Limits...
Mature oocyte retrieval during laparotomic debulking surgery following random-start controlled ovarian stimulation for fertility preservation in a patient with suspected ovarian cancer.

Kim SK, Kim MS, Kim H, Kim SM, Lee JR, Suh CS, Kim SH - Obstet Gynecol Sci (2015)

Bottom Line: And she had subsequently undergone four rounds of postoperative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin.Eight mature oocytes were successfully retrieved and vitrified for fertility preservation.The final pathologic diagnosis was mature cystic teratoma of the ovary and peritoneal implants consistent with gliomatosis peritonei.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
Herein, we report a case of successful mature oocyte retrieval during laparotomy after random-start controlled ovarian stimulation (COS) in a 21-year-old iparous woman with suspected recurrent ovarian immature teratoma. The patient had been diagnosed with stage IIIC immature teratoma two years earlier following a staging operation, including right oophorectomy and left ovarian cystectomy. And she had subsequently undergone four rounds of postoperative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. Approximately two years after the initial surgery, she was strongly suspected of having recurrent ovarian immature teratoma on radiologic follow-up. We performed random-start COS and in vivo oocyte retrieval during laparotomic debulking surgery including left oophorectomy. Eight mature oocytes were successfully retrieved and vitrified for fertility preservation. The final pathologic diagnosis was mature cystic teratoma of the ovary and peritoneal implants consistent with gliomatosis peritonei. This is the first case report in which random-start COS and in vivo oocyte retrieval were performed.

No MeSH data available.


Related in: MedlinePlus

(A) In vivo oocyte retrieval via laparotomy after controlled ovarian stimulation of the cancer-affected ovary. (B) Ex vivo oocyte retrieval from the excised ovary after oophorectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4663237&req=5

Figure 1: (A) In vivo oocyte retrieval via laparotomy after controlled ovarian stimulation of the cancer-affected ovary. (B) Ex vivo oocyte retrieval from the excised ovary after oophorectomy.

Mentions: Laparotomy showed that the stimulated enlarged left ovary was intact with no rupture. We had planned to perform oocyte retrieval within a pouch; however, this was not possible because of adhesion around the ovary. Therefore, we performed oocyte retrieval carefully without a pouch in the operation field. All visible follicles were aspirated using a 5-mL syringe with an 18-gauge needle before starting the surgical procedure (Fig. 1A). After aspiration, buffer solution including Ham's F-10 nutrient mixture (Gibco Life Technologies, Breda, The Netherlands) and 40 IU/mL of heparin was supplemented. And then, we immediately performed ex vivo oocyte retrieval on the excised ovary to obtain additional oocytes using syringe prefilled with 1 mL of buffer solution (Fig. 1B); however, only a small amount of blood was obtained. Before oocyte retrieval, 10 follicles had been observed on ultrasonography; nine oocytes were obtained including eight mature (metaphase II) oocytes and one oocyte in metaphase I. For oocyte cryopreservation, oocytes were denuded from cumulus cells using hyaluronidase. After denudation, the oocytes were washed several times to eliminate hyaluronidase or other cell fragmentations. After preparation, the eight mature oocytes were cryopreserved by performing vitrification.


Mature oocyte retrieval during laparotomic debulking surgery following random-start controlled ovarian stimulation for fertility preservation in a patient with suspected ovarian cancer.

Kim SK, Kim MS, Kim H, Kim SM, Lee JR, Suh CS, Kim SH - Obstet Gynecol Sci (2015)

(A) In vivo oocyte retrieval via laparotomy after controlled ovarian stimulation of the cancer-affected ovary. (B) Ex vivo oocyte retrieval from the excised ovary after oophorectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663237&req=5

Figure 1: (A) In vivo oocyte retrieval via laparotomy after controlled ovarian stimulation of the cancer-affected ovary. (B) Ex vivo oocyte retrieval from the excised ovary after oophorectomy.
Mentions: Laparotomy showed that the stimulated enlarged left ovary was intact with no rupture. We had planned to perform oocyte retrieval within a pouch; however, this was not possible because of adhesion around the ovary. Therefore, we performed oocyte retrieval carefully without a pouch in the operation field. All visible follicles were aspirated using a 5-mL syringe with an 18-gauge needle before starting the surgical procedure (Fig. 1A). After aspiration, buffer solution including Ham's F-10 nutrient mixture (Gibco Life Technologies, Breda, The Netherlands) and 40 IU/mL of heparin was supplemented. And then, we immediately performed ex vivo oocyte retrieval on the excised ovary to obtain additional oocytes using syringe prefilled with 1 mL of buffer solution (Fig. 1B); however, only a small amount of blood was obtained. Before oocyte retrieval, 10 follicles had been observed on ultrasonography; nine oocytes were obtained including eight mature (metaphase II) oocytes and one oocyte in metaphase I. For oocyte cryopreservation, oocytes were denuded from cumulus cells using hyaluronidase. After denudation, the oocytes were washed several times to eliminate hyaluronidase or other cell fragmentations. After preparation, the eight mature oocytes were cryopreserved by performing vitrification.

Bottom Line: And she had subsequently undergone four rounds of postoperative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin.Eight mature oocytes were successfully retrieved and vitrified for fertility preservation.The final pathologic diagnosis was mature cystic teratoma of the ovary and peritoneal implants consistent with gliomatosis peritonei.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
Herein, we report a case of successful mature oocyte retrieval during laparotomy after random-start controlled ovarian stimulation (COS) in a 21-year-old iparous woman with suspected recurrent ovarian immature teratoma. The patient had been diagnosed with stage IIIC immature teratoma two years earlier following a staging operation, including right oophorectomy and left ovarian cystectomy. And she had subsequently undergone four rounds of postoperative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. Approximately two years after the initial surgery, she was strongly suspected of having recurrent ovarian immature teratoma on radiologic follow-up. We performed random-start COS and in vivo oocyte retrieval during laparotomic debulking surgery including left oophorectomy. Eight mature oocytes were successfully retrieved and vitrified for fertility preservation. The final pathologic diagnosis was mature cystic teratoma of the ovary and peritoneal implants consistent with gliomatosis peritonei. This is the first case report in which random-start COS and in vivo oocyte retrieval were performed.

No MeSH data available.


Related in: MedlinePlus