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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