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Choi YJ, Hong YH, Paik H, Kim SK, Lee JR, Suh CS. A Successful Live Birth From a Vitrified Oocyte for Fertility Preservation of a Patient With Borderline Ovarian Tumor Undergoing Bilateral Ovarian Surgery: A Case Report. J Korean Med Sci 2024; 39:e14. [PMID: 38193330 PMCID: PMC10782042 DOI: 10.3346/jkms.2024.39.e14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/03/2023] [Indexed: 01/10/2024] Open
Abstract
This article reports the live birth of a healthy newborn using vitrified-warmed oocytes from fertility preservation before ovarian surgery. The patient in our case underwent two cycles of controlled ovarian stimulation before laparoscopic bilateral ovarian cystectomy for endometriosis, and a total of 23 mature oocytes were vitrified. After surgery, her pathologic reports revealed a serous borderline tumor and endometrioma. Fifteen months after her second surgery of laparoscopic right salpingo-oophorectomy and left ovarian cystectomy owing to recurrence, she had been married by then, and three of the frozen oocytes were thawed for intracytoplasmic sperm injection. These oocytes were cryopreserved for 2.5 years. All three were fertilized, and two grade-A cleavage-stage embryos were transferred. A singleton pregnancy was achieved, resulting in the delivery of a healthy baby boy at 39.3 weeks of gestation. Oocyte cryopreservation is an effective method for fertility preservation prior to ovarian surgery when ovarian function decline is predictable.
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Affiliation(s)
- Yae Ji Choi
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yeon Hee Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Haerin Paik
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
| | - Chang Suk Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
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Antunes MB, Cardeal SP, Magalhães M, Vale-Fernandes E, Barreiro M, Sá R, Sousa M. Preservation of fertility in female patients with hematologic diseases. Blood Rev 2023; 62:101115. [PMID: 37562987 DOI: 10.1016/j.blre.2023.101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023]
Abstract
Recent developments of assisted reproduction techniques turned possible to avoid the infertility consequences of oncologic treatments, but fertility preservation (FP) has been somewhat neglected in women with hematologic diseases undergoing gonadotoxic treatments. For these specific cases, the current options for FP include the cryopreservation of embryos, mature oocytes and ovarian tissue, and oocyte in-vitro maturation. We intend to make patients and clinicians aware of this important and relevant issue, and provide hematologists, assisted reproduction physicians and patients, with updated tools to guide decisions for FP. The physicians of the units responsible for female FP should always be available to decide on the best-individualized FP option in strict collaboration with hematologists. With a wide range of options for FP tailored to each case, a greater level of training and information is needed among clinicians, so that patients proposed to gonadotoxic treatments can be previously advised for FP techniques in hematological conditions. ABBREVIATED ABSTRACT: Recent developments of assisted reproduction techniques turned possible to preserve the fertility of women with hematologic diseases undergoing gonadotoxic treatments. Current options for fertility preservation in women with hematologic diseases are presented. It is imperative to offer fertility preservation to all women before starting any gonadotoxic treatment and in some cases after treatment. Fertility preservation methods enable to later achieve the desired pregnancy.
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Affiliation(s)
- Marika Bini Antunes
- Department of Clinical Hematology, Centro Hospitalar Universitário do Porto, Largo do Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
| | - Sara Pinto Cardeal
- Laboratory of Cell Biology, Department of Microscopy, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Manuel Magalhães
- UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Department of Oncology, Centro Hospitalar Universitário do Porto, Largo do Professor Abel Salazar, 4099-001 Porto, Portugal
| | - Emídio Vale-Fernandes
- UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Centro de Procriação Medicamente Assistida, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Largo da Maternidade, 4050-371, Porto, Portugal
| | - Márcia Barreiro
- UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Centro de Procriação Medicamente Assistida, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Largo da Maternidade, 4050-371, Porto, Portugal.
| | - Rosália Sá
- UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Laboratory of Cell Biology, Department of Microscopy, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Mário Sousa
- UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Laboratory of Cell Biology, Department of Microscopy, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
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Porcu E, Cipriani L, Dirodi M, De Iaco P, Perrone AM, Zinzani PL, Taffurelli M, Zamagni C, Ciotti PM, Notarangelo L, Calza N, Damiano G. Successful Pregnancies, Births, and Child Development Following Oocyte Cryostorage in Female Cancer Patients During 25 Years of Fertility Preservation. Cancers (Basel) 2022; 14:cancers14061429. [PMID: 35326578 PMCID: PMC8946047 DOI: 10.3390/cancers14061429] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary The study goal is to demonstrate that oocyte cryopreservation is a feasible and efficient option for fertility preservation in cancer patients through the comparison of in vitro fertilization treatments in nononcological patients. Abstract The preservation of fertility in cancer patients is a crucial aspect of modern reproductive medicine. Amenorrhea and infertility often occur after cancer therapy, worsening the quality of life. Cryopreservation of oocytes in young cancer patients is a therapeutic option for preserving fertility. A prospective study was conducted on 508 cancer patients who underwent oocyte cryopreservation to preserve fertility between 1996 and 2021 including the COVID-19 pandemic period. Patients underwent ovarian stimulation, followed by egg retrieval, and oocytes were cryopreserved by slow freezing or vitrification. Sixty-four thawing/warming cycles were performed. Survival, fertilization, pregnancy, and birth rate over the thawing/warming cycles were obtained. The data were compared with those from a group of 1042 nononcological patients who cryopreserved supernumerary oocytes. An average of 8.8 ± 6.9 oocytes were retrieved per cycle, and 6.1 ± 4.2 oocytes were cryopreserved. With their own stored oocytes, 44 patients returned to attempt pregnancy. From a total of 194 thawed/warmed oocytes, 157 survived (80%). In total, 100 embryos were transferred in 57 transfer/cycles, and 18 pregnancies were achieved. The pregnancy rate per transfer and pregnancy rate per patient were 31% and 41%, respectively. No statistically significant differences were observed between oncological patients and nononcological patients. A total of 15 babies were born from oncological patients. Children born showed normal growth and development. One minor malformation was detected.
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Affiliation(s)
- Eleonora Porcu
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-0512144364
| | - Linda Cipriani
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
| | - Maria Dirodi
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
| | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (P.D.I.); (A.M.P.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy
| | - Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (P.D.I.); (A.M.P.)
- Centro di Studio e Ricerca delle Neoplasie Ginecologiche (CSR), University of Bologna, 40138 Bologna, Italy
| | - Pier Luigi Zinzani
- Institute of Haematology “Seragnoli”, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy;
| | - Mario Taffurelli
- Breast Unit, Department of Woman and Child, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy;
| | - Claudio Zamagni
- “Addari” Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40126 Bologna, Italy;
| | - Patrizia Maria Ciotti
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
| | - Leonardo Notarangelo
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Nilla Calza
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
| | - Giuseppe Damiano
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy; (L.C.); (M.D.); (P.M.C.); (L.N.); (N.C.); (G.D.)
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Park JK, Lee JH, Park EA, Lim HJ, Lyu SW, Lee WS, Kim J, Song H. Development of Optimized Vitrification Procedures Using Closed Carrier System to Improve the Survival and Developmental Competence of Vitrified Mouse Oocytes. Cells 2021; 10:cells10071670. [PMID: 34359838 PMCID: PMC8304188 DOI: 10.3390/cells10071670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
The open carrier system (OC) is used for vitrification due to its high efficiency in preserving female fertility, but concerns remain that it bears possible risks of cross-contamination. Closed carrier systems (CC) could be an alternative to the OC to increase safety. However, the viability and developmental competence of vitrified/warmed (VW) oocytes using the CC were significantly lower than with OC. We aimed to improve the efficiency of the CC. Metaphase II oocytes were collected from mice after superovulation and subjected to in vitro fertilization after vitrification/warming. Increasing the cooling/warming rate and exposure time to cryoprotectants as key parameters for the CC effectively improved the survival rate and developmental competence of VW oocytes. When all the conditions that improved the outcomes were applied to the conventional CC, hereafter named the modified vitrification/warming procedure using CC (mVW-CC), the viability and developmental competence of VW oocytes were significantly improved as compared to those of VW oocytes in the CC. Furthermore, mVW-CC increased the spindle normality of VW oocytes, as well as the cell number of blastocysts developed from VW oocytes. Collectively, our mVW-CC optimized for mouse oocytes can be utilized for humans without concerns regarding possible cross-contamination during vitrification in the future.
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Affiliation(s)
- Jae Kyun Park
- Department of Biomedical Sciences, CHA University, Seongnam 13488, Korea; (J.K.P.); (J.H.L.)
- CHA Fertility Center Gangnam, CHA University, Seoul 06125, Korea; (S.W.L.); (W.S.L.)
| | - Ju Hee Lee
- Department of Biomedical Sciences, CHA University, Seongnam 13488, Korea; (J.K.P.); (J.H.L.)
| | - Eun A Park
- CHA Fertility Center Seoul Station, CHA University, Seoul 04637, Korea;
| | - Hyunjung J. Lim
- Department of Veterinary Medicine, School of Veterinary Medicine, Konkuk University, Seoul 05029, Korea;
| | - Sang Woo Lyu
- CHA Fertility Center Gangnam, CHA University, Seoul 06125, Korea; (S.W.L.); (W.S.L.)
| | - Woo Sik Lee
- CHA Fertility Center Gangnam, CHA University, Seoul 06125, Korea; (S.W.L.); (W.S.L.)
| | - Jayeon Kim
- CHA Fertility Center Seoul Station, CHA University, Seoul 04637, Korea;
- Correspondence: (J.K.); (H.S.)
| | - Haengseok Song
- Department of Biomedical Sciences, CHA University, Seongnam 13488, Korea; (J.K.P.); (J.H.L.)
- Correspondence: (J.K.); (H.S.)
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5
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Cobo A, García-Velasco JA, Remohí J, Pellicer A. Oocyte vitrification for fertility preservation for both medical and nonmedical reasons. Fertil Steril 2021; 115:1091-1101. [DOI: 10.1016/j.fertnstert.2021.02.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
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Lee JR, Takae S, Suzuki N. Editorial: Fertility Preservation in Asia. Front Endocrinol (Lausanne) 2020; 11:603213. [PMID: 33488519 PMCID: PMC7821869 DOI: 10.3389/fendo.2020.603213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea
- *Correspondence: Jung Ryeol Lee, ; Nao Suzuki,
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
- *Correspondence: Jung Ryeol Lee, ; Nao Suzuki,
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Salama M, Anazodo A, Woodruff TK. Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach. Ann Oncol 2019; 30:1760-1775. [PMID: 31418765 DOI: 10.1093/annonc/mdz284] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.
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Affiliation(s)
- M Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - T K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA.
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8
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Cobo A, García-Velasco J, Domingo J, Pellicer A, Remohí J. Elective and Onco-fertility preservation: factors related to IVF outcomes. Hum Reprod 2019; 33:2222-2231. [PMID: 30383235 DOI: 10.1093/humrep/dey321] [Citation(s) in RCA: 175] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/22/2018] [Indexed: 12/25/2022] Open
Abstract
STUDY QUESTION Is the indication for fertility preservation (FP) related to success in IVF cycles after elective-FP (EFP) for age-related fertility decline and FP before cancer treatment (Onco-FP)? SUMMARY ANSWER Although success rates were lower in cancer patients, there was no statistically significant association between malignant disease and reproductive outcome after correction for age and controlled-ovarian stimulation (COS) regime. WHAT IS KNOWN ALREADY FP is increasingly applied in assisted reproduction, but little is known about the outcome of IVF cycles with vitrified oocytes in FP patients. STUDY DESIGN, SIZE, DURATION Retrospective, observational multicenter study of vitrification cycles for FP and of the warming cycles of women who returned to attempt pregnancy from January 2007 to May 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 6362 women (EFP = 5289 patients; 7044 cycles + Onco-FP = 1073 patients; 1172 cycles) had their oocytes vitrified for FP. A logistic regression analysis was performed to examine the impact of indication for FP corrected for age at vitrification. The protocol used for COS was also included as a possible confounder. The main outcome measures were oocyte survival and live birth. A detailed description of the baseline and clinical data is provided, with comparisons between EFP and Onco-FP. The cumulative live birth rate (CLBR) per utilized oocyte according to age at vitrification was analyzed in those patients returning to use their oocytes. MAIN RESULTS AND ROLE OF CHANCE Age at vitrification was significantly older in EFP patients (37.2 ± 4.9 vs. 32.3 ± 3.5 year; P < 0.0001). Fewer oocytes were retrieved and vitrified per cycle in EFP (9.6 ± 8.4 vs. 11.4 ± 3.5 and 7.3 ± 11.3 vs. 8.7 ± 2.1, respectively; P < 0.05), but numbers became comparable when analyzed per patient (12.8 ± 7.4 vs. 12.5 ± 3.2 and 9.8 ± 6.4 vs. 9.5 ± 2.6). Storage time was shorter in EFP (2.1 ± 1.6 vs. 4.1 ± 0.9 years; P < 0.0001). In all, 641 (12.1%) EFP and 80 (7.4%) Onco-FP patients returned to attempt pregnancy (P < 0.05). Overall oocyte survival was comparable (83.9% vs. 81.8%; NS), but lower for onco-FP patients among younger (≤35 year) subjects (81.2% vs. 91.4%; P > 0.05). Fewer EFP cycles finished in embryo transfer (50.2% vs. 72.5%) (P < 0.05). The implantation rate was 42.6% and 32.5% in EFP versus Onco-FP (P < 0.05). Ongoing pregnancy (57.7% vs. 35.7%) and live birth rates (68.8% vs. 41.1%) were higher in EFP patients aged ≤35 than the Onco-FP matching age patients (P < 0.05). The reason for FP per se had no effect on oocyte survival (OR = 1.484 [95%CI = 0.876-2.252]; P = 0.202) or the CLBR (OR = 1.275 [95%CI = 0.711-2.284]; P = 0.414). Conversely, age (<36 vs. ≥36 y) impacted oocyte survival (adj.OR = 1.922 [95%CI = 1.274-2.900]; P = 0.025) and the CLBR (adj.OR= 3.106 [95%CI = 2.039-4.733]; P < 0.0001). The Kaplan-Meier analysis showed a significantly higher cumulative probability of live birth in patients <36 versus >36 in EFP (P < 0.0001), with improved outcomes when more oocytes were available for IVF. LIMITATIONS, REASONS FOR CAUTION Statistical power to compare IVF outcomes is limited by the few women who came to use their oocytes in the Onco-FP group. The patients' ages and the COS protocols used were significantly different between the EFP and ONCO-PP groups. WIDER IMPLICATIONS OF THE FINDINGS Although the implantation rate was significantly lower in the Onco-FP patients the impact of cancer disease per se was not proven'. EFP patients should be counseled according to their age and number of available oocytes. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A Cobo
- IVIRMA-Valencia, Plaza de la Policía Local 3, Valencia, Spain
| | | | - J Domingo
- IVIRMA-Las Palmas, Av. Juan Carlos I, 17, Edificio Corona, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - A Pellicer
- IVIRMA-Valencia, Plaza de la Policía Local 3, Valencia, Spain
| | - J Remohí
- IVIRMA-Valencia, Plaza de la Policía Local 3, Valencia, Spain
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Melatonin Improves Parthenogenetic Development of Vitrified⁻Warmed Mouse Oocytes Potentially by Promoting G1/S Cell Cycle Progression. Int J Mol Sci 2018; 19:ijms19124029. [PMID: 30551578 PMCID: PMC6321189 DOI: 10.3390/ijms19124029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022] Open
Abstract
This study aimed to investigate the effect of melatonin on the cell cycle of parthenogenetic embryos derived from vitrified mouse metaphase II (MII) oocytes. Fresh oocytes were randomly allocated into three groups: untreated (control), or vitrified by the open-pulled straw method without (Vitrification group) or with melatonin (MT) supplementation (Vitrification + MT group). After warming, oocytes were parthenogenetically activated and cultured in vitro, then the percentage of embryos in the G1/S phase, the levels of reactive oxygen species (ROS) and glutathione (GSH), and the mRNA expression of cell cycle-related genes (P53, P21 and E2F1) in zygotes and their subsequent developmental potential in vitro were evaluated. The results showed that the vitrification/warming procedures significantly decreased the frequency of the S phase, markedly increased ROS and GSH levels and the expression of P53 and P21 genes, and decreased E2F1 expression in zygotes at the G1 stage and their subsequent development into 2-cell and blastocyst stage embryos. However, when 10−9 mol/L MT was administered for the whole duration of the experiment, the frequency of the S phase in zygotes was significantly increased, while the other indicators were also significantly improved and almost recovered to the normal levels shown in the control. Thus, MT might promote G1-to-S progression via regulation of ROS, GSH and cell cycle-related genes, potentially increasing the parthenogenetic development ability of vitrified–warmed mouse oocytes.
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Gerstl B, Sullivan E, Chong S, Chia D, Wand H, Anazodo A. Reproductive Outcomes After a Childhood and Adolescent Young Adult Cancer Diagnosis in Female Cancer Survivors: A Systematic Review and Meta-analysis. J Adolesc Young Adult Oncol 2018; 7:627-642. [PMID: 30452301 DOI: 10.1089/jayao.2018.0036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Improvements in cancer therapy for childhood and adolescent and young adult (AYA) survivors have increased in excess of 80% among pediatric patients and in excess of 85% among AYA cancer patients. Our research group explored the late effects consequences of cancer treatment on pregnancy and birth outcomes subsequent to a childhood (0-14 years) or AYA (15-25 years) diagnosis of cancer in female cancer survivors. Embase and Medline databases were searched. There were 17 review (n = 10 matched and n = 7 unmatched) studies that met the inclusion criteria. Subanalyses were conducted on 10 matched studies. The median age for all studies for patients at diagnosis and birth was 11 and 27 years, respectively. In matched cohort studies, female childhood and AYA cancer patients, who received chemotherapy alone, had a pooled estimated rate of 18% of experiencing a live birth compared with 10% of females who received radiotherapy alone and subsequently had a live birth. Females who received surgery alone reported higher pooled estimated rates of 44% for a live birth. For matched retrospective review studies, 79% (n = 973) of women experienced a live birth, of which 22% of these babies were born preterm. This meta-analysis found lower birth rates for survivors. Access to fertility-related information and discussions around fertility preservation options and oncofertility psychosocial support should be offered to all cancer patients and their families before starting cancer treatment.
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Affiliation(s)
- Brigitte Gerstl
- 1 Department of Biostatistics, The Kirby Institute, University of New South Wales , Kensington, Australia
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
- 3 Nulune Comprehensive Cancer Centre, Prince of Wales Hospital , Sydney, Australia
| | - Elizabeth Sullivan
- 4 Australian Centre for Public Health and Population Health Research, Faculty of Health, University of Technology, Sydney, Australia
| | - Serena Chong
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
| | - Debbie Chia
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
| | - Handan Wand
- 1 Department of Biostatistics, The Kirby Institute, University of New South Wales , Kensington, Australia
| | - Antoinette Anazodo
- 2 Kids Cancer Centre, Sydney Children's Hospital , Sydney, Australia
- 3 Nulune Comprehensive Cancer Centre, Prince of Wales Hospital , Sydney, Australia
- 5 Women's and Children's, School of Medical Sciences, University of New South Wales , Sydney, Australia
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Abstract
PURPOSE OF REVIEW The use of oocyte cryopreservation via vitrification has increased lately, becoming a common strategy in many IVF centers. This review summarizes the current state of oocyte vitrification, by analyzing the most recent reports on its use in IVF as part of infertile treatment and its contribution to elective fertility preservation (EFP). RECENT FINDINGS Oocyte vitrification has become helpful for managing different clinical situations currently providing similar results to fresh oocytes. Owing to satisfactory results, oocyte vitrification is being offered to healthy women to extend their reproductive options (EFP). Although little is known about outcomes in this specific population, new evidence is starting to emerge. Currently, most women are motivated by age and lack of partner. Age is strongly related to the probability of having a child with better chances when they do EFP younger than 35. In contrast to the biological efficiency, the majority of studies show that EFP is more cost-effective at 37-38 years. SUMMARY Oocyte vitrification is an efficient tool which can be helpful in managing the IVF cycle. Fertility preservation providers should inform women about their specific probabilities according to their age at vitrification, making emphasis in the fact that egg freezing does not guarantee success, but increases the possibilities of having a biological child in the future.
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Jach R, Pabian W, Spaczyński R, Szamatowicz J, Zbroch T, Knapp P, Smolarczyk R, Kolawa W, Bodnar L, Kurzawa R, Zawirska D, Krzakowski M, Radowicki S, Fijuth J, Wielgoś M, Wysocki P, Kozioł K, Zalewski K, Warzocha K, Hałaburda K, Rdwan M, Radwan P, Jabłoński MJ, Kojs Z, Wołczyński S, Pawelczyk L, Kluz T, Lukaszuk K. Recommendations of the Fertility Preservation Working Group in Oncological, Hematological and Other Patients Treated With Gonadotoxic Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology. J Adolesc Young Adult Oncol 2017; 6:388-395. [PMID: 28657411 DOI: 10.1089/jayao.2017.0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robert Jach
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | - Wojciech Pabian
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | - Robert Spaczyński
- 2 Gynaecology and Obstetrics Clinical Hospital of K. Marcinkowski Medical University in Poznań , Poznań, Poland
| | | | - Tomasz Zbroch
- 4 Artemida-Gynaecology, Endocrinology and Reproductive Medicine Centre , Białystok, Poland
| | - Paweł Knapp
- 3 Medical University of Białystok , Białystok, Poland
| | - Roman Smolarczyk
- 5 Princess Anna Mazowiecka Clinical Hospital in Warsaw , Warsaw, Poland
| | - Wojciech Kolawa
- 6 G. Narutowicz Municipal Specialist Hospital in Krakow , Krakow, Poland
| | | | | | - Daria Zawirska
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | | | | | - Jacek Fijuth
- 10 Oncological Haematology Centre in Łódź , Łódź, Poland
| | | | - Piotr Wysocki
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | | | | | | | | | - Michał Rdwan
- 15 GAMETA Infertility Treatment Clinic , Rzgów, Poland
| | - Paweł Radwan
- 15 GAMETA Infertility Treatment Clinic , Rzgów, Poland
| | | | - Zbigniew Kojs
- 17 Oncology Centre-M. Skłodowska-Curie Institute , Krakow, Poland
| | | | - Leszek Pawelczyk
- 2 Gynaecology and Obstetrics Clinical Hospital of K. Marcinkowski Medical University in Poznań , Poznań, Poland
| | - Tomasz Kluz
- 18 Department of Obstetrics and Gynecology, Fryderyk Chopin University Hospital No 1, Faculty of Medicine, Rzeszow University , Rzeszow, Poland
| | - Krzysztof Lukaszuk
- 10 Oncological Haematology Centre in Łódź , Łódź, Poland,11 Medical University of Warsaw , Warsaw, Poland,12 "nOvum" Medical Clinic , Warsaw, Poland,13 Świętokrzyskie Oncology Centre , Kielce, Poland
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13
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State of the art on oocyte cryopreservation in female cancer patients: A critical review of the literature. Cancer Treat Rev 2017; 57:50-57. [PMID: 28550713 DOI: 10.1016/j.ctrv.2017.04.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/11/2022]
Abstract
During the last decades, important advances in therapeutic options have led to increased survival rates in cancer patients; however, cancer treatments are associated with several potential adverse effects including infertility in those diagnosed during their reproductive years. A proper discussion about fertility preservation options before the use of therapies with potential gonadotoxicity (i.e. oncofertility counseling) is standard of care and should be offered to all patients of childbearing age. Temporary ovarian suppression with LH-RH analogs, oocyte and embryo cryopreservation are standard strategies for fertility preservation in female cancer patients. Oocyte cryopreservation should be preferred to embryo cryopreservation when this latter is prohibited by law, avoided for ethical or religious issues and in single women refusing sperm donation. Despite the increasing use of this strategy, data are still lacking about the efficacy and safety of the procedure in female cancer patients, with most of the evidence on this regard deriving from infertile non-oncologic women. This article aims at critically review the available evidence about the success of oocyte cryopreservation in female cancer patients with the final goal to further improve the oncofertility counseling of these women.
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Sonigo C, Simon C, Boubaya M, Benoit A, Sifer C, Sermondade N, Grynberg M. What threshold values of antral follicle count and serum AMH levels should be considered for oocyte cryopreservation after in vitro maturation? Hum Reprod 2016; 31:1493-500. [PMID: 27165625 DOI: 10.1093/humrep/dew102] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 04/12/2016] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What threshold values of ultrasonographic antral follicle count (AFC) and serum anti-Müllerian hormone (AMH) levels should be considered for ensuring the cryopreservation of sufficient number of in vitro matured (IVM) oocytes, in cancer patients seeking fertility preservation (FP)? SUMMARY ANSWER AFC and serum AMH values >20 follicles and 3.7 ng/ml, respectively, are required for obtaining at least 10 IVM oocytes for cryopreservation. WHAT IS KNOWN ALREADY IVM of cumulus oocyte complexes (COCs) followed by oocyte cryopreservation has emerged recently as an option for urgent FP. Recent data have reported that, in healthy patients, 8-20 cryopreserved oocytes after ovarian stimulation would maximize the chance of obtaining a live birth. Although both AFC and AMH have been reported as predictive factors of IVM success in infertile patients with polycystic ovary syndrome (PCOS), there is a dramatic lack of data regarding the values of these parameters in oncological patients as candidates for FP. STUDY DESIGN, SIZE, DURATION From January 2009 to April 2015, we prospectively studied 340 cancer patients, aged 18-41 years, as candidates for oocyte cryopreservation following IVM. PARTICIPANTS/MATERIALS, SETTING, METHODS All patients had AFC and AMH measurements, 48-72 h before oocyte retrieval, regardless of the phase of the cycle. COCs were recovered under ultrasound guidance 36 h after hCG priming. Logistic regression allowed the determination of threshold values of AFC and AMH, for obtaining at least 8, 10 or 15 matures oocytes frozen after the IVM procedure. Similar analyses were performed for a final number of mature oocytes ≤2. MAIN RESULTS AND THE ROLE OF CHANCE Among the 340 cancer patients included, 300 were diagnosed with breast cancers, 14 had hematological malignancies and 26 underwent the procedure for others indications. Overall, the mean age of the population was 31.8 ± 4.5 years. Mean AFC and serum AMH levels were 21.7 ± 13.3 follicles and 4.4 ± 3.8 ng/ml, respectively. IVM was performed in equal proportions during the follicular or luteal phase of the cycle (49 and 51%, respectively). Statistical analysis showed that AFC and AMH values above 28 follicles and 3.9 ng/ml, 20 follicles and 3.7 ng/ml and 19 follicles and 3.5 ng/ml are required, respectively, for obtaining at least 15, 10 or 8 frozen IVM oocytes with a sensitivity ranging from 0.82 to 0.90. On the contrary, ≤2 IVM oocytes were cryopreserved when AFC and AMH were <19 follicles and 3.0 ng/ml, respectively. LIMITATIONS, REASONS FOR CAUTION Although the potential of cryopreserved IVM oocytes from cancer patients remains unknown, data obtained from infertile PCOS women have shown a dramatically reduced competence of these oocytes when compared with that of oocytes recovered after ovarian stimulation. As a consequence, the optimal number of IVM oocytes frozen in candidates for FP is currently unpredictable. WIDER IMPLICATIONS OF THE FINDINGS Cryopreservation of oocytes after IVM should be considered in the FP strategy when ovarian stimulation is unfeasible, in particular when markers of the follicular ovarian status are at a relatively high range. Further investigation is needed to objectively assess the real potential of these IVM oocytes after cryopreservation. Therefore, even when a good COCs yield is expected, we should systematically encourage IVM in combination with ovarian tissue cryopreservation. STUDY FUNDING/COMPETING INTERESTS No external funding was obtained for the present study. The authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- C Sonigo
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France INSERM, U1185, Université Paris-Sud, Le Kremlin-Bicêtre 94270, France Université Paris XIII, Bobigny 93000, France
| | - C Simon
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - M Boubaya
- Unité de Recherche Clinique, Hôpital Avicenne, Bobigny 93009, France
| | - A Benoit
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - C Sifer
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - N Sermondade
- AP-HP, Service de Cytogénétique et Biologie de la Reproduction, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France
| | - M Grynberg
- AP-HP, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Jean Verdier, Avenue du 14 Juillet, Bondy 93143, France Université Paris XIII, Bobigny 93000, France INSERM, U1133, Université Paris-Diderot, Paris 75013, France
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15
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Argyle CE, Harper JC, Davies MC. Oocyte cryopreservation: where are we now? Hum Reprod Update 2016; 22:440-9. [DOI: 10.1093/humupd/dmw007] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/15/2016] [Indexed: 11/15/2022] Open
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16
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Kato K. Vitrification of embryos and oocytes for fertility preservation in cancer patients. Reprod Med Biol 2016; 15:227-233. [PMID: 29259440 DOI: 10.1007/s12522-016-0239-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/12/2016] [Indexed: 12/24/2022] Open
Abstract
As survival rates and the life expectancy of those with malignancy have increased, more women in their reproductive years are referred for fertility preservation. Chemotherapy and radiotherapy can severely affect ovarian function, and the effect is irreversible. Therefore, it is optimal to attempt fertility preservation before chemotherapy and radiotherapy are initiated. Oocyte and embryo cryopreservation is the most common option for fertility preservation in women. Several reports have proven that embryo and oocyte cryopreservation can achieve a successful pregnancy. This review discusses the impact of chemotherapy and radiotherapy on ovarian function, and the importance of oocyte and embryo cryopreservation for fertility preservation. In addition, the current status of pregnancy outcomes and potential for cryopreserved oocytes to result in live births in cancer patients was reviewed. This may provide useful information for decision-making in cancer patients regarding oocyte and embryo cryopreservation and fertility preservation.
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Affiliation(s)
- Keiichi Kato
- Kato Ladies' Clinic7-20-3 Nishishinjuku, Shinjuku-ku 160-0023 Tokyo Japan
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17
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Perrin J, Saïas-Magnan J, Broussais F, Bouabdallah R, D'Ercole C, Courbiere B. First French live-birth after oocyte vitrification performed before chemotherapy for fertility preservation. J Assist Reprod Genet 2016; 33:663-666. [PMID: 26861964 DOI: 10.1007/s10815-016-0674-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/26/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- J Perrin
- CECOS - Centre Clinico-Biologique d'Assistance Médicale à la Procréation, Pole Femmes Parents Enfants, AP-HM La Conception, 147 Bd Baille, 13005, Marseille, France.,Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397, Marseille, France.,Plateforme Régionale « Cancer & Fertilité », Réseau Régional de Cancérologie ONCOPACA Corse, Marseille, France
| | - J Saïas-Magnan
- CECOS - Centre Clinico-Biologique d'Assistance Médicale à la Procréation, Pole Femmes Parents Enfants, AP-HM La Conception, 147 Bd Baille, 13005, Marseille, France.,Plateforme Régionale « Cancer & Fertilité », Réseau Régional de Cancérologie ONCOPACA Corse, Marseille, France
| | - F Broussais
- Cancer Center Institut J. Paoli-Calmettes, Aix Marseille Université, Marseille, France
| | - R Bouabdallah
- Cancer Center Institut J. Paoli-Calmettes, Aix Marseille Université, Marseille, France
| | - C D'Ercole
- CECOS - Centre Clinico-Biologique d'Assistance Médicale à la Procréation, Pole Femmes Parents Enfants, AP-HM La Conception, 147 Bd Baille, 13005, Marseille, France
| | - B Courbiere
- CECOS - Centre Clinico-Biologique d'Assistance Médicale à la Procréation, Pole Femmes Parents Enfants, AP-HM La Conception, 147 Bd Baille, 13005, Marseille, France. .,Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397, Marseille, France. .,Plateforme Régionale « Cancer & Fertilité », Réseau Régional de Cancérologie ONCOPACA Corse, Marseille, France.
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18
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Zapardiel I, Cruz M, Diestro MD, Requena A, Garcia-Velasco JA. Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers. Hum Reprod Update 2016; 22:281-305. [PMID: 26759231 DOI: 10.1093/humupd/dmv066] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 12/18/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The trend toward late childbearing has made fertility preservation a major issue for women who face gynecological cancer. New techniques in assisted reproductive medicine enable conception after primary treatment of these cancers. Here, we aimed to review the efficacy and safety of assisted reproductive techniques (ART) after fertility-preserving treatment of gynaecological cancers. METHODS We conducted a systematic literature review of both prospective and retrospective studies in the PubMed, EMBASE, CENTRAL and SciSearch databases. In the retrieved studies, we evaluated live births, clinical pregnancies, overall survival and disease-free survival. RESULTS We identified many prospective and retrospective studies on this topic, but no relevant randomized clinical trials. Fertility-sparing treatments with safe oncological outcomes are feasible in endometrial, cervical and ovarian cancer cases. After cancer treatment, ART seem safe and show variable obstetrical outcomes. CONCLUSIONS After fertility-preserving treatment for gynaecological cancers, ART can enable pregnancy to be achieved with apparent oncological safety. The success of such procedures should directly impact clinical practice and management of those patients who require fertility-sparing treatment.
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Affiliation(s)
- Ignacio Zapardiel
- Gynaecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
| | | | - Maria D Diestro
- Gynaecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
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19
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Grynberg M, Poulain M, le Parco S, Sifer C, Fanchin R, Frydman N. Similar in vitro maturation rates of oocytes retrieved during the follicular or luteal phase offer flexible options for urgent fertility preservation in breast cancer patients. Hum Reprod 2016; 31:623-9. [PMID: 26759139 DOI: 10.1093/humrep/dev325] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 11/30/2015] [Indexed: 12/23/2022] Open
Abstract
STUDY QUESTION Are in vitro maturation (IVM) rates of cumulus-oocyte complexes (COCs), retrieved from breast cancer patients seeking urgent fertility preservation (FP) before neoadjuvant chemotherapy, different between those recovered in the follicular or in the luteal phase of the cycle? SUMMARY ANSWER The present investigation reveals no major difference in the number of COCs recovered or their IVM rates whatever the phase of the cycle at which egg retrieval is performed, suggesting that IVM is a promising tool for breast cancer patients seeking urgent oocyte cryopreservation. WHAT IS KNOWN ALREADY FP now represents a standard of care for young cancer patients having to undergo gonadotoxic treatment. Mature oocyte cryopreservation after IVM of COCs has been proposed for urgent FP, especially in women, who have no time to undergo ovarian stimulation, or when it is contraindicated. STUDY DESIGN, SIZE, DURATION From January 2011 to December 2014, we prospectively studied 248 breast cancer patients awaiting neoadjuvant chemotherapy, aged 18-40 years, candidates for oocyte vitrification following IVM, either at the follicular or the luteal phase of the cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Serum anti-Müllerian hormone and progesterone levels and antral follicle count (AFC) were measured prior to oocyte retrieval. Patients were sorted into two groups according to the phase of the cycle during which eggs were harvested (Follicular phase group, n = 127 and Luteal phase group, n = 121). Number of COCs recovered, maturation rates after 48 h of culture and total number of oocytes cryopreserved were assessed. Moreover, the oocyte retrieval rate (ORR) was calculated by the number of COCs recovered ×100/AFC. MAIN RESULTS AND THE ROLE OF CHANCE In the Follicular and the Luteal phase groups, women were comparable in terms of age, BMI and markers of follicular ovarian status. There was no significant difference in the number of COCs recovered (mean ± SEM), 9.3 ± 0.7 versus 11.1 ± 0.8, and ORR (median (range)) 43.1 (1-100) versus 47.8 (7.7-100)%. Moreover, maturation rates after 48 h of culture (median (range)) were comparable in the follicular and luteal phase groups, 66.7 (20-100) versus 64.5 (0-100)%. Finally, the total number of oocytes cryopreserved (mean ± SEM) was similar in both groups (6.2 ± 0.4 versus 6.8 ± 0.5). LIMITATIONS, REASONS FOR CAUTION Despite the intact meiotic competence of immature oocytes recovered during the follicular or the luteal phase, there is a dramatic lack of data regarding the outcome of IVM oocytes cryopreserved in cancer patients. WIDER IMPLICATIONS OF THE FINDINGS IVM of oocytes may be an interesting method of FP in urgent situations. Improving the culture conditions will be needed to increase the maturation rates and the overall potential of in vitro matured oocytes. STUDY FUNDING/COMPETING INTERESTS None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Grynberg
- Department of Reproductive Medicine, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France University Paris XIII, 93000 Bobigny, France Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France
| | - M Poulain
- Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France
| | - S le Parco
- Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France
| | - C Sifer
- Department of Cytogenetic and Reproductive Biology, AP-HP, Hôpital Jean Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - R Fanchin
- Unit Inserm U1133, Université Paris-Diderot, 75013 Paris, France Univ Paris-Sud, Clamart F-92140, France Department of Obstetric-Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart F-92140, France
| | - N Frydman
- Unit of Reproductive Biology, AP-HP, Hôpital Antoine Béclère, Clamart F-92141, France Univ Paris-Sud, Clamart F-92140, France
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Virant-Klun I. Very Small Embryonic-Like Stem Cells: A Potential Developmental Link Between Germinal Lineage and Hematopoiesis in Humans. Stem Cells Dev 2015; 25:101-13. [PMID: 26494182 DOI: 10.1089/scd.2015.0275] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
It has been suggested that hematopoietic stem/progenitor cells (HSPCs) could become specified from a population of migrating primordial germ cells (PGCs), precursors of gametes, during embryogenesis. Some recent experimental data demonstrated that the cell population that is usually considered to be PGCs, moving toward the gonadal ridges of an embryo, contains a subset of cells coexpressing several germ cell and hematopoietic markers and possessing hematopoietic activity. Experimental data showed that bone morphogenetic protein 4 (BMP4) generates PGCs from mouse bone marrow-derived pluripotent stem cells. Interestingly, functional reproductive hormone receptors have been identified in HSPCs, thus indicating their potential role in reproductive function. Several reports have demonstrated fertility restoration and germ cell generation after bone marrow transplantation in both animal models and humans. A potential link between HSPCs and germinal lineage might be represented by very small embryonic-like stem cells (VSELs), which have been found in adult human bone marrow, peripheral blood, and umbilical cord blood, express a specific pattern of pluripotency, germinal lineage, and hematopoiesis, and are proposed to persist in adult tissues and organs from the embryonic period of life. Stem cell populations, similar to VSELs, expressing several genes related to pluripotency and germinal lineage, especially to PGCs, have been discovered in adult human reproductive organs, ovaries and testicles, and were related to primitive germ cell-like cell development in vitro, thus supporting the idea of VSELs as a potential link between germinal lineage and hematopoiesis.
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Affiliation(s)
- Irma Virant-Klun
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana , Ljubljana, Slovenia
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Sonigo C, Sermondade N, Benard J, Benoit A, Shore J, Sifer C, Grynberg M. The past, present and future of fertility preservation in cancer patients. Future Oncol 2015; 11:2667-2680. [DOI: 10.2217/fon.15.152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Fertility preservation strategies have been developed for men and women whose fertility is compromised for medical reasons, especially in case of cancer therapy. At present, many reliable options for preserving fertility are available. However, a part of these fertility preservation methods, despite being promising, are still considered experimental. Nevertheless, there are still situations where no methods can be offered. Remarkable scientific progress is currently underway to improve available techniques and to develop new technologies to solve problems with current fertility strategies. These new options may drastically change reproductive options for young patients facing germ cell loss and hence sterility. Therefore, oncofertility counseling by a specialist is recommended for all young cancer patients having to undergo treatment that may reduce fertility potential.
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Affiliation(s)
- Charlotte Sonigo
- Department of Reproductive Medicine, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
- University Paris XIII, 93000 Bobigny, France
- Unité Inserm U1185, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Nathalie Sermondade
- Department of Cytogenetic & Reproductive Biology, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Julie Benard
- Department of Reproductive Medicine, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
- University Paris XIII, 93000 Bobigny, France
| | - Alexandra Benoit
- Department of Reproductive Medicine, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Joanna Shore
- Department of Obstetrics & Gynecology, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Christophe Sifer
- Department of Cytogenetic & Reproductive Biology, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
| | - Michael Grynberg
- Department of Reproductive Medicine, Hôpital Jean-Verdier, Avenue du 14 Juillet, 93140 Bondy, France
- University Paris XIII, 93000 Bobigny, France
- Unité Inserm U1133, Université Paris-Diderot, 75013 Paris, France
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Shanshan G, Mei L, Keliang W, Yan S, Rong T, Zi-Jiang C. Effect of different rehydration temperatures on the survival of human vitrified-warmed oocytes. J Assist Reprod Genet 2015; 32:1197-203. [PMID: 25956261 DOI: 10.1007/s10815-015-0480-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 04/13/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the effect of different exposure temperatures during the dilution process on the survival rate of vitrified oocytes and following development. METHODS Patients were divided at random into two groups for different dilution temperature (20-22 °C, RT group; 37 °C,37 °C group) according to computer-generated random numbers on the day of oocyte warming. The survival and fertilization rates of vitrified oocytes as well as the implantation and clinical pregnancy rates of the resulting embryos were recorded. RESULTS A total of 662 and 676 oocytes were warmed in the 37 °C group and RT group, respectively, and significant difference was observed in the survival rate between 37 °C group (88.37%) and RT group (79.88%) (P = 0.0000). There was significant difference between the survival rate of 37 °C group (87.27%) and RT group (75.64%) in nondonor patients (P = 0.0001). Multiple linear regression analysis showed that dilution temperature (β = 0.079, P = 0.017) and clinical outcomes of fresh cycles (β = 0.063, P = 0.001) were significantly and independently associated with survival rate. No significant difference was found between the 37 °C group and RT group in: fertilization rate (66.67 versus 65.37%), implantation rate (20.0 versus 19.46%), clinical pregnancy rate (37.5 versus 35.0%). CONCLUSIONS In conclusion, the results of this study give supportive evidence of the application of 37 °C in the dilution process, especially for oocytes of poor quality. Further studies with well-controlled experimental groups are needed to optimize protocols for human oocyte vitrification.
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Affiliation(s)
- Gao Shanshan
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
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The role of stem cell transplantation for chronic myelogenous leukemia in the 21st century. Blood 2015; 125:3230-5. [PMID: 25852053 DOI: 10.1182/blood-2014-10-567784] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 03/21/2015] [Indexed: 12/13/2022] Open
Abstract
The introduction of tyrosine kinase inhibitors (TKIs), a treatment of chronic myelogenous leukemia (CML), has largely replaced curative strategies based on allogeneic stem cell transplantation (SCT). Nevertheless, SCT still remains an option for accelerated/blastic-phase and selected chronic-phase CML. Transplant outcomes can be optimized by peritransplant TKIs, conditioning regimen, BCR-ABL monitoring, and relapse management. Controversies exist in transplant timing, pediatric CML, alternative donors, and economics. SCT continues to serve as a platform of "operational cure" for CML with TKIs and immunotherapies.
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Martinez M, Rabadan S, Domingo J, Cobo A, Pellicer A, Garcia-Velasco JA. Obstetric outcome after oocyte vitrification and warming for fertility preservation in women with cancer. Reprod Biomed Online 2014; 29:722-8. [DOI: 10.1016/j.rbmo.2014.09.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 08/28/2014] [Accepted: 09/03/2014] [Indexed: 11/24/2022]
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Tsai YY, Chen SU, Shieh CJ, Yao YL, Yang YS, Chen CD. Live birth after single embryo transfer of autologous cryopreserved oocytes from a patient with myelodysplastic syndrome who underwent allogenic peripheral blood stem cell transplantation. J Formos Med Assoc 2014; 113:966-9. [PMID: 25294099 DOI: 10.1016/j.jfma.2014.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/27/2014] [Accepted: 08/29/2014] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yi-Yi Tsai
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Shee-Uan Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chia-Jen Shieh
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Lin Yao
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yu-Shih Yang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chin-Der Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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Abstract
Enhanced long-term survival rates of young women with cancer and advances in reproductive medicine and cryobiology have culminated in an increased interest in fertility preservation methods in girls and young women with cancer. Present data suggest that young patients with cancer should be referred for fertility preservation counselling quickly to help with their coping process. Although the clinical application of novel developments, including oocyte vitrification and oocyte maturation in vitro, has resulted in reasonable success rates in assisted reproduction programmes, experience with these techniques in the setting of fertility preservation is in its infancy. It is hoped that these and other approaches, some of which are still regarded as experimental (eg, ovarian tissue cryopreservation, pharmacological protection against gonadotoxic agents, in-vitro follicle growth, and follicle transplantation) will be optimised and become established within the next decade. Unravelling the complex mechanisms of activation and suppression of follicle growth will not only expand the care of thousands of women diagnosed with cancer, but also inform the care of millions of women confronted with reduced reproductive fitness because of ageing.
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Affiliation(s)
- Michel De Vos
- Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium.
| | - Johan Smitz
- Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Brussels, Belgium
| | - Teresa K Woodruff
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Alvarez M, Solé M, Devesa M, Fábregas R, Boada M, Tur R, Coroleu B, Veiga A, Barri PN. Live birth using vitrified--warmed oocytes in invasive ovarian cancer: case report and literature review. Reprod Biomed Online 2014; 28:663-8. [PMID: 24745835 DOI: 10.1016/j.rbmo.2014.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 02/07/2014] [Accepted: 02/13/2014] [Indexed: 12/28/2022]
Abstract
This article reports the live birth of a healthy newborn using vitrified-warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after insemination of warmed oocytes. Eighteen days after the transfer, she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. As far as is known, this is the first live birth reported through vitrified-warmed oocytes in a patient with invasive ovarian cancer. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, controversial issues are discussed. Fertility preservation is a proven possibility in some cancer patients according to their age, disease and time available until the beginning of their oncological treatment. Although oocyte vitrification is an alternative to be considered for fertility preservation in highly selected cases of ovarian cancer, no live birth has been reported. We report the live birth of a healthy newborn through vitrified-warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after the insemination of the warmed oocytes. Eighteen days after the transfer she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum. A right cornual ectopic pregnancy in the uterus was diagnosed and a wedge resection was performed to resolve it. One week later, a viable intrauterine pregnancy was confirmed under ultrasound. An elective Caesarean section was performed at week 38 of gestation, resulting in the birth of a healthy boy weighing 2650 g. To our knowledge, this is the first live birth reported using vitrified-warmed oocytes in invasive ovarian cancer. Controversial issues are reviewed and discussed.
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Affiliation(s)
- Manuel Alvarez
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain.
| | - Miquel Solé
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
| | - Marta Devesa
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
| | - Rafael Fábregas
- Service of Oncological Gynaecology, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
| | - Montserrat Boada
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
| | - Rosa Tur
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
| | - Buenaventura Coroleu
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
| | - Anna Veiga
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain; Center of Regenerative Medicine (CMR [B]), Barcelona, Spain
| | - Pedro N Barri
- Service of Reproductive Medicine, Department of Obstetrics, Gynaecology and Reproduction, University Hospital Quirón Dexeus, Barcelona, Spain
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28
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Stoop D, van der Veen F, Deneyer M, Nekkebroeck J, Tournaye H. Oocyte banking for anticipated gamete exhaustion (AGE) is a preventive intervention, neither social nor nonmedical. Reprod Biomed Online 2014; 28:548-51. [PMID: 24631381 DOI: 10.1016/j.rbmo.2014.01.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/12/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
The scope of female fertility preservation through cryopreservation of oocytes or ovarian cortex has widened from mainly oncological indications to a variety of fertility-threatening conditions. So far, no specific universally accepted denomination name has been given to cryopreservation of oocytes or ovarian cortex for the prevention of age-related fertility decline. We argue that the commonly used phrases 'social' and 'nonmedical freezing' to denote the indication for cryopreservation are not entirely correct. We suggest 'AGE banking', as this has not only the advantage of being catchy but also depicts the exact indication for the strategy, anticipated gamete exhaustion.
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Affiliation(s)
- Dominic Stoop
- Centre for Reproductive Medicine, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
| | - Fulco van der Veen
- Center for Reproductive Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Michel Deneyer
- Department of Paediatrics, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Julie Nekkebroeck
- Centre for Reproductive Medicine, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Herman Tournaye
- Centre for Reproductive Medicine, UZ Brussel of the Dutch Speaking Free University of Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
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Abstract
In women, ∼10% of cancers occur in those <45 years old. Chemotherapy, radiotherapy and bone marrow transplantation can cure >90% of girls and young women with diseases that require such treatments. However, these treatments can result in premature ovarian failure, depending on the follicular reserve, the age of the patient and the type and dose of drugs used. This article discusses the different fertility preservation strategies: medical therapy before chemotherapy; ovarian transposition; embryo cryopreservation; oocyte vitrification; and ovarian tissue cryopreservation. The indications, results and risks of these options are discussed. Whether medical therapy should be used to protect the gonads during chemotherapy remains a source of debate. Fertility preservation needs to be completed before chemotherapy and/or irradiation is started and might take 2-3 weeks with established techniques such as embryo or oocyte cryopreservation. Further studies are needed in patients with cancer to confirm the excellent outcomes obtained in patients without cancer or in egg donation programmes. For prepubertal girls or cases where immediate therapy is required, cryopreservation of ovarian tissue is the only available option. Finally, possible future approaches are reviewed, including in vitro maturation of nonantral follicles, the artificial ovary, oogonial stem cells and drugs to prevent follicle loss.
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Affiliation(s)
- Jacques Donnez
- Société de Recherche pour l'Infertilité, Avenue Grandchamp, 143, B-1150 Brussels, Belgium
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Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, Quinn G, Wallace WH, Oktay K. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2013; 31:2500-10. [PMID: 23715580 PMCID: PMC5321083 DOI: 10.1200/jco.2013.49.2678] [Citation(s) in RCA: 1073] [Impact Index Per Article: 97.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To update guidance for health care providers about fertility preservation for adults and children with cancer. METHODS A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language. RESULTS There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials. After review of the new evidence, the Update Panel concluded that no major, substantive revisions to the 2006 American Society of Clinical Oncology recommendations were warranted, but clarifications were added. RECOMMENDATIONS As part of education and informed consent before cancer therapy, health care providers (including medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, and surgeons) should address the possibility of infertility with patients treated during their reproductive years (or with parents or guardians of children) and be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Although patients may be focused initially on their cancer diagnosis, the Update Panel encourages providers to advise patients regarding potential threats to fertility as early as possible in the treatment process so as to allow for the widest array of options for fertility preservation. The discussion should be documented. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. Other fertility preservation methods should be considered investigational and should be performed by providers with the necessary expertise.
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Affiliation(s)
- Alison W. Loren
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Pamela B. Mangu
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Lindsay Nohr Beck
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Lawrence Brennan
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Anthony J. Magdalinski
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Ann H. Partridge
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Gwendolyn Quinn
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - W. Hamish Wallace
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | - Kutluk Oktay
- Alison W. Loren, Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Anthony J. Magdalinski, Private Practice, Sellersville, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Lindsay Nohr Beck, LIVESTRONG Foundation's Fertile Hope Program, Austin, TX; Kutluk Oktay, Innovation Institute for Fertility Preservation, New York Medical College, Rye and New York, NY; Lawrence Brennan, Oncology Hematology Care, Crestview Hills, KY; Ann H. Partridge, Dana-Farber Cancer Institute, Boston, MA; Gwendolyn Quinn, Moffitt Cancer Center, Tampa, FL; and W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom
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Doshida M, Nakajo Y, Toya M, Kyono K. A live birth from vitrified-warmed oocytes in a Philadelphia chromosome-positive acute lymphoid leukemia patient 5 years following allogenic bone marrow transplantation and after a magnitude 9.0 earthquake in Japan. Reprod Med Biol 2013; 12:187-191. [PMID: 29699145 DOI: 10.1007/s12522-013-0154-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 05/18/2013] [Indexed: 01/06/2023] Open
Abstract
Purpose To report a live birth from vitrified-warmed oocytes for a Philadelphia chromosome-positive acute lymphoid leukemia (Ph-ALL) patient. Methods A 20-year-old single woman with Ph-ALL requested oocyte cryopreservation at a private fertility clinic using assisted reproduction technology (ART). In cases of leukemia, there is a very short time before chemotherapy, follwed shortly by total body irradiation (TBI), and although she had already received the chemotherapy, ten oocytes were vitrified and stored for 59 months before warming. Soon after the oocyte cryopreservation, she received TBI and bone marrow transplant (BMT). During the storage, a magnitude 9.0 earthquake occurred making oocyte transport necessary. The embryo transfer was planned in a hormone replacement cycle, and intracytoplasmic sperm injection (ICSI) was performed on the vitrified-warmed oocytes. On day 3, two embryos were transferred. Results The patient became pregnant and delivered a healthy girl after ICSI using vitrified-warmed oocytes. Conclusions Oocyte cryopreservation is the best option for fertility preservation of young single women with leukemia. Oncologists and gynecologists who conduct ART should cooperate to improve the quality of life of cancer patients.
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Affiliation(s)
- Masakazu Doshida
- Kyono ART Clinic 1-1-1-3F, Honcho, Aobaku 980-0014 Sendai Miyagi Japan
| | - Yukiko Nakajo
- Kyono ART Clinic 1-1-1-3F, Honcho, Aobaku 980-0014 Sendai Miyagi Japan
| | - Mayumi Toya
- Kyono ART Clinic 1-1-1-3F, Honcho, Aobaku 980-0014 Sendai Miyagi Japan
| | - Koichi Kyono
- Kyono ART Clinic 1-1-1-3F, Honcho, Aobaku 980-0014 Sendai Miyagi Japan
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Cobo A, Garcia-Velasco JA, Domingo J, Remohí J, Pellicer A. Is vitrification of oocytes useful for fertility preservation for age-related fertility decline and in cancer patients? Fertil Steril 2013; 99:1485-95. [PMID: 23541405 DOI: 10.1016/j.fertnstert.2013.02.050] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 02/20/2013] [Accepted: 02/25/2013] [Indexed: 02/05/2023]
Abstract
The aim of this review is to provide current knowledge on oocyte cryopreservation, with special emphasis on vitrification as a means to preserve fertility in different indications. Major advancements achieved in the past few years in the cryolaboratory have facilitated major changes in our practice. Areas such as fertility preservation for social or oncologic reasons, the possibility to create oocyte banks for egg donation programs, the opportunity to avoid ovarian hyperstimulation syndrome, or to accumulate oocytes in low-yield patients, or even to offer treatment segmentation by stimulating the ovaries, vitrifying, and then transferring in a natural cycle are some of the options that are now available with the development of cryopreservation. We present general experience from our group and others on fertility preservation for age-related fertility decline as well as in oncologic patients, confirming that oocyte vitrification is a standardized, simple, reproducible, and efficient option.
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