Intergenerational Gestational Surrogacy In A Patient With Ovarian Dysgerminocarcinoma
In the appropriate clinical setting, women desiring future fertility with a diagnosis of ovarian cancer without the option of ovarian-sparing surgery may be candidates for controlled ovarian hyperstimulation for the purposes of fertility preservation, especially if altruistic gestational carriers are available and willing.
KEY FINDINGS: In the appropriate clinical setting, women desiring future fertility with a diagnosis of ovarian cancer without the option of ovarian-sparing surgery may be candidates for controlled ovarian hyperstimulation for the purposes of fertility preservation, especially if altruistic gestational carriers are available and willing.
BACKGROUND: Ovarian cancer in young women that has progressed to Stage 1B or beyond compromises patients' reproductive options to have genetically related offspring. A case of a successful pregnancy from oocytes stimulated and retrieved from an affected ovary before staging surgery, with the patient's mother acting as a gestational carrier was reported.
DETAILS: A 20-year-old woman was diagnosed with an ovarian dysgerminoma on the right ovary and underwent fertility-preserving right salpingo-oophorectomy and staging. Eight months later she was found to have a left ovarian solid mass. She underwent controlled ovarian hyperstimulation and oocyte cryopreservation before total abdominal hysterectomy, left salpingo-oophorectomy, and exploratory surgery were performed. The patient was optimally debulked, with no recurrent cancer to date. Thirty-six oocytes were mature and cryopreserved using vitrification. Now, the patient's mother has undergone embryo transfer that resulted in a clinical pregnancy, acting as a gestational carrier, for her daughter. To our knowledge, this is the first case describing the uterine transfer of embryos into a gestational carrier where the embryos were generated using oocytes obtained through controlled ovarian hyperstimulation in the context of active ovarian cancer.
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Source: Morris, J. M., Tillmanns, T. D., Brezina, P. R., et al. (2021). Intergenerational Gestational Surrogacy In A Patient With Ovarian Dysgerminocarcinoma. Intl J Gynecol Obstet.. 2021; 156(1): 55-63. Published: January, 2022. DOI: 10.1002/ijgo.13824.
