Case Report Retrieval of immature oocytes followed by in vitro maturation and vitrification: A case report on a new strategy of fertility preservation in women with borderline ovarian malignancy Jack Y.J. Huang, William M. Buckett, Lucy Gilbert, Seang Lin Tan, Ri-Cheng Chian ⁎ Department of Obstetrics and Gynecology, McGill University Health Center, McGill University, Montreal, Quebec, Canada H3A 1A1 Received 22 December 2006 Available online 26 March 2007 Abstract Background. We report a novel fertility preservation strategy in a woman with borderline ovarian tumors involving retrieval of immature oocytes, in vitro maturation (IVM) and subsequent cryopreservation. Case. A 43-year-old woman underwent laparotomy for cystic ovarian masses on day 18 of her menstrual cycle. A diagnosis of bilateral borderline ovarian tumors was made following histological frozen section analysis. Left salpingo-oophorectomy, right ovarian cystectomy, omentectomy and lymph node sampling were performed. All visible follicles on the surface of the removed ovary were aspirated. Four immature oocytes were retrieved and underwent IVM. Three oocytes matured after 48 h and were cryopreserved. Conclusion. Immature oocytes can be successfully isolated from the oophorectomy specimen regardless of the day of menstrual cycle, matured in vitro and cryopreserved, providing a possible strategy for fertility preservation in this group of women. © 2007 Elsevier Inc. All rights reserved. Keywords: Borderline; Low malignant potential; Ovarian cancer; Malignancy; Fertility preservation; Cryopreservation; Oocyte; In vitro maturation; Vitrification Introduction Borderline or low malignant potential ovarian tumors account for 10% to 15% of all ovarian epithelial tumors. Standard management of borderline tumors is similar to that of malignant ovarian tumors and includes surgical staging, total hysterectomy (TH), bilateral salpingo-oophorectomy (BSO), omentectomy, lymph node sampling, peritoneal sampling and cytoreductive surgery. Given the fact that a third of borderline ovarian tumors are diagnosed in patients aged less than 40 years and 75% of these tumors present as FIGO stage 1 at the time of diagnosis, conservative surgery defined as surgery with complete staging but where the uterus and at least a part of one ovary are preserved has been advocated [1]. However, conservative surgery is not suitable for patients who previously had unilateral oophorectomy, those with bilateral bulky tumors or advanced stage disease. This group, as well as patients who are at high risk of recurrence in the conserved ovary, would benefit from additional strategies for fertility preservation. We report a novel possibility for fertility preservation in a woman with borderline ovarian tumors involving retrieval of immature oocytes from the oophorectomy specimen followed by in vitro maturation (IVM) of these oocytes and subsequent cryopreservation by vitrification. Case report A 43-year-old woman (gravida 1, para 0, aborta 1) under- went an explorative laparotomy for bilateral ovarian masses and a CA125 of 47 U/ml. Prior to the surgery, the patient was counseled about the risk of malignancy, but wished to preserve her fertility if possible. Intraoperative findings included a 8 × 8 × 6 cm right ovarian cyst and two cysts, measuring 4×3×3 cm and 2×2×2 cm respectively, in left ovary. The uterus appeared normal with no Gynecologic Oncology 105 (2007) 542 – 544 www.elsevier.com/locate/ygyno ⁎ Corresponding author. Women's Pavilion F3.46, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1. Fax: +1 514 843 1662. E-mail address: ri-cheng.chian@muhc.mcgill.ca (R.-C. Chian). 0090-8258/$ - see front matter © 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.ygyno.2007.01.036