Premature ovarian insufficiency caused by the treatment of an ovarian malignant mixed germ cell tumor: a case report

Abstract

This is the case of a 17-year old female patient to whom a left ovariectomy and chemotherapy was carried out because of a left ovarian malignant mixed germ cell tumor when she was 6 years old, who now visited our clinic for fertility preservation. After examination she was diagnosed with premature ovarian insufficiency (POI) and had lost the chance of fertility preservation. We preferred and finally decided to optimize the sequential hormone replacement therapy by using estradiol (14 days) in the first phase and estradiol + dydrogesterone (14 days) in the second phase. This patient was a child when she incurred in an iatrogenic POI. For this situation the only possible fertility preservation method would have been ovarian tissue cryopreservation; however, she and her family were not informed about this option, which should have been performed before chemotherapy. If she would have come to our center of tissue preservation, maybe she still would have had the chance to preserve her fertility. Before proceeding with treatments that may lead to POI, doctors should inform patients of the possible reproductive consequences; and in her case, inform the family of the possible fertility preservation methods.