PDF(Pubmed)
Abstract：
BACKGROUND: Despite the recent progress of fertility preservation technique, achievement of pregnancy in women with ovarian tumor is still challenging. Here, we report a case of OTO-IVM (ovarian tissue oocyte in-vitro maturation) resulting in a successful delivery.
METHODS: The patient, a 33-year-old woman with a history of left borderline ovarian tumor (BOT) who underwent left salpingo-oophorectomy three years ago, presented with an enlarged right ovary during infertility treatment, indicating the recurrence of BOT. Because the patient disagreed with curative surgery and normal part-preservation surgery, we eventually performed OTO-IVM. A right salpingo-oophorectomy was first performed. Eight immature oocytes were immediately aspirated not only from visible follicles, but also from entire cortex for invisible follicles, of the removed ovary. In addition, IVM procedure generated six mature oocytes, and were subjected to intracytoplasmic sperm injection (ICSI). Accordingly, three embryos were obtained and cryopreserved. Three months after surgery, hormone replacement therapy was initiated, and a frozen-thawed embryo was transferred, resulting in a successful pregnancy. Although a cesarean section was performed at 36 weeks due to maternal ileus, the baby was delivered without complications.
CONCLUSIONS: This report indicates this treatment to be an effective approach for fertility preservation in BOT patients, especially, the importance of collecting oocytes from the entire ovarian cortex was suggested.
METHODS: The patient, a 33-year-old woman with a history of left borderline ovarian tumor (BOT) who underwent left salpingo-oophorectomy three years ago, presented with an enlarged right ovary during infertility treatment, indicating the recurrence of BOT. Because the patient disagreed with curative surgery and normal part-preservation surgery, we eventually performed OTO-IVM. A right salpingo-oophorectomy was first performed. Eight immature oocytes were immediately aspirated not only from visible follicles, but also from entire cortex for invisible follicles, of the removed ovary. In addition, IVM procedure generated six mature oocytes, and were subjected to intracytoplasmic sperm injection (ICSI). Accordingly, three embryos were obtained and cryopreserved. Three months after surgery, hormone replacement therapy was initiated, and a frozen-thawed embryo was transferred, resulting in a successful pregnancy. Although a cesarean section was performed at 36 weeks due to maternal ileus, the baby was delivered without complications.
CONCLUSIONS: This report indicates this treatment to be an effective approach for fertility preservation in BOT patients, especially, the importance of collecting oocytes from the entire ovarian cortex was suggested.
摘要：
背景：尽管生育力保存技术最近取得了进展，在卵巢肿瘤妇女中实现妊娠仍然具有挑战性。这里,我们报道一例OTO-IVM(卵巢组织卵母细胞体外成熟)导致分娩成功.
方法：患者，一名33岁的女性，有左卵巢交界性肿瘤（BOT）的病史，三年前接受了左输卵管卵巢切除术，在不孕症治疗期间出现右卵巢增大，表明BOT的复发。因为患者不同意根治性手术和正常的保留部分手术，我们最终执行了OTO-IVM。首先进行了右输卵管卵巢切除术。不仅从可见的卵泡中立即吸出八个未成熟的卵母细胞，而且来自整个皮层的隐形毛囊，切除的卵巢。此外,IVM程序产生了六个成熟卵母细胞，并进行了胞浆内精子注射（ICSI）。因此，获得三个胚胎并冷冻保存。手术三个月后,开始激素替代疗法，一个冻融的胚胎被转移,导致成功怀孕。尽管由于产妇肠梗阻在36周时进行了剖宫产，婴儿分娩时没有出现并发症。
结论：本报告表明，这种治疗方法是一种有效的方法，可以保护BOT患者的生育能力。尤其是,提示了从整个卵巢皮质收集卵母细胞的重要性。
方法：患者，一名33岁的女性，有左卵巢交界性肿瘤（BOT）的病史，三年前接受了左输卵管卵巢切除术，在不孕症治疗期间出现右卵巢增大，表明BOT的复发。因为患者不同意根治性手术和正常的保留部分手术，我们最终执行了OTO-IVM。首先进行了右输卵管卵巢切除术。不仅从可见的卵泡中立即吸出八个未成熟的卵母细胞，而且来自整个皮层的隐形毛囊，切除的卵巢。此外,IVM程序产生了六个成熟卵母细胞，并进行了胞浆内精子注射（ICSI）。因此，获得三个胚胎并冷冻保存。手术三个月后,开始激素替代疗法，一个冻融的胚胎被转移,导致成功怀孕。尽管由于产妇肠梗阻在36周时进行了剖宫产，婴儿分娩时没有出现并发症。
结论：本报告表明，这种治疗方法是一种有效的方法，可以保护BOT患者的生育能力。尤其是,提示了从整个卵巢皮质收集卵母细胞的重要性。
