In vitro maturation rates in young premenarche patients

The in vitro maturation yield in oocytes retrieved from premenarche patients undergoing ovarian tissue cryopreservation is low.

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Volume 112, Issue 2, Pages 315–322

Authors:

Gilad Karavani, M.D., Natali Schachter-Safrai, M.D., Ariel Revel, M.D., Talya Mordechai-Daniel, Ph.D., Dvora Bauman, M.D., Tal Imbar, M.D.

Abstract:

Objective

To evaluate in vitro maturation (IVM) efficacy and oocyte retrieval rates after ovarian tissue cryopreservation in young premenarche girls facing chemo- and radiotherapy.

Design

A retrospective cohort study.

Setting

University-affiliated tertiary medical center.

Patient(s)

A total of 84 chemotherapy-naïve patients ages 0–18 years referred for fertility preservation between 2004 and 2017: 33 premenarche and 51 postmenarche patients.

Intervention(s)

None.

Main Outcome Measure(s)

IVM in the pre- and postmenarche groups and in the subgroups of very young (up to age 5 years) and older (5–10 years) premenarche girls.

Results

The number of oocytes retrieved did not significantly differ between the postmenarche and premenarche groups (10.8 ± 8.5 and 8.1 ± 6.8, respectively). However, the overall IVM rate was significantly higher in the postmenarche group (28.2% vs. 15.5%, respectively; odds ratio = 0.47). A separate analysis for patients up to 5 years of age demonstrated significantly lower oocyte yield compared with the older (5–10 years) premenarche girls (4.7 ± 5.2 vs.10.3 ± 7.0 oocytes, respectively) and much lower IVM rates (4.9% and 18.2%, respectively). Correlation of age with number of retrieved and matured oocytes showed a positive significant correlation (r = 0.45 and r = 0.64, respectively).

Conclusions

IVM performed after ovarian tissue cryopreservation in premenarche girls and specifically in very young girls (4 years and younger) yields substantially decreased maturation rates compared with postmenarche patients, raising a question as to the utility of current IVM technique in this age group. Further studies are required to assess modification of the IVM technique for young girls.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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