeking fertility preservation before chemotherapy. INTERVENTION(S): 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. MAIN OUTCOME MEASURE(S): Recovery of immature oocytes after ovulation, in vitro maturation of these oocytes, and fertilization and vitrification of generated embryos. RESULT(S): 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. CONCLUSION(S): This case illustrates that under time constraints, immature oocytes can be recovered after ovulation and used to generate embryos for fertility preservation.

Published 14 January 2008 in Fertil Steril, 89(1): 228.e19-22.
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