The use of ex-vivo in-vitro maturation of ovarian tissues oocytes (OTO-IVM) for fertility preservation in gynaecologic cancers

Background: Fertility preservation in ovarian tumours or advanced gynaecologic malignancies is often challenging. Traditional fertility preservation techniques, such as ovarian tissue cryopreservation or oocyte retrieval, may not always be suitable, especially in cases where immediate cancer treatment is necessary or where hormonal stimulation is contraindicated. Ex-vivo in-vitro maturation of ovarian tissue oocytes (OTO-IVM) offers a promising alternative in these women by enabling the retrieval and maturation of immature oocytes outside the body from the oophorectomy tissue specimen. Method: We present a case series of four women with gynaecologic malignancies who underwent ex-vivo oocyte retrieval and in-vitro maturation at the time of their oncologic surgeries. Conclusion: Evidence supporting live births following OTO-IVM remains limited, and as such, the technique is currently regarded as experimental. Nevertheless, for selected women in whom conventional fertility preservation is not feasible, OTO-IVM may provide the only opportunity for fertility preservation and warrants consideration.