Autotransplantation of Cryopreserved Ovarian Tissue in Oncological Patients: Recovery of Ovarian Function

Fabbri, Raffaella; Pasquinelli, Gianandrea; Magnani, Valentina; Macciocca, Maria; Vicenti, Rossella; Parazza, Isabella; Paradisi, Roberto; Battaglia, Cesare; Rossi, Stefania; Venturoli, Stefano

doi:10.2217/fon.13.234

Cited by 22 publications

(27 citation statements)

References 31 publications

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“…A summary of the initial data is presented in Table 2. Return to menstruation as one of the primary outcomes was reported to take place between 2 months [26, 28, 31, 35, 40] to 1 year after transplantation [38]. The onset of ovarian activity and hormonal function at the closest time after transplantation was 1 week; estradiol and FSH levels showed an increase and decrease patterns, respectively [41].…”

Section: Resultsmentioning

confidence: 99%

“…The onset of ovarian activity and hormonal function at the closest time after transplantation was 1 week; estradiol and FSH levels showed an increase and decrease patterns, respectively [41]. Some of the recipients, however, did not respond to transplantation [26, 28, 34, 36, 40]. For example, in Dittrich et al study, from 20 transplant recipients just one patient showed no activity after transplantation [17], whereas in one study about 50 percent of the patients exhibited ovarian function restoration after 12 months [28].…”

Section: Resultsmentioning

confidence: 99%

“…Some of the recipients, however, did not respond to transplantation [26, 28, 34, 36, 40]. For example, in Dittrich et al study, from 20 transplant recipients just one patient showed no activity after transplantation [17], whereas in one study about 50 percent of the patients exhibited ovarian function restoration after 12 months [28]. After second transplantation, ovarian function improved at 2–4 months post-transplantation and sustained for 9–84 months [42].…”

Section: Resultsmentioning

confidence: 99%

“…However, no significant differences between fresh and vitrification groups were observed [35]. In Fabbri’s study, approximately 30% of the follicles in the slow freezing group showed signs of degeneration, probably due to osmotic stress [28]. In general, reports have shown that the ratio of healthy follicles and primordial follicle density with the vitrification method is higher than in with slow freezing technique [13].…”

Section: Discussionmentioning

confidence: 99%

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Ovarian function and reproductive outcome after ovarian tissue transplantation: a systematic review

et al. 2019

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The aim of this systematic review study is to summarize the current knowledge of ovarian tissue transplantation and provide insight on ovarian function, fertility and reproductive outcome following ovarian tissue transplantation. Relevant studies were identified by searching through PubMed, Cochrane Library, Embase, ProQuest, and Scopus databases until August 2018. Ovarian function by examination of the hormonal level was evaluated, together with follicular growth, the return of menstrual cycle and assessment of reproductive consequences: pregnancy, miscarriage rates and live birth after transplantation. Studies including female patients aged between 22 and 49 years that were subjected to ovarian tissue transplantation were considered. A total of 1185 studies were identified in the primary search. Titles and abstracts were screened for assessment of the inclusion criteria. Finally, twenty-five articles met the criteria and were included in this study. In general, 70% of patients that underwent ovarian tissue transplantation had ovarian and endocrine function restoration as well as follicular growth. Pregnancy was reported with 52% of the patients. The available evidence suggests that ovarian tissue transplantation is a useful and an applied approach to restore hormonal function, endocrine balance and eventually fertility outcomes in patients that are predisposed to lose their fertility, diagnosed with premature ovarian failure (POF), as well as women undergoing cancer treatments. Identification of the techniques with the lowest invasions for follicular and oocyte development after ovarian tissue transplantation aiming to reduce probable adverse effects after treatment is indispensable.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ovarian function and reproductive outcome after ovarian tissue transplantation: a systematic review

et al. 2019

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“…However, the follicular development in graft sites and the recovery of ovarian function for more than 2 years after transplantation of ovarian tissue cryopreserved using the slow-freezing/rapid-thawing protocol, described in Fabbri et al [37], provides evidence of the feasibility of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Long-term storage does not impact the quality of cryopreserved human ovarian tissue

et al. 2016

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BackgroundOvarian tissue cryopreservation is an emerging technique, also addressed to very young cancer patients, for whom it is not possible to perform an ovarian stimulation for oocytes freezing, before gonadotoxic treatment. In this cases, ovarian tissue must be cryopreserved for a long period of time and it is very important to know if it maintains fertility function after a long period of storage. Here we aimed to assess the effect of long-term storage on preservation and viability of cryopreserved human ovarian tissue.MethodsDescriptive study of three cases of cancer patients whose cryopreserved ovarian tissue remained stored for 18 years. Long-term stored tissue was examined by histological and immunohistochemical analysis, transmission electron microscopy, TUNEL assay and LIVE/DEAD viability/citotoxicity test.ResultsOvarian tissue stored for 18 years showed a good morphology. Follicles presented negative staining for estrogen and progesterone receptors, positive staining for ki67 in granulosa cells and/or oocytes and for bcl2 in granulosa cells. Regarding stroma, patch/focal positive expression was found for estrogen receptor and ki67, diffusely positive expression for progesterone receptor and bcl2. After long-term storage, ultrastructural examination showed sub-cellular integrity of follicles and interstitial oedema foci. No apoptosis was observable by TUNEL assay. Stromal cell viability remained >97 % during the culture period.ConclusionThe evaluation of different aspects of the tissue provides evidence that the storage time does not impact on tissue quality and gives hope especially to cancer girls, whose tissues could remain cryopreserved for a very long time.

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Transplantation of frozen-thawed ovarian tissue: an update on worldwide activity published in peer-reviewed papers and on the Danish cohort

Gellert

Pors

Kristensen

et al. 2018

J Assist Reprod Genet

245

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This study found no indications of sufficient numbers of malignant cells present in the ovarian tissue to cause recurrence of cancer after OTT. Further, it is unlikely that OTC affects the well-being of children born. OTC is now an established method of fertility preservation in Denmark with public reimbursement. The current data encourage that women who require gonadotoxic treatment should be offered an individual evaluation considering fertility preservation.

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Autotransplantation of Cryopreserved Ovarian Tissue in Oncological Patients: Recovery of Ovarian Function

Abstract: Ovarian tissue cryopreservation and transplantation is a promising approach for preserving ovarian function in women with cancer.

Cited by 22 publications

References 31 publications

Ovarian function and reproductive outcome after ovarian tissue transplantation: a systematic review

Ovarian function and reproductive outcome after ovarian tissue transplantation: a systematic review

Long-term storage does not impact the quality of cryopreserved human ovarian tissue

Transplantation of frozen-thawed ovarian tissue: an update on worldwide activity published in peer-reviewed papers and on the Danish cohort

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