Abstract
Objective(s)
In vitro maturation (IVM) of oocytes retrieved ex vivo from ovarian tissue (OTO-IVM)
could be an additional source of mature oocytes with the potential to optimise medical
fertility preservation (FP) after oophorectomy. It is often undertaken at the same
time as the ovarian tissue cryopreservation (OTC). In the presence of an organic ovarian
cyst, OTO-IVM could prove to be the only technique available to permit FP since ovarian
stimulation, transvaginal ovarian needle puncture or future ovarian tissue graft are
contraindicated. However, the presence of an organic cyst could alter follicular growth
and the number of retrievd oocytes. Our study aims to assess the efficiency of OTO-IVM
in such situations.
Study design
Retrospective, observational study involving 20 female patients with FP by OTO-IVM
between May 2017 and November 2021 at the University Hospital of Toulouse. Oocytes
retrieved “ex vivo” were transferred to an IVM medium with HP-hMG, LH and HSA and
then vitrified after 24 to 48 h of IVM. Data analysis was performed on the total population
and comparatively between patients who had or did not have an organic ovarian cyst.
Results
The indications included 15 oncologic and 5 non-oncologic indications. Ten had an
organic ovarian cyst on the retrieved ovary. The number of retrieved oocytes was 17.4+/−12.0
in the absence of cyst vs 4.1+/−6.3 in the presence (p = 0.003). The number of vitrified
mature oocytes was 5.8+/−5.3 in the absence vs 1.1+/−2.2 (median = 0) in the presence
of a cyst (p = 0.03). Ninety percent of the patients with an organic cyst had less
than two vitrified mature oocytes. The mean maturation rate was 34%, not significantly
different between the two groups. We found a correlation between serum AMH level and
the number of mature oocytes: ρ: 0.47 CI95 = [0.02; 0.76]; p = 0.04.
Conclusion(s)
OTO-IVM is an additional source of mature oocytes to optimise FP after oophorectomy.
However, in the presence of an organic ovarian cyst on the retrieved ovary, the exocrine,
paracrine and endocrine functions of the ovary are impaired. As such, the number of
immature oocytes obtained is highly impacted and appears to be insufficient to be
able to propose systematically this technique in such situations.
Keywords
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Article info
Publication history
Published online: December 26, 2022
Accepted:
December 24,
2022
Received in revised form:
July 21,
2022
Received:
March 29,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
