Heterotopic Ovarian Tissue Transplantation

Soares, Michelle; Dolmans, Marie-Madeleine; Donnez, Jacques

doi:10.1007/978-4-431-55963-4_7

Cited by 2 publications

(1 citation statement)

References 62 publications

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“…Once full cancer recovery is achieved, thawed tissues can be transplanted back into the patient who wishes to have a baby [69]. Ovarian tissue can be transplanted orthotopically (ie, into the pelvic cavity in or near the remaining ovary) or heterotopically (ie, extrapelvically into the forearm or the abdomen for example), the former technique being associated with greater success rates [70][71][72][73].…”

Section: Introductionmentioning

confidence: 99%

Development of Ovarian Tissue Autograft to Restore Ovarian Function: Protocol for a French Multicenter Cohort Study (Preprint)

Pretalli¹,

Franck²,

Pazart³

et al. 2018

Preprint

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BACKGROUND Sterility is a major late effect of radiotherapy and chemotherapy treatments. Iatrogenic sterility is often permanent and greatly impacts long-term quality of life. Ovarian tissue cryopreservation (OTC) performed before gonadotoxic treatments with subsequent autograft is a method of fertility preservation available for girls and women. Its application in prepubertal girls is of particular value as it is the only possible approach in this patient group. In addition, it does not require a delay in cancer therapy and no ovarian stimulation is needed. OBJECTIVE The primary aim of this protocol is to help increase the implementation of ovarian tissue autografting in France. Knowledge is still lacking regarding the efficacy of ovarian transplantation in restoring ovarian function and regarding the safety of this procedure, especially the risk of cancer cell reseeding in certain types of cancer. A secondary aim of this study is to generate data to improve our understanding of these two essential aspects. METHODS The DATOR (Development of Ovarian Tissue Autograft in Order to Restore Ovarian Function) study is ongoing in 17 university hospitals. The DATOR protocol includes the autograft of ovarian cortex fragments. Candidates are identified from an observational prospective cohort (called the Prospective Cohort of Patients Candidates for Ovarian Tissue Autograft [PERIDATOR]) of patients who have undergone OTC. Enrollment in the study is initiated at the patient’s request and must be validated by the center’s multidisciplinary team and by the study steering committee. The DATOR study begins with a total medical checkup. Ovarian tissue qualification and residual disease detection, if required, are performed. RESULTS The study is ongoing. Currently, 38 patients have provided informed consent and have been entered into the DATOR study. Graft has been performed for 34 of these patients. An interim analysis was conducted on the first 25 patients for whom the period of at least 1 year posttransplantation was achieved. Out of these 25 patients, 11 women succeeded in becoming pregnant (pregnancy rate=44% [11/25]; delivery rate=40% [10/25]). Among these, 6 women conceived twice, and 1 pregnancy led to a miscarriage. CONCLUSIONS Our preliminary analysis appears to be coherent with the accumulating body of evidence indicating the potential utility of ovarian tissue autograft for patients with premature ovarian failure. All these elements justify the pursuit of our study. CLINICALTRIAL ClinicalTrials.gov NCT02846064; https://clinicaltrials.gov/ct2/show/NCT02846064 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/12944

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Section: Introductionmentioning

confidence: 99%

Development of Ovarian Tissue Autograft to Restore Ovarian Function: Protocol for a French Multicenter Cohort Study (Preprint)

Pretalli¹,

Franck²,

Pazart³

et al. 2018

Preprint

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Recent advances in the field of ovarian tissue cryopreservation and opportunities for research

Ladanyi

Mor

Christianson

et al. 2017

J Assist Reprod Genet

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Ovarian tissue auto-transplantation in post-pubertal women is capable of restoring fertility with over 80 live births currently reported with a corresponding pregnancy rate of 23 to 37%. The recently reported successes of live births from transplants, both in orthotopic and heterotopic locations, as well as the emerging methods of in vitro maturation (IVM), in vitro culture of primordial follicles, and possibility of in vitro activation (IVA) suggest new fertility options for many women and girls. Vitrification, as an ovarian tissue cryopreservation technique, has also demonstrated successful live births and may be a more cost-effective method to freezing with less tissue injury. Further, transplantation via the artificial ovary with an extracellular tissue matrix (ECTM) scaffolding as well as the effects of sphingosine-1-phosphate (SIP) and fibrin modified with heparin-binding peptide (HBP), heparin, and a vascular endothelial growth factor (VEGF) have demonstrated important advancements in fertility preservation. As a fertility preservation method, ovarian tissue cryopreservation and auto-transplantation are currently considered experimental, but future research may pave the way for these modalities to become a standard of care for women facing the prospect of sterility from ovarian damage.

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Heterotopic Ovarian Tissue Transplantation

Cited by 2 publications

References 62 publications

Development of Ovarian Tissue Autograft to Restore Ovarian Function: Protocol for a French Multicenter Cohort Study (Preprint)

Development of Ovarian Tissue Autograft to Restore Ovarian Function: Protocol for a French Multicenter Cohort Study (Preprint)

Recent advances in the field of ovarian tissue cryopreservation and opportunities for research

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