The first birth of a child, by a woman with breast cancer after thawing of immature cryopreserved oocytes

The issue of fertility preservation (FP) in young cancer patients has become an important issue. Although many techniques have been developed, vitrification of fertilized or unfertilized eggs recovered after controlled ovarian stimulation, prior to cancer treatment, is now the most established and effective method of maintaining female fertility.

When ovarian stimulation is not possible or contraindicated, cryopreservation of the ovaries or vitrification of eggs / embryos after in vitro maturation (IVM) of eggs recovered from small follicles may be alternatives. The place of IVF in the strategy of women FPs has recently been discussed.

We herein report the case of a 29-year-old nulligravida woman diagnosed with left grade III invasive ductal carcinoma. The tumor was positive for both estrogen receptors and progesterone and negative for Her2 overexpression. After left tumorectomy with sentinel node biopsy (1N+/4), adjuvant chemotherapy was scheduled 3 weeks later.

17 small follicles were detected by vaginal ultrasound on the 16th day of the cycle before counseling to maintain fertility. Due to the contraindication of ovarian stimulation for oncological purposes, the patient was offered oocyte vitrification after maturation of eggs (IVM) in the laboratory in combination with ovarian cryopreservation.

Seven immature oocytes were retrieved and were matured and vitrified in the laboratory. Five years later, the patient experienced infertility. The pregnancy was approved by the oncology team, but the patient was advised to avoid ovarian stimulation.

Therefore, the multidisciplinary decision was the re-utilization of cryopreserved oocytes as a first choice. The six oocytes were thawed and all survived the procedure, allowing fertilization with Intracytoplasmic Sperm Injection (ICSI) technique. Five embryos were created and one of them was transferred to the uterus. The patient became pregnant and gave birth to a healthy baby boy.

This is the first live birth achieved using vitrification and in vitro egg maturation (IVM) to maintain fertility (FP) in a woman with cancer. This approach was based on the inability to perform ovarian stimulation based on the patient’s oncological history. Therefore, IVM should be considered as a viable and effective choice in the strategy for women to maintain fertility.

The article was published in Analls of Oncology.

Do you think that this technique could be used by any woman who does not want to use hormones for in vitro fertilization?

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Hair sample tests may give women more accurate fertility predictions

Women wanting to know how many eggs they have left may in future be able to have their hair tested to reveal their hormone levels.

A signalling chemical related to women’s fertility called anti-Müllerian hormone (AMH) is incorporated into hair shafts while they are still underneath the skin. Testing the hair may give a better indication of fertility than current blood tests.

AMH is released by eggs in the ovaries, the number of which decline with age. Blood AMH levels broadly correlate with how many eggs a woman has left, and therefore how long it will be before she stops being fertile.

Some firms offer AMH blood testing for any woman trying to get pregnant – although doctors’ bodies have warned that for the general population, it isn’t a good indicator of how likely someone is to conceive. But for people having IVF, it does predict which women are likely to respond well or poorly to stimulation of their ovaries, according to the European Society of Human Reproduction and Embryology.


In future, women may be able to send off a hair sample for testing, instead of having a blood sample taken. In a group of 152 women aged between 18 and 65, hair AMH levels correlated with levels in their blood, and with the number of eggs present in their ovaries as seen by an ultrasound scan – but hair levels of the hormone tracked age better than blood levels, suggesting the hair test may be more accurate.

Hormone levels in hair may be a better indicator of longer-term average blood levels than a one-off blood sample, says Sarthak Sawarkar at US fertility company MedAnswers, who did the study. “Hair is a medium that can accumulate biomarkers over several weeks, while hormone levels in blood can fluctuate rapidly in response to stimuli,” he said in a statement.

The work was presented at this year’s online meeting of the European Society of Human Reproduction and Embryology.