CPT® Code 0357T | Case2Code

Official Description

Cryopreservation; immature oocyte(s)

Common Language Description

Cryopreservation of immature oocyte(s) is a specialized procedure aimed at preserving a woman's fertility, particularly when she faces the risk of losing ovarian function due to medical treatments such as chemotherapy or radiation therapy for cancer. This process involves the collection of immature oocytes, which are the early developmental forms of eggs, from the ovaries. These oocytes are typically harvested during a separate surgical procedure, either from excised ovarian tissue or through aspiration from antral follicles, which are small fluid-filled sacs in the ovaries that contain the immature eggs. Notably, this collection does not necessitate hormone stimulation, making it a viable option for patients who may not be able to undergo traditional ovarian stimulation protocols. Once harvested, the immature oocytes are evaluated for quality, and a series of cryoprotectant solutions, specifically designed for oocyte preservation, are prepared. The cryopreservation process can utilize different techniques, including the traditional slow freezing method and the more contemporary vitrification method. In the slow freezing method, oocytes are gradually cooled through a series of solutions with increasing concentrations of cryoprotectant, ultimately reaching extremely low temperatures. In contrast, vitrification employs a high concentration of cryoprotectant to achieve a rapid freezing process that results in a glass-like state, preventing the formation of ice crystals that can damage the oocytes. After freezing, the oocytes are securely stored in labeled straws or vials, ensuring proper identification and traceability until they are required for future assisted reproduction procedures.

1. Indications

The procedure of cryopreservation of immature oocyte(s) is indicated for patients who are at risk of losing ovarian function due to specific medical conditions or treatments. The following are the primary indications for this procedure:

Cancer Treatment Patients undergoing chemotherapy or radiation therapy that may adversely affect ovarian function.
Ovarian Function Preservation Women seeking to preserve their fertility prior to surgical interventions that may compromise ovarian health.

2. Procedure

The cryopreservation of immature oocyte(s) involves several critical procedural steps that ensure the successful harvesting and preservation of oocytes. The following outlines the detailed steps of the procedure:

Step 1: Oocyte Harvesting The first step involves the collection of immature oocytes from the ovaries. This can be achieved through two methods: excising ovarian tissue or aspirating fluid from antral follicles. The procedure is performed without the need for hormone stimulation, making it suitable for patients who may not tolerate such treatments.
Step 2: Assessment of Oocytes After harvesting, the immature oocytes are carefully assessed for quality. This evaluation is crucial to determine the viability of the oocytes for subsequent cryopreservation.
Step 3: Preparation of Cryoprotectant Solutions A series of cryoprotectant solutions specifically formulated for oocytes are prepared. These solutions are essential for protecting the oocytes during the freezing process.
Step 4: Cryopreservation Techniques The harvested oocytes are subjected to one of two cryopreservation techniques. In the traditional slow freezing method, oocytes are gradually cooled through a series of solutions with increasing concentrations of cryoprotectant. Alternatively, in the vitrification method, a high concentration of cryoprotectant is used to achieve rapid freezing, resulting in a solid, glass-like state that prevents ice crystal formation.
Step 5: Storage of Oocytes Following the freezing process, the oocytes are securely stored in labeled straws or vials. Each container is marked with identifying information, including the patient's name and number, ensuring proper tracking and management of the specimens. The oocytes are then cooled to -270 degrees centigrade in a controlled rate freezing chamber and stored in either vapor phase or submerged under liquid nitrogen until they are needed for future assisted reproduction procedures.

3. Post-Procedure

After the cryopreservation procedure, patients can expect to undergo a period of monitoring and follow-up to ensure their overall health and well-being. The harvested oocytes remain stored until the patient is ready to utilize them in an assisted reproduction procedure. It is essential for patients to maintain communication with their healthcare providers regarding the timing and planning of future fertility treatments, as well as any potential changes in their medical condition that may affect their reproductive options.

Short Descr	CRYOPRESERVATION OOCYTE(S)
Medium Descr	CRYOPRESERVATION IMMATURE OOCYTE(S)
Long Descr	Cryopreservation; immature oocyte(s)
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Berenson-Eggers TOS (BETOS)	T2D - Other tests - other
MUE	Not applicable/unspecified.