Triple stimulation (TriStim) before bilateral oophorectomy in a young woman with ovarian cancer: a case report and review of the literature

Fertility Research and Practice

Paula C. Brady¹  Laura C. Gemmell²  Jason D. Wright³ 

[1] Department of Obstetrics and Gynecology, Columbia University Fertility Center, Columbia University Irving Medical Center, New York, USA;Department of Obstetrics and Gynecology, Columbia University Irving Medical Center/New York Presbyterian Hospital, 622 west 168th street, 10032, New York, NY, USA;Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbia University Irving Medical Center, New York, USA;

关键词: Double ovarian stimulation;    DuoStim;    Fertility preservation;    Oncofertility;    Triple stimulation;    TriStim;   

DOI  :  10.1186/s40738-020-00087-y

来源: Springer

【 摘 要 】

BackgroundDouble ovarian stimulation (DuoStim) involves two rounds of controlled ovarian stimulation (COS) and oocyte retrieval in immediate succession. It represents a promising approach to increase oocyte yield for patients with diminished ovarian reserve or those with limited time before fertility-threatening oncologic treatment. We report the case of a 31-year-old woman with Stage IC endometrioid ovarian cancer who underwent a triple stimulation or “TriStim,” completing three rounds of COS and oocyte retrieval within 42 days prior to bilateral salpingo-oophorectomy.Case presentationA 31 year old nulligravid woman presented for fertility preservation counseling following a bilateral ovarian cystectomy that revealed Stage IC endometroid adenocarcinoma arising within endometrioid borderline tumors. The patient was counseled for bilateral salpingo-oophorectomy, lymph node dissection, and omentectomy followed by three cycles of carboplatin/paclitaxel. Prior to this, all within six weeks, the patient underwent three rounds of controlled ovarian stimulation using an antagonist protocol and human chorionic gonadotropin (hCG) trigger, resulting in vitrification of nine two-pronuclear zygotes (2PN), after which definitive surgery was performed.ConclusionsAdvantages of DuoStim procedures are increasingly recognized, especially for oncology patients with limited time before potentially sterilizing cancer treatment. To our knowledge, this is the first report of a triple stimulation (“TriStim”). Our case highlights that triple stimulation is a viable option for patients needing urgent fertility preservation in order to maximize egg and embryo yield within a limited time period.

【 授权许可】

CC BY