Fertility preservation using controlled ovarian hyperstimulation and oocyte cryopreservation in a premenarcheal female with myelodysplastic syndrome.

OBJECTIVE To report the first case of fertility preservation in a premenarcheal female by use of controlled ovarian hyperstimulation and oocyte cryopreservation. DESIGN Case report. SETTING Reproductive endocrinology and infertility unit of a tertiary care university-based medical center. PATIENT(S) A 13-year-old premenarcheal female with Tanner stage 3 breast development and Tanner stage 1 pubic hair diagnosed with myelodysplastic syndrome, referred by her medical oncologist for fertility preservation before undergoing a potentially sterilizing antineoplastic therapy. INTERVENTION(S) Evaluation of ovarian reserve, ovarian stimulation, transvaginal oocyte aspiration, in vitro maturation of immature oocytes, and oocyte cryopreservation. MAIN OUTCOME MEASURE(S) Cryopreservation of mature oocytes. RESULT(S) Successful controlled ovarian hyperstimulation allowed for the cryopreservation of 18 mature oocytes before the patient's gonadotoxic treatment. The oocyte retrieval and cryopreservation did not delay the patient's planned chemotherapy. CONCLUSION(S) Ovarian stimulation and oocyte cryopreservation can be successfully performed in premenarcheal/peripubertal patients, thus providing a viable alternative to ovarian tissue freezing for fertility preservation in the pediatric population.