Ovarian tissue cryopreservation from contemporary indications to cutting edge research (original) (raw)
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Journal of Assisted Reproduction and Genetics, 2012
Background As advancements in cancer therapies have led to dramatic improvements in long term survival, there has been increasing interest in methods to expand fertility preservation options for cancer patients. Methods An experimental protocol for ovarian tissue cryopreservation was developed at the University of Pennsylvania for patients requiring gonadotoxic therapies. The protocol for adults was implemented at the Hospital of the University of Pennsylvania and for children at the Children's Hospital of Philadelphia in collaboration with the Oncofertility Consortium and the National Physicians Cooperative (NPC). Results A total of twenty-one patients (age range: 8-36 years) have cryopreserved ovarian tissue as part of this study. While patients had a variety of diagnoses and treatment exposures, 10/ 21 (48 %) patients suffered from hematologic disorders and 43 % were anticipating stem cell transplantation. No patients have requested that the tissue be used for clinical purposes. Conclusions Ovarian tissue cryopreservation protocols can be implemented at pediatric and adult institutions through multi-disciplinary collaboration. While more research is needed to determine the safety and efficacy of ovarian tissue cryopreservation, this procedure provides hope for preserving the ability to have biological offspring to patients facing gonadotoxic therapies for a variety of medical conditions. Capsule A protocol for ovarian tissue cryopreservation has been successfully established at an adult and pediatric hospital through multi-disciplinary collaboration.
Reproductive Sciences
Although advances in cancer treatment and early diagnosis have significantly improved cancer survival rates, cancer therapies can cause serious side effects, including ovarian failure and infertility, in women of reproductive age. Infertility following cancer treatment can have significant adverse effects on the quality of life. However, established methods for fertility preservation, including embryo or oocyte cryopreservation, are not always suitable for female cancer patients because of complicated individual conditions and treatment methods. Ovarian tissue cryopreservation and transplantation is a promising option for fertility preservation in pre-pubertal girls and adult patients with cancer who require immediate treatment, or who are not eligible to undergo ovarian stimulation. This review introduces various methods and strategies to improve ovarian tissue cryopreservation and transplantation outcomes, to help patients and clinicians choose the best option when considering the...
Ovarian tissue banking for cancer patients: is ovarian cortex cryopreservation presently justified?
2004
The effect of chemotherapy and radiotherapy on future fertility is of concern to patients and their families. Whereas sperm banking is commonly performed, female gametes are not so amenable to cryopreservation. One alternative includes postponing cancer treatment to enable ovulation induction and oocyte aspiration. Whenever possible, retrieved oocytes should be fertilized in vitro prior to cryopreservation. Frozen embryos could serve
European Journal of Cancer, 2009
Radiotherapy Chemotherapy Infertility Ovary Cryopreservation Tissue banks Transplantation A B S T R A C T Increasing survival rates in young cancer patients, new reproductive techniques and the growing interest in quality of life after gonadotoxic cancer therapies have placed fertility preservation as an important issue to oncologists, fertility specialists and patients. Several techniques are now available for fertility preservation in these patients. A new promising method is cryopreservation and transplantation of ovarian cortex. Ovarian tissue can be extracted by laparoscopy without any significant delay of gonadotoxic therapy. The tissue can be cryopreserved by specialised centres of reproductive medicine and transplanted in case the women experience premature ovarian failure (POF).
Frontiers in endocrinology, 2018
In current years, ovarian tissue cryopreservation (OTC) and transplantation is gaining ground as a successful method of preserving fertility in young women with primarily cancer diseases, hereby giving them a chance of becoming biological mothers later on. However, OTC preserves more than just the reproductive potential; it restores the ovarian endocrine function and thus the entire female reproductive cycle with natural levels of essential hormones. In a female population with an increased prevalence in the loss of ovarian function due to induced primary ovarian insufficiency (POI) and aging, there is now, a need to develop new treatments and provide new opportunities to utilize the enormous surplus of follicles that most females are born with and overcome major health issues associated with the lack of ovarian hormones. Cell/tissue-based hormone replacement therapy (cHRT) by the use of stored ovarian tissue could be one such option comprising both induction of puberty in prepubert...
Human reproduction (Oxford, England), 2014
Do the benefits of ovarian tissue cryopreservation outweigh the risks for patients seeking to preserve fertility before gonadotoxic treatment in various indications? In >90% of the patients undergoing cryopreservation of ovarian tissue, oncological treatment was associated with a reduced ovarian reserve and in 30% of patients, premature ovarian failure (POF) occurred within 5 years. Ovarian tissue cryopreservation is an effective fertility preservation option, especially for pre-pubertal patients and patients who have a short time between diagnosis of a disease and gonadotoxic treatment. This study retrospectively analysed ovarian function and fertility recovery rates, as well as ovarian tissue characteristics, of patients who underwent ovarian tissue cryopreservation at Erasme Hospital between 1999 and 2011. A total of 225 patients referred from 15 Belgian oncological units underwent cryopreservation of ovarian tissue before gonadotoxic therapy for malignant or benign diseases. ...
Ovarian tissue cryopreservation for non-malignant indications
Archives of Gynecology and Obstetrics, 2010
Background Ovarian tissue cryopreservation (OTC) is not restricted to patients suVering from malignancies. Benign haematopoietic diseases such as autoimmune diseases and others have been mentioned to be feasible indications. The aim of our study was to demonstrate that surgery for OTC is a safe procedure for fertility preservation in patients with non-malignant diseases. Methods In a retrospective cohort study intra-and postoperative courses were evaluated. Histological examination of one random ovarian cortical slice was performed to determine the presence of primordial follicles. Immediately after the excision, microbiological culture techniques from swabs were taken from all slices. Results Seven of 85 patients (8.2%) have undergone surgery for OTC for non-malignant indications. All patients had an uncomplicated intraoperative course. A median number of 12 cortical stripes were excised and cryopreserved (range 7-17). Only for one patient an adverse event was found which was not related to laparoscopy for OTC. All patients having undergone routine laparoscopy for OTC only could be released from hospital on the Wrst postopera-tive day. Selective microbiological tests showed negative results in all cases. Histological examinations revealed intact ovarian tissue with primordial follicles in 6/7 patients. Conclusion Whether surgery for OTC in patients with non-malignant indications is feasible from an ethical point of view remains open. However, laparoscopy for ovarian tissue harvesting is a safe procedure for patients undergoing cytotoxic treatment for benign diseases.
Cryopreservation of Human Ovarian Tissue: A Review
Transfusion Medicine and Hemotherapy, 2019
Background: Cryopreservation of human ovarian tissue has been increasingly applied worldwide to safeguard fertility in cancer patients, notably in young girls and women who cannot delay the onset of their treatment. Moreover, it has been proposed to patients with benign pathologies with a risk of premature ovarian insufficiency. So far, more than 130 live births have been reported after transplantation of cryopreserved ovarian tissue, and almost all patients recovered their ovarian function after tissue reimplantation. Summary: This review aims to summarize the recent results described in the literature regarding human ovarian tissue cryopreservation in terms of methods and main results obtained so far. To cryopreserve human ovarian tissue, most studies describe a slow freezing/rapid thawing protocol, which is usually an adaptation of a protocol developed for sheep ovarian tissue. Since freezing has been shown to have a deleterious effect on ovarian stroma and granulosa cells, vario...