Live Birth Following Dibutyryl-cAMP-Enhanced Biphasic in Vitro Maturation of Ovarian Tissue Oocytes From a Patient With Ovarian Fibromatosis: A First Report.

Abstract

Case: A 23-year-old nulligravida with bilateral ovarian fibromatosis, amenorrhea, and severe ovulatory dysfunction was diagnosed via laparoscopic biopsy. As pregnancy was desired but transvaginal oocyte retrieval was not feasible due to dense fibrosis, partial ovarian resection was performed, and oocytes were obtained using ovarian tissue oocyte in vitro maturation (OTO-IVM).

Outcome: In the first OTO-IVM cycle with human chorionic gonadotropin (hCG) priming, 11 mature and 63 immature oocytes were retrieved. Mature oocytes underwent intracytoplasmic sperm injection (ICSI), whereas immature oocytes were cultured in vitro for maturation before ICSI. A total of 13 oocytes were fertilized, five embryos were cryopreserved, and one embryo transfer resulted in a biochemical pregnancy. At age 28, a second OTO-IVM using dibutyryl-cyclic AMP (dbcAMP)-enhanced biphasic IVM produced seven germinal vesicle oocytes; three matured to metaphase II, two fertilized, and one cleavage-stage embryo led to a live birth at 39 weeks of gestation.

Conclusion: This is the first documented live birth following dbcAMP-enhanced biphasic IVM of ovarian tissue-derived oocytes. These findings suggest that dbcAMP-enhanced biphasic IVM may be a feasible option when granulosa cell support is limited, offering a potential addition to fertility preservation strategies.