Retrieval of immature oocytes after chemotherapy for Hodgkin's disease and prolonged ovarian down-regulation with gonadotropin-releasing hormone agonist

Objective To describe isolation and in vitro maturation of primary oocytes from the ovarian cortex in the presence of hypothalamic pituitary down-regulation. Design Case report. Setting Tertiary care university-affiliated hospital. Patient(s) An 18-year-old patient was given treatment with the ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine) protocol for Hodgkin's disease. She underwent ovarian tissue cryopreservation while being cotreated with GnRH agonist because of disease relapse. Intervention(s) Laparoscopic oophorectomy, ovarian tissue cryopreservation, and in vitro maturation of primary oocytes. Main Outcome Measure(s) Maturation of primary oocytes isolated from the medium used for preparation of ovarian tissue. Result(s) Twenty-one immature germinal vesicle–stage oocytes were isolated from the medium of dissection. All were incubated in in vitro maturation medium, and five were maturated and frozen. Conclusion(s) The fact that germinal vesicle–stage oocytes were present in our patient's medium despite hormonal down-regulation demonstrates that GnRH agonist does not completely inhibit antral follicle development.