Twins born after transplantation of ovarian cortical tissue and oocyte vitrification

Objective: To present a combination of ovarian tissue and oocyte cryopreservation as an effective strategy for achieving pregnancy in a breast cancer patient. Design: Case report. Setting: Tertiary care university-affiliated hospital, tissue bank, and infertility clinic. Patient(s): A 36-year-old patient diagnosed with atypical medullar breast cancer and negative for estrogen, P, and HER2 receptors underwent ovarian tissue cryopreservation before receiving chemotherapy and radiotherapy. Intervention(s): Laparoscopic ovarian cortex extraction, ovarian tissue cryopreservation, ovarian tissue thawing and transplantation, controlled ovarian stimulation (COS), oocyte retrieval, vitrification and IVF, and embryo culture and replacement. Main Outcome Measure(s): Resumption of spontaneous ovarian function after transplantation, response to COS, oocyte vitrification, IVF, pregnancy, and delivery. Result(s): Menses occurred 63 days after transplantation. Sixteen mature oocytes were obtained in four COS procedures. All vitrified oocytes survived warming, and 77.7% were fertilized. Two day 3 embryos were replaced, and two healthy boys were born at 34 weeks. Conclusion(s): Ovarian tissue cryopreservation and grafting preserves fertility. Simultaneous oocyte vitrification increases the success of assisted reproductive technology in poor-prognosis patients and avoids the consequences of the short lifespan of the transplanted tissue. (Fertil Steril (R) 2010;93:268.e11-e13. (C)2010 by American Society for Reproductive Medicine.)