In vitro maturation of germinal vesicle oocytes recovered after premature luteinizing hormone surge: description of a novel approach to fertility preservation.

OBJECTIVE: To report a novel approach to fertility preservation by in vitro maturation and embryo cryopreservation after LH surge and ovulation.

DESIGN: Case report.

SETTING: Two university-based reproductive endocrinology clinics.

PATIENT(S): Forty-year-old woman with breast cancer seeking fertility preservation before chemotherapy.

INTERVENTION(S): The plan was ovarian stimulation and retrieval of mature oocytes, followed by IVF; however, premature LH surge and ovulation occurred before oocyte retrieval. Because no mature oocyte was recovered, follicles <10 mm in diameter were also aspirated.

MAIN OUTCOME MEASURE(S): Recovery of immature oocytes after ovulation, in vitro maturation of these oocytes, and fertilization and vitrification of generated embryos.

RESULT(S): Four immature oocytes were recovered, and two matured in vitro. After fertilization with intracytoplasmic sperm injection, embryos progressed to the four-cell stage on day 2 and were vitrified for future use.

CONCLUSION(S): This case illustrates that under time constraints, immature oocytes can be recovered after ovulation and used to generate embryos for fertility preservation.