Pregnancy and birth after intracytoplasmic sperm injection of in vitro matured germinal-vesicle stage oocytes: case report

OBJECTIVE

To report a normal pregnancy and the delivery of a healthy child after the combination of in vitro maturation of germinal-vesicle stage oocytes and intracytoplasmic sperm injection (ICSI) in a patient.

SETTING

Procedures were performed in a tertiary IVF center coupled with an institutional research environment.

MAIN OUTCOME MEASURES

Maturation rate of immature oocytes after in vitro maturation and intactness, fertilization, and developmental rates of oocytes after microinjection.

RESULTS

Nine of 14 germinal-vesicle stage oocytes matured to the metaphase II stage after 30 hours of in vitro culture (64%). Seven of eight injected and intact oocytes fertilized normally (78%) and five of them cleaved with < 20% fragmentation (71%). Four embryos were transferred and a singleton pregnancy was obtained that ended in the delivery of a healthy child.

CONCLUSION

In vitro maturation of immature oocytes together with ICSI can result in normal fertilization, embryo development, pregnancy, and the delivery of healthy child.

Gardner syndrome and desmoid tumors

Desmoid tumours present difficult management problems in patients with Gardner's syndrome. We recently studied two patients with Gardner's syndrome, who developed a desmoid tumour arising of the abdominal wall and mesenteric root. One patient had a total resection of the mesenteric desmoid tumour followed by postoperative radiotherapy. No recurrence occurred in the last three years. The other patient had an incomplete resection and refused postoperative radiotherapy. Abdominal CT scan revealed tumour expansion 6 months postoperatively. From our experience and with respect to current literature, we suggest that complete surgical excision combined with radiotherapy (4.000-6.000 rads) could diminish the recurrence rate of desmoid tumours. When resection is incomplete or technically impossible, radiotherapy remains the second choice of treatment.