Skip to main content
SpringerLink
Log in

Live births after in vitro maturation of oocytes in women who had suffered adnexal torsion and unilateral oophorectomy following conventional ovarian stimulation

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To report the first successful application of in vitro maturation (IVM) of oocytes resulting in live births in two anovulatory women who had suffered oophorectomy following ovarian torsion after stimulation with gonadotropins.

Methods

Data abstraction was performed from medical records of two subfertile women with excessive functional ovarian reserve. Both women had previously received gonadotropins for ovulation induction or ovarian stimulation, resulting in ovarian torsion. They were offered IVM of oocytes retrieved from antral follicles after mild ovarian stimulation, insemination of mature oocytes using ICSI, and embryo transfer. Outcome measures were the incidence of complications and live birth after fertility treatment.

Results

Transvaginal retrieval of cumulus-oocyte complexes from a unique ovary was conducted. One patient had a singleton live birth after vitrified-warmed embryo transfer in the second IVM cycle. The other patient had a singleton live birth after transfer of a fresh blastocyst in her first IVM cycle.

Conclusions

Although approaches have been developed to prevent ovarian hyperstimulation syndrome (OHSS) and to increase the safety profile of fertility treatment in predicted high responders, women with an excessive functional ovarian reserve may have a non-negligible risk of ovarian torsion. For these patients, IVM should be considered as a safer alternative approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

All data were obtained from chart review and are available from the corresponding author (M.D.V.) on request.

Code availability

Not applicable.

References

  1. Bodri D, Guillén JJ, Trullenque M, Schwenn K, Esteve C, Coll O. Early ovarian hyperstimulation syndrome is completely prevented by gonadotropin releasing-hormone agonist triggering in high-risk oocyte donor cycles: a prospective, luteal-phase follow-up study. Fertil Steril. 2010;93:2418–20.

    Article  CAS  Google Scholar 

  2. Zhu Q, Chen Q, Wang L, Lu X, Lyu Q, Wang Y, et al. Live birth rates in the first complete IVF cycle among 20 687 women using a freeze-all strategy. Hum Reprod. 2018;33:924–9.

    Article  Google Scholar 

  3. Drakopoulos P, Blockeel C, Stoop D, Camus M, De Vos M, Tournaye H, et al. Conventional ovarian stimulation and single embryo transfer for IVF/ICSI. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos? Hum Reprod. 2016;31:370–6.

    PubMed  Google Scholar 

  4. Gorkemli H, Camus M, Clasen K. Adnexal torsion after gonadotrophin ovulation induction for IVF or ICSI and its conservative treatment. Arch Gynecol Obstet. 2002;267:4–6.

    Article  CAS  Google Scholar 

  5. Mostinckx L, Segers I, Belva F, Buyl R, Santos-Ribeiro S, Blockeel C, et al. Obstetric and neonatal outcome of ART in patients with polycystic ovary syndrome: IVM of oocytes versus controlled ovarian stimulation. Hum Reprod. 2019;34:1595–607.

    Article  CAS  Google Scholar 

  6. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11:307–11.

    Article  CAS  Google Scholar 

  7. Santos-Ribeiro S, Mackens S, Racca A, Blockeel C. Towards complication-free assisted reproduction technology. Best Pract Res Clin Endocrinol Metab. 2019;33:9–19.

    Article  Google Scholar 

  8. Lind T, Holte J, Olofsson JI, Hadziosmanovic N, Gudmundsson J, Nedstrand E, et al. Reduced live-birth rates after IVF/ICSI in women with previous unilateral oophorectomy: results of a multicenter cohort study. Hum Reprod. 2018;33:238–47.

    Article  Google Scholar 

  9. Mashiach S, Bider D, Moran O, Goldenberg M, Ben-Rafael Z. Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril. 1990;53:76–80.

    Article  CAS  Google Scholar 

  10. Oelsner G, Cohen SB, Soriano D, Admon D, Mashiach S, Carp H. Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod. 2003;18:2599–602.

    Article  Google Scholar 

  11. Weitzman VN, DiLuigi AJ, Maier DB, Nulsen JC. Prevention of recurrent adnexal torsion. Fertil Steril. 2008;90:2018–20.

    Article  Google Scholar 

  12. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Fertil Steril. 2004;81:19–25.

    Google Scholar 

  13. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110:364–79.

    Article  Google Scholar 

  14. Nastri CO, Teixeira DM, Moroni RM, Leitão VM, Martins WP. Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention. Ultrasound Obstet Gynecol. 2015;45:377–93.

    Article  CAS  Google Scholar 

  15. Braam SC, de Bruin JP, Mol BWJ, van Wely M. The perspective of women with an increased risk of OHSS regarding the safety and burden of IVF: a discrete choice experiment. Hum Reprod Open. 2020;hoz034. https://doi.org/10.1093/hropen/hoz034.

  16. De Vos M, Smitz J, Thompson JG, Gilchrist RB. The definition of IVM is clear-variations need defining. Hum Reprod. 2016;31:2411–5.

    Article  Google Scholar 

  17. Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril. 1994;62:353–62.

    Article  CAS  Google Scholar 

  18. Fadini R, Dal Canto MB, Mignini Renzini M, Brambillasca F, Comi R, Fumagalli D, et al. Effect of different gonadotrophin priming on IVM of oocytes from women with normal ovaries: a prospective randomized study. Reprod BioMed Online. 2009;19:343–51.

    Article  CAS  Google Scholar 

  19. Zheng X, Guo W, Zeng L, Zheng D, Yang S, Wang L, et al. Live birth after in vitro maturation versus standard in vitro fertilisation for women with polycystic ovary syndrome: protocol for a non-inferiority randomised clinical trial. BMJ Open. 2020;10:e035334.

    Article  Google Scholar 

  20. Fadini R, Comi R, Mignini Renzini M, Coticchio G, Crippa M, De Ponti E, et al. Anti-Mullerian hormone as a predictive marker for the selection of women for oocyte in vitro maturation treatment. J Assist Reprod Genet. 2011;28:501–8.

    Article  Google Scholar 

  21. Guzman L, Adriaenssens T, Ortega-Hrepich C, Albuz FK, Mateizel I, Devroey P, et al. Human antral follicles <6 mm: a comparison between in vivo maturation and in vitro maturation in non-hCG primed cycles using cumulus cell gene expression. Mol Hum Reprod. 2013;19:7–16.

    Article  CAS  Google Scholar 

  22. Siristatidis C, Sergentanis TN, Vogiatzi P, Kanavidis P, Chrelias C, Papantoniou N, et al. In vitro maturation in women with vs. without polycystic ovarian syndrome: a systematic review and meta-analysis. PLoS One. 2015;10:e0134696.

    Article  Google Scholar 

  23. Sánchez F, Le AH, Ho VNA, Romero S, Van Ranst H, De Vos M, et al. Biphasic in vitro maturation (CAPA-IVM) specifically improves the developmental capacity of oocytes from small antral follicles. J Assist Reprod Genet. 2019;62:353–10.

    Google Scholar 

  24. Mackens S, Pareyn S, Drakopoulos P, Deckers T, Mostinckx L, Blockeel C, et al. Outcome of in vitro oocyte maturation (IVM) in patients with PCOS: does phenotype have an impact? Hum Reprod. 2020;35:2272–9.

    Article  Google Scholar 

  25. Vuong LN, Ho VNA, Ho TM, Dang VQ, Phung TH, Giang NH, et al. In-vitro maturation of oocytes versus conventional IVF in women with infertility and a high antral follicle count: a randomized non-inferiority controlled trial. Hum Reprod. 2020;35:2537–47.

    Article  CAS  Google Scholar 

  26. Ho VNA, Braam SC, Pham TD, Mol BW, Vuong LN. The effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilization in women with a high antral follicle count. Hum Reprod. 2019;34:1055–64.

    Article  Google Scholar 

  27. Walls ML, Ryan JP, Keelan JA, Hart R. In vitro maturation is associated with increased early embryo arrest without impairing morphokinetic development of useable embryos progressing to blastocysts. Hum Reprod. 2015;30:1842–9.

    Article  CAS  Google Scholar 

  28. Giulini S, Dante G, Xella S, La Marca A, Marsella T, Volpe A. Adnexal torsion during pregnancy after oocyte in vitro maturation and intracytoplasmic sperm injection cycle. Case Rep Med. 2010;2010:141875. https://doi.org/10.1155/2010/141875.

Download references

Funding

Dóra Vesztergom received an Erasmus+ grant as a contribution to her travel and subsistence costs (grant number: 19/1/KA103/060095/SMP /STT).

Author information

Authors and Affiliations

  1. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 109, Brussels, Belgium

    Dóra Vesztergom, Ingrid Segers, Linde Mostinckx, Christophe Blockeel & Michel De Vos

  2. Centre for Assisted Reproduction, Clinic of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary

    Dóra Vesztergom

  3. Department of Obstetrics and Gynaecology, University of Zagreb-School of Medicine, Zagreb, Croatia

    Christophe Blockeel

  4. Follicle Biology Laboratory (FOBI), UZ Brussel, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium

    Michel De Vos

  5. Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Sechenov University, Moscow, Russia

    Michel De Vos

Authors
  1. Dóra Vesztergom
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ingrid Segers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linde Mostinckx
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christophe Blockeel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michel De Vos
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

D.V. and M.D.V. drafted the manuscript. All the other authors critically reviewed the manuscript and approved the final version.

Corresponding author

Correspondence to Michel De Vos.

Ethics declarations

Ethics approval

Publication of this case series was approved by the local ethical committee (no. B1432020000125).

Consent to participate

Patients signed informed consent regarding publishing their data.

Consent for publication

Patients signed informed consent regarding publishing their data.

Conflict of interest

D.V., I.S., L.M., and C.B. declare no competing interests. M.D.V. has received speaker honoraria from MSD, Ferring and Gedeon Richter, and a grant from MSD, outside the submitted work.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vesztergom, D., Segers, I., Mostinckx, L. et al. Live births after in vitro maturation of oocytes in women who had suffered adnexal torsion and unilateral oophorectomy following conventional ovarian stimulation. J Assist Reprod Genet 38, 1323–1329 (2021). https://doi.org/10.1007/s10815-021-02171-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-021-02171-8

Keywords

Search

Navigation