JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):115
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263749
P-103. Fertility preservation by ex vivo oocyte retrieval in a 17-year-old with bilateral borderline ovarian tumors: a case report
Rodrigo Guimarães Furtado1, Francisco Furtado Filho1, Reitan Ribeiro2, Ivana Rippel Hauer1, Gustavo Wandresen1, Luiza Sonaglio1, Fabricio Vieira Furtado1, Renato Nisihara1
1 Fertway Reprodução Humana - Curitiba - Paraná – Brasil
2 Hospital Erasto Gaertner - Curitiba - Paraná - Brasil
Objective: To report a case of fertility preservation using ex vivo oocyte retrieval following controlled ovarian stimulation in an adolescent patient undergoing bilateral oophorectomy for asynchronous borderline ovarian tumors.
Methods: A 17-year-old nulligravid patient was initially diagnosed with a left-sided serous borderline ovarian tumor and underwent laparoscopic left salpingo-oophorectomy. One year later, imaging revealed a new lesion in the contralateral ovary. Given the indication for right salpingo-oophorectomy and the patient's desire for fertility preservation, ex vivo oocyte retrieval was planned. Controlled ovarian stimulation followed a Progestin-Primed Ovarian Stimulation (PPOS) protocol, using follitropin delta (Rekovelle®) 10 μg/day and menotropin (Menopur®) 150 IU/day for seven days. From day 8, Menopur was increased to 300 IU/day, while Rekovelle remained unchanged. Dydrogesterone (Duphaston®) 20 mg/day was started on day 1 to suppress premature LH surge. On day 11, eight follicles measuring 20–23 mm were identified. Final oocyte maturation was triggered on day 12 with triptorelin 0.3 mg (Gonapeptyl®), 36 hours before surgery. During laparoscopy, the right ovary was removed via Pfannenstiel incision using a protective retrieval bag. Ex vivo follicular aspiration was performed immediately under ultrasound guidance. The follicular fluid was placed in pre-warmed media and transported in a temperature-controlled device (TO 42®, 37±0.5°C) to the IVF lab, where oocytes were identified and vitrified. The patient and her legal guardians provided informed consent for both the procedure and case publication. The study was approved by the institutional ethics committee.
Results: Thirteen oocytes were retrieved, ten of which were mature (metaphase II) and vitrified; three were atretic. The procedure was uneventful, with precise coordination between surgical and laboratory teams, ensuring temperature stability and oocyte viability. This is the youngest patient reported to undergo ex vivo oocyte retrieval after controlled stimulation. Despite a slightly reduced ovarian reserve (AMH 0.86 ng/mL), the 17-year-old yielded 10 mature oocytes—an encouraging result. Although data on aneuploidy in adolescents are scarce, younger patients typically have lower rates of chromosomal abnormalities. According to Namath et al. (2025), with 10 mature oocytes, women under 35 have over a 75% chance of achieving at least one live birth. Given the patient's age and expected high euploidy rate, this outcome offers a meaningful chance of future biological motherhood.
Conclusion: This case illustrates the feasibility and safety of ex vivo oocyte retrieval for fertility preservation in an adolescent undergoing bilateral oophorectomy for asynchronous borderline ovarian tumors. The recovery of ten mature oocytes in a low-aneuploidy-risk context provides a meaningful chance of future biological motherhood. The report reinforces the importance of individualized fertility planning and timely coordination between oncology and reproductive medicine to expand reproductive options for young cancer patients.