Feasibility and Safety of Intraoperative Oocyte Retrieval in Patients With Ovarian Tumor: Results From the Japan Oncofertility Registry

ABSTRACT Purpose To evaluate the clinical utility and safety of intraoperative oocyte retrieval (IOR) as a fertility preservation (FP) strategy for patients with ovarian tumors using data from the Japan Oncofertility Registry (JOFR). Methods This retrospective study analyzed data from 226 patients with ovarian tumors registered in the JOFR between November 2018 and July 2024. Among them, 49 patients received FP and oncologic treatment at the same institution, and 10 underwent IOR. Tumor characteristics, stimulation methods, retrieval procedures, oocyte yield, complications, recurrence, and pregnancy outcomes were reviewed. Results Patients were aged 21–35 years, and histological types varied. IOR was performed in vivo in four patients, ex vivo in two, and using both approaches in two, whereas two patients underwent transvaginal oocyte retrieval under general anesthesia. No intraoperative complications were observed. Tumor recurrence occurred in only one metastatic case. Oocyte yield was limited. One patient conceived through timed intercourse, whereas a pregnancy achieved using cryopreserved oocytes resulted in miscarriage. Conclusions IOR was technically feasible and safely performed in patients with ovarian tumors, with no retrieval‐related complications or tumor recurrence. Although reproductive efficacy remains unclear, IOR may be considered a feasible FP option when conventional approaches are difficult to apply.