Alvarez Manuel, Solé Miquel, Devesa Marta, Fábregas Rafael, Boada Montserrat, Tur Rosa, Coroleu Buenaventura, Veiga Anna, Barri Pedro N
Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
Reprod Biomed Online. 2014 Jun;28(6):663-8. doi: 10.1016/j.rbmo.2014.02.010. Epub 2014 Mar 4.
This article reports the live birth of a healthy newborn using vitrified-warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after insemination of warmed oocytes. Eighteen days after the transfer, she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. As far as is known, this is the first live birth reported through vitrified-warmed oocytes in a patient with invasive ovarian cancer. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, controversial issues are discussed. Fertility preservation is a proven possibility in some cancer patients according to their age, disease and time available until the beginning of their oncological treatment. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, no live birth has been reported. We report the live birth of a healthy newborn through vitrified-warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after the insemination of the warmed oocytes. Eighteen days after the transfer she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. To our knowledge, this is the first live birth reported using vitrified-warmed oocytes in invasive ovarian cancer. Controversial issues are reviewed and discussed.
本文报道了一名患有浸润性黏液性卵巢癌（Ic期）的年轻患者通过玻璃化冷冻复苏卵母细胞成功分娩出一名健康新生儿的案例。诊断是在腹腔镜下左侧附件切除术后进行的。她接受了两个周期的卵巢刺激，在进行保留子宫的保留生育功能手术前，14枚卵母细胞被玻璃化冷冻。一年后，在对复苏的卵母细胞进行授精后，移植了两枚胚胎。移植18天后，因腹痛、阴道出血和腹腔积血，她接受了剖腹手术。诊断为子宫右侧宫角异位妊娠，并进行了楔形切除术以解决该问题。一周后，超声检查确认宫内妊娠存活。妊娠38周时进行了选择性剖宫产，分娩出一名体重2650克的健康男婴。据我们所知，这是首例通过玻璃化冷冻复苏卵母细胞在浸润性卵巢癌患者中实现的活产报道。尽管在高度选择的卵巢癌病例中，卵母细胞玻璃化冷冻是一种可考虑用于保留生育功能的方法，但仍存在一些有争议的问题。根据癌症患者的年龄、疾病情况以及开始肿瘤治疗前的可用时间，保留生育功能在一些癌症患者中已被证实是可行的。尽管在高度选择的卵巢癌病例中，卵母细胞玻璃化冷冻是一种可考虑用于保留生育功能的方法，但此前尚未有活产报道。我们报道了一名患有浸润性黏液性卵巢癌（Ic期）的年轻患者通过玻璃化冷冻复苏卵母细胞成功分娩出一名健康新生儿的案例。诊断是在腹腔镜下左侧附件切除术后进行的。她接受了两个周期的卵巢刺激，在进行保留子宫的保留生育功能手术前，14枚卵母细胞被玻璃化冷冻。一年后，在对复苏的卵母细胞进行授精后，移植了两枚胚胎。移植18天后，因腹痛、阴道出血和腹腔积血，她接受了剖腹手术。诊断为子宫右侧宫角异位妊娠，并进行了楔形切除术以解决该问题。一周后，超声检查确认宫内妊娠存活。妊娠38周时进行了选择性剖宫产，分娩出一名体重2650克的健康男婴。据我们所知，这是首例在浸润性卵巢癌中使用玻璃化冷冻复苏卵母细胞实现活产的报道。对有争议的问题进行了回顾和讨论。
