A live birth from vitrified-warmed oocytes in a Philadelphia chromosome-positive acute lymphoid leukemia patient 5 years
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CASE REPORT
A live birth from vitrified-warmed oocytes in a Philadelphia chromosome-positive acute lymphoid leukemia patient 5 years following allogenic bone marrow transplantation and after a magnitude 9.0 earthquake in Japan Masakazu Doshida • Yukiko Nakajo Mayumi Toya • Koichi Kyono
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Received: 5 December 2012 / Accepted: 18 May 2013 Ó Japan Society for Reproductive Medicine 2013
Abstract Purpose To report a live birth from vitrified-warmed oocytes for a Philadelphia chromosome-positive acute lymphoid leukemia (Ph-ALL) patient. Methods A 20-year-old single woman with Ph-ALL requested oocyte cryopreservation at a private fertility clinic using assisted reproduction technology (ART). In cases of leukemia, there is a very short time before chemotherapy, follwed shortly by total body irradiation (TBI), and although she had already received the chemotherapy, ten oocytes were vitrified and stored for 59 months before warming. Soon after the oocyte cryopreservation, she received TBI and bone marrow transplant (BMT). During the storage, a magnitude 9.0 earthquake occurred making oocyte transport necessary. The embryo transfer was planned in a hormone replacement cycle, and intracytoplasmic sperm injection (ICSI) was performed on the vitrified-warmed oocytes. On day 3, two embryos were transferred. Results The patient became pregnant and delivered a healthy girl after ICSI using vitrified-warmed oocytes. Conclusions: Oocyte cryopreservation is the best option for fertility preservation of young single women with leukemia. Oncologists and gynecologists who conduct ART should cooperate to improve the quality of life of cancer patients. Keywords Earthquake Human oocyte Leukemia Transport Vitrification
M. Doshida (&) Y. Nakajo M. Toya K. Kyono Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai 980-0014, Miyagi, Japan e-mail: [email protected]
Introduction In 2012, an estimated 790,740 women were newly diagnosed with cancer [1]. The data regarding the survival rate of cancer in women of reproductive age are unclear; however, the survival rate of these patients is increasing. Notable improvements since 1975 in the relative 5-year survival rates are due to earlier diagnosis and improved treatments [2]. In particular, patients with hematological malignancies such as lymphoma and leukemia have high survival rates. Cancer treatments include surgery, chemotherapy, and radiotherapy; however, chemotherapy and radiotherapy may impact fertility in women of reproductive age. Thus, in recent years, the importance of reducing the side effects of treatment in these patients has increased; in addition, maintaining the quality of life (QOL) and fertility preservation has increased in importance. Oocyte cryopreservation is an attractive strategy for the preservation of fertility in women; it avoids surgery and there is no risk of cancer cell contamination. In particular, in hematopoietic cancer patients who are single and wish to use their future spouse’s sperm for fertilization, oocyte cryopreservation is the only fer
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