Oocyte cryopreservation in a patient with sickle cell disease prior to hematopoietic stem cell transplantation: first report

J Assist Reprod Genet. 2012 Mar;29(3):265-9. doi: 10.1007/s10815-011-9698-2. Epub 2012 Jan 5.

Abstract

Purpose: To report the first occurrence of successful ovarian stimulation, oocyte retrieval and oocyte cryopreservation for fertility preservation in an adolescent with severe sickle cell disease scheduled to undergo a hematopoietic stem cell transplant

Methods: Case report.

Results: A 19 year old female with severe sickle cell disease presented for fertility preservation counseling prior to hematopoietic stem cell transplantation. She ultimately underwent ovarian stimulation using a minimal stimulation GnRH antagonist protocol resulting in the successful banking of oocytes prior to transplant. The unique hazards associated with ovarian stimulation in patients with sickle cell disease, such as thrombosis and vaso-occlusive events, are discussed and the methods undertaken to minimize these risks are described.

Conclusions: Controlled ovarian hyperstimulation and oocyte banking for fertility preservation is feasible in young women with sickle cell disease requiring hematopoietic stem cell transplant and deserves further investigation. Given the elevated risk of thrombosis and predisposition to painful vaso-occlusive events, controlled ovarian hyperstimulation in patients with sickle cell disease is not straightforward and requires a multi-disciplinary team approach to adequately address and minimize the risks in this unique patient population.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Sickle Cell / physiopathology
  • Anemia, Sickle Cell / therapy*
  • Cryopreservation*
  • Female
  • Fertility Preservation*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Oocyte Retrieval / adverse effects*
  • Oocytes*
  • Ovulation Induction / adverse effects*
  • Ovulation Induction / methods
  • Severity of Illness Index
  • Young Adult