Retrieval of immature oocytes after chemotherapy for Hodgkin's disease and prolonged ovarian down-regulation with gonadotropin-releasing hormone agonist
Received 21 February 2009; received in revised form 10 April 2009; accepted 27 April 2009. published online 15 June 2009.
Objective
To describe isolation and in vitro maturation of primary oocytes from the ovarian cortex in the presence of hypothalamic pituitary down-regulation.
Design
Case report.
Setting
Tertiary care university-affiliated hospital.
Patient(s)
An 18-year-old patient was given treatment with the ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine) protocol for Hodgkin's disease. She underwent ovarian tissue cryopreservation while being cotreated with GnRH agonist because of disease relapse.
Intervention(s)
Laparoscopic oophorectomy, ovarian tissue cryopreservation, and in vitro maturation of primary oocytes.
Main Outcome Measure(s)
Maturation of primary oocytes isolated from the medium used for preparation of ovarian tissue.
Result(s)
Twenty-one immature germinal vesicle–stage oocytes were isolated from the medium of dissection. All were incubated in in vitro maturation medium, and five were maturated and frozen.
Conclusion(s)
The fact that germinal vesicle–stage oocytes were present in our patient's medium despite hormonal down-regulation demonstrates that GnRH agonist does not completely inhibit antral follicle development.
Racine In Vitro Fertilization Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Reprint requests: Foad Azem, M.D., Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel (FAX: 972-3-6925687).
F.A. has nothing to disclose. J.H. has nothing to disclose. T.C. has nothing to disclose. T.S. has nothing to disclose. N.M.-R. has nothing to disclose. B.A. has nothing to disclose. A.A. has nothing to disclose. D.B.-Y. has nothing to disclose.
ABSTRACT