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Pais AS, Reis S, Laranjo M, Caramelo F, Silva F, Botelho MF, Almeida-Santos T. The challenge of ovarian tissue culture: 2D versus 3D culture. J Ovarian Res 2021; 14:147. [PMID: 34724957 PMCID: PMC8561954 DOI: 10.1186/s13048-021-00892-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 10/06/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cryopreservation of ovarian tissue is a powerful technique for preserving female fertility, as it can restore fertility and endocrine function. To increase the longevity of the transplant and decrease the risk of reimplantation of neoplastic cells, several studies have been carried out with culture of ovarian tissue. The aim of this study was to compare a conventional (2D) culture with an alginate matrix three-dimensional (3D) model for ovarian tissue culture. RESULTS The ovarian tissue culture within the alginate matrix (3D) was similar to 2D culture, regarding follicular density and cell apoptosis in follicles and stroma. The proliferation rate remained stable in both models for follicles, but for stromal cell proliferation it decreased only in 3D culture (p = 0.001). At 24 h of culture, cytotoxicity was lower in the 3D model (p = 0.006). As culture time increased, cytotoxicity seemed similar. Degradation of the tissue was suggested by the histological score analysis of tissue morphology after 72 h of culture. Tissue injury was greater (p = 0.01) in 3D culture due to higher interstitial oedema (p = 0.017) and tissue necrosis (p = 0.035). CONCLUSION According to our results, 3D culture of ovarian tissue has no advantage over 2Dculture; it is more time consuming and difficult to perform and has worse reproducibility.
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Affiliation(s)
- Ana Sofia Pais
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), E.P.E., Coimbra, Portugal.
- Obstetrics Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Biophysics Institute of Faculty of Medicine, Coimbra, Portugal.
- University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal.
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.
| | - Sandra Reis
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), E.P.E., Coimbra, Portugal
- Center for Neuroscience and Cell Biology (CNC), CIBB, Azinhaga de Santa Comba, Celas, University of Coimbra, Coimbra, Portugal
- PhD Programme in Experimental Biology and Biomedicine, IIIUC - Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Mafalda Laranjo
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Biophysics Institute of Faculty of Medicine, Coimbra, Portugal
- University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Francisco Caramelo
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Biophysics Institute of Faculty of Medicine, Coimbra, Portugal
- University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Fátima Silva
- Pathology Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), E.P.E., Coimbra, Portugal
| | - Maria Filomena Botelho
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Biophysics Institute of Faculty of Medicine, Coimbra, Portugal
- University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Teresa Almeida-Santos
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), E.P.E., Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Center for Neuroscience and Cell Biology (CNC), CIBB, Azinhaga de Santa Comba, Celas, University of Coimbra, Coimbra, Portugal
- University of Coimbra, Faculty of Medicine, Coimbra, Portugal
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Cacciottola L, Donnez J, Dolmans MM. Ovarian tissue damage after grafting: systematic review of strategies to improve follicle outcomes. Reprod Biomed Online 2021; 43:351-369. [PMID: 34384692 DOI: 10.1016/j.rbmo.2021.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 12/17/2022]
Abstract
Frozen-thawed human ovarian tissue endures large-scale follicle loss in the early post-grafting period, characterized by hypoxia lasting around 7 days. Tissue revascularization occurs progressively through new vessel invasion from the host and neoangiogenesis from the graft. Such reoxygenation kinetics lead to further potential damage caused by oxidative stress. The aim of the present manuscript is to provide a systematic review of proangiogenic growth factors, hormones and various antioxidants administered in the event of ovarian tissue transplantation to protect the follicle pool from depletion by boosting revascularization or decreasing oxidative stress. Although almost all investigated studies revealed an advantage in terms of revascularization and reduction in oxidative stress, far fewer demonstrated a positive impact on follicle survival. As the cascade of events driven by ischaemia after transplantation is a complex process involving numerous players, it appears that acting on specific molecular mechanisms, such as concentrations of proangiogenic growth factors, is not enough to significantly mitigate tissue damage. Strategies exploiting the activated tissue response to ischaemia for tissue healing and remodelling purposes, such as the use of antiapoptotic drugs and adult stem cells, are also discussed in the present review, since they yielded promising results in terms of follicle pool protection.
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Affiliation(s)
- Luciana Cacciottola
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Jacques Donnez
- Prof. Emeritus, Université Catholique de Louvain, Brussels, Belgium
| | - Marie-Madeleine Dolmans
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium; Department of Gynecology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Onder GO, Balcioglu E, Baran M, Ceyhan A, Cengiz O, Suna PA, Yıldız OG, Yay A. The different doses of radiation therapy-induced damage to the ovarian environment in rats. Int J Radiat Biol 2021; 97:367-375. [PMID: 33320730 DOI: 10.1080/09553002.2021.1864497] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE The sequelae of premature loss of ovarian function can undoubtedly have undesirable effects for a woman although radiotherapy is one of the most relevant treatment modalities for various types of malignancies. The aim of this study was to determine the effect of different doses of radiation on ovarian folliculogenesis, inflammation, and apoptotic markers. MATERIALS AND METHODS For this purpose, 40 healthy Wistar albino female rats divided into four groups: 1) Control group; 2) those that were exposed to total body 1 Gy of gamma rays; 3) those that were exposed to the total body 5 Gy of gamma rays, and 4) those that were exposed to total body 10 Gy of gamma rays. External irradiation to the total body was given with gamma irradiation delivered by the Co60 teletherapy machine. The day after radiation application the rats were sacrificed and the ovaries were removed in all groups. Histopathologic examination, follicle counting, and classification were performed in the ovarian tissues. The expression of AMH, TNF-α, IL1-β, Bax, and Bcl-2 was detected. The stained sections were examined for caspase 3 positive apoptotic cell numbers. RESULTS The recorded results revealed that increased radiation dose induced obvious ovarian injuries that were indicated by histopathological, and immunohistochemical alterations, including elevation of ovarian injury markers. A significantly lower number of total and primordial follicles was detected with increasing radiation dose compared with the control group. According to our immunohistochemical results, 10 Gy of gamma rays group had the lowest AMH expression levels, while had the highest TNF-α, IL1-β expression level compared to the control group. When the groups were evaluated in terms of apoptosis, it was seen that the number of caspase 3 positive cells and Bax immunoreactivity intensity increased with radiation dose. In contrast, Bcl-2 immunoreactivity intensity decreased with increasing radiation dose compared with the control group. CONCLUSIONS We demonstrate here that dose rate plays an important role when estimating the relation between exposure to an increased dose of ionizing radiation and the risk of ovarian disease. According to these results, certain factors have to be optimized before introducing them into clinics.
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Affiliation(s)
- Gozde Ozge Onder
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Esra Balcioglu
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.,Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
| | - Munevver Baran
- Department of Pharmaceutical Basic Science, Faculty of Pharmacy, Erciyes University, Kayseri, Turkey
| | - Ayse Ceyhan
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ozge Cengiz
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Pinar Alisan Suna
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Oguz Galip Yıldız
- Department of Radiation Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Arzu Yay
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.,Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
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Dolmans MM, Donnez J, Cacciottola L. Fertility Preservation: The Challenge of Freezing and Transplanting Ovarian Tissue. Trends Mol Med 2020; 27:777-791. [PMID: 33309205 DOI: 10.1016/j.molmed.2020.11.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/06/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
Cancer treatments are increasingly effective, but can result in iatrogenic premature ovarian insufficiency. Ovarian tissue cryopreservation is the only option available to preserve fertility in prepubertal girls and young women who require immediate chemotherapy. Ovarian tissue transplantation has been shown to restore hormonal cycles and fertility, but a large proportion of the follicle reserve is lost as a consequence of exposure to hypoxia. Another crucial concern is the risk of reimplanting malignant cells together with the grafted tissue. In this review, the authors advance some challenging propositions, from prevention of chemotherapy-related gonadotoxicity to ovarian tissue cryopreservation and transplantation, including the artificial ovary approach.
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Affiliation(s)
- Marie-Madeleine Dolmans
- Gynecology Department, Cliniques universitaires St-Luc, Brussels, Belgium; Pôle de Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
| | - Jacques Donnez
- Prof. Em. Catholic University of Louvain, Brussels, Belgium; Société de Recherche pour l'Infertilité (SRI), Brussels, Belgium
| | - Luciana Cacciottola
- Pôle de Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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Herraiz S, Monzó S, Gómez-Giménez B, Pellicer A, Díaz-García C. Optimizing ovarian tissue quality before cryopreservation: comparing outcomes of three decortication methods on stromal and follicular viability. Fertil Steril 2020; 113:609-617.e3. [PMID: 32192593 DOI: 10.1016/j.fertnstert.2019.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/27/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate whether specific ovarian decortication techniques vary in promoting ovarian cortex cryopreservation and transplant outcomes. DESIGN Experimental design. SETTING University hospital. ANIMAL(S) Nonobese diabetic (NOD)/severe combined immunodeficiency (SCID) female mice. INTERVENTION(S) Human ovarian biopsy samples allocated to one of the following decortication procedures: scratching with scalpel blade (B), cutting with microsurgical scissors (M), separation with slicer (S), or no-separation (control, C). Parallel, in vivo experiment: decortication techniques combined with slow freezing (SF) and vitrification (VT) before xenograft into immunodeficient mice. MAIN OUTCOME MEASURE(S) Follicular counts, apoptosis, shear stress, Hippo pathway and inflammation. In vivo: recovered grafts analyzed for follicular counts, angiogenesis, proliferation, and fibrosis. RESULT(S) There were no differences in follicular density or number of damaged follicles between the decortication techniques in the in vitro study. Nevertheless, the M samples showed statistically significantly increased stromal damage compared with the controls and S samples, and up-regulation of Hsp60 shear stress gene expression. Decortication by both M and S inhibited the Hippo pathway, promoting gene expression changes. In the 21-day xenograft, total follicular density statistically significantly decreased compared with the nongrafted controls in all groups. Nevertheless, no differences were observed between the decortication techniques. Ovarian stroma vascularization was increased in the vitrified samples, but among the slow-freezing samples, the B samples had the lowest microvessel density. The M decorticated xenografts had increased fibrosis. CONCLUSION(S) Decortication with a slicer causes less damage to ovarian tissue than other commonly used methods although microsurgical scissors seem to preserve slightly increased follicular numbers. Nevertheless, blade decortication seems to be a reliable technique for maintaining acceptable follicular conditions without inducing serious stromal impairment.
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Affiliation(s)
- Sonia Herraiz
- IVI Foundation, Valencia, Spain; Reproductive Medicine Research Group, Valencia, Spain
| | - Susana Monzó
- Fertility Preservation Unit, Women's Health Area, La Fe University Hospital, Valencia, Spain
| | | | - Antonio Pellicer
- IVI Foundation, Valencia, Spain; Reproductive Medicine Research Group, Valencia, Spain; IVI-RMA Rome, Rome, Italy
| | - César Díaz-García
- Reproductive Medicine Research Group, Valencia, Spain; IVI-London, London, United Kingdom.
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Cacciottola L, Nguyen TYT, Chiti MC, Camboni A, Amorim CA, Donnez J, Dolmans MM. Long-Term Advantages of Ovarian Reserve Maintenance and Follicle Development Using Adipose Tissue-Derived Stem Cells in Ovarian Tissue Transplantation. J Clin Med 2020; 9:jcm9092980. [PMID: 32942743 PMCID: PMC7564479 DOI: 10.3390/jcm9092980] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Ovarian tissue transplantation with adipose tissue-derived stem cells (ASCs) has been shown to enhance graft vascularization and increase follicle survival after a short interval of 7 days. The aim of the present study was to investigate their long-term effects on primordial follicle pool maintenance and follicle development. (2) Methods: A total of 14 severe combined immunodeficient (SCID) mice were grafted with frozen-thawed human ovarian tissue with or without ASCs. Blood was taken monthly in order to quantify the anti-Müllerian hormone (AMH) and estradiol. After 6 months, all the grafts were retrieved and sent for histology and immunolabeling (AMH, AMH receptor II, estrogen receptors α and β, and c-kit/kit ligand). (3) Results: A significant upturn was observed in AMH and estradiol plasma levels 4 months after transplantation in both grafted groups. The primordial follicle pool was better preserved in the ASC group (41.86 ± 28.35) than in the standard transplantation group (9.65 ± 17.6, p < 0.05) compared to non-grafted controls (124.7 ± 140). (4) Conclusions: The use of ASCs prior to ovarian tissue transplantation yielded a larger primordial follicle pool and more physiological follicle distribution after long-term grafting. These findings suggested that ASC use might extend the ovarian tissue lifespan.
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Affiliation(s)
- Luciana Cacciottola
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200 Brussels, Belgium; (L.C.); (T.Y.T.N.); (M.C.C.); (A.C.); (C.A.A.)
| | - Thu Y. T. Nguyen
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200 Brussels, Belgium; (L.C.); (T.Y.T.N.); (M.C.C.); (A.C.); (C.A.A.)
| | - Maria C. Chiti
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200 Brussels, Belgium; (L.C.); (T.Y.T.N.); (M.C.C.); (A.C.); (C.A.A.)
| | - Alessandra Camboni
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200 Brussels, Belgium; (L.C.); (T.Y.T.N.); (M.C.C.); (A.C.); (C.A.A.)
- Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200 Brussels, Belgium
| | - Christiani A. Amorim
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200 Brussels, Belgium; (L.C.); (T.Y.T.N.); (M.C.C.); (A.C.); (C.A.A.)
| | - Jacques Donnez
- Society for Research into Fertility, Av. Grandchamp 143, 1150 Brussels, Belgium;
| | - Marie-Madeleine Dolmans
- Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Av. Mounier 52, 1200 Brussels, Belgium; (L.C.); (T.Y.T.N.); (M.C.C.); (A.C.); (C.A.A.)
- Department of Gynecology, Cliniques Universitaires Saint-Luc, Av. Hippocrate 10, 1200 Brussels, Belgium
- Correspondence: ; Tel.: +32-(0)2-764-5237; Fax: +32-(0)2-764-9507
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Mizuno Y, Taguchi T. A hydrophobic gelatin fiber sheet promotes secretion of endogenous vascular endothelial growth factor and stimulates angiogenesis. RSC Adv 2020; 10:24800-24807. [PMID: 35517459 PMCID: PMC9055140 DOI: 10.1039/d0ra03593a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/20/2020] [Indexed: 01/24/2023] Open
Abstract
In tissue engineering and regenerative medicine, the formation of vascular beds is an effective method to supply oxygen and nutrients to implanted cells or tissues to improve their survival and promote normal cellular functions. Various types of angiogenic materials have been developed by incorporating growth factors, such as vascular endothelial growth factor, in biocompatible materials. However, these exogenous growth factors suffer from instability and inactivation under physiological conditions. In this study, we designed a novel angiogenic electrospun fiber sheet (C16-FS) composed of Alaska pollock-derived gelatin (ApGltn) modified with hexadecyl (C16) groups to induce localized and sustained angiogenesis without growth factors. C16-FS was thermally crosslinked to enhance its stability. We demonstrated that C16-FS swells in phosphate-buffered saline for over 24 h and resists degradation. Laser doppler perfusion imaging showed that C16-FS induced increased blood perfusion when implanted subcutaneously in rats compared with unmodified ApGltn-fiber sheets (Org-FS) and the sham control. Furthermore, angiogenesis was sustained for up to 7 days following implantation. Immunohistochemical studies revealed elevated nuclear factor-κB and CD31 levels around the C16-FS implantation site compared with the Org-FS implantation site and the control incision site. These results demonstrate that C16-FS is a promising angiogenic material to promote the formation of vascular beds for cell and tissue transplantation without the need for growth factors. In vivo long-term growth factor-free angiogenesis by LPS-mimicking C16-modified gelatin based electrospun fiber sheet.![]()
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Affiliation(s)
- Yosuke Mizuno
- Graduate School of Science and Technology
- University of Tsukuba
- Tsukuba
- Japan
- Polymers and Biomaterials Field
| | - Tetsushi Taguchi
- Graduate School of Science and Technology
- University of Tsukuba
- Tsukuba
- Japan
- Polymers and Biomaterials Field
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Dolmans M, Cacciottola L, Amorim CA, Manavella D. Translational research aiming to improve survival of ovarian tissue transplants using adipose tissue‐derived stem cells. Acta Obstet Gynecol Scand 2019; 98:665-671. [DOI: 10.1111/aogs.13610] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/12/2019] [Indexed: 01/28/2023]
Affiliation(s)
- Marie‐Madeleine Dolmans
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
- Gynecology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Luciana Cacciottola
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
| | - Christiani A. Amorim
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
| | - Diego Manavella
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
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Effect of cryopreservation techniques on proliferation and apoptosis of cultured equine ovarian tissue. Theriogenology 2019; 126:88-94. [DOI: 10.1016/j.theriogenology.2018.11.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 12/20/2022]
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Dolmans MM, Cordier F, Amorim CA, Donnez J, Vander Linden C. In vitro Activation Prior to Transplantation of Human Ovarian Tissue: Is It Truly Effective? Front Endocrinol (Lausanne) 2019; 10:520. [PMID: 31428051 PMCID: PMC6688053 DOI: 10.3389/fendo.2019.00520] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/15/2019] [Indexed: 01/12/2023] Open
Abstract
Research Question: What are the true benefits, if any, of disrupting the Hippo signaling pathway and stimulating the Akt pathway in xenotransplanted human ovarian tissue using an in vitro activation (IVA) approach? Design: Human ovarian tissue was retrieved from 18 young patients by laparoscopy and grafted to 54 severe combined immunodeficient mice. The experiment was conducted using fresh ovarian tissue (group I; n = 6 women), slow-frozen-thawed ovarian tissue (group II; n = 6 women), and vitrified-warmed ovarian tissue (group III; n = 6 women). Slow-freezing and vitrification procedures were performed according to Gosden's and Kawamura's protocols, respectively. The tissue (fresh, slow-frozen, and vitrified) was fragmented into small cubes (1 × 1 × 1 mm) to disrupt the Hippo signaling pathway and cultured or not in IVA medium for 48 h with Akt stimulators (PI3K stimulator and PTEN inhibitor), before being transplanted to the mice. All the grafts were maintained for 28 days. Results: (1) Follicular density: Follicular density decreased in all groups after transplantation, most significantly in the vitrification group. Culture with IVA had no impact. (2) Follicle activation: Addition of PI3K stimulator and PTEN inhibitor for 48 h prior to grafting did not significantly change the proportion of primordial follicles in any of the groups (fresh, slow-frozen, or vitrified tissue) compared to 48 h of control culture without these molecules. Particularly, vitrification and culture in IVA medium yielded no benefits in terms of growing follicle percentages or follicle proliferation rates. The large proportion of growing follicles in the vitrified tissue group after grafting may have been responsible for the higher rate of atresia. Conclusion: We were unable to demonstrate any significant benefits of cutting ovarian tissue into small cubes and applying IVA with Akt stimulators. The association of vitrification and transplantation was actually found to be the most deleterious combination with respect to the follicle reserve, and even worse when culture with Akt stimulators was performed.
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Affiliation(s)
- Marie-Madeleine Dolmans
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Department of Gynecology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
- *Correspondence: Marie-Madeleine Dolmans
| | - Florence Cordier
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Department of Gynecology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Christiani A. Amorim
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Jacques Donnez
- Société de Recherche pour l'Infertilité, Brussels, Belgium
| | - Catherine Vander Linden
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
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In vivo characterization of metabolic activity and oxidative stress in grafted human ovarian tissue using microdialysis. Fertil Steril 2018; 110:534-544.e3. [DOI: 10.1016/j.fertnstert.2018.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 12/26/2022]
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Dolmans MM. Recent advances in fertility preservation and counseling for female cancer patients. Expert Rev Anticancer Ther 2017; 18:115-120. [PMID: 29220203 DOI: 10.1080/14737140.2018.1415758] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Ensuring quality of life for increasing numbers of women surviving cancer has become a key challenge. Patients need to be counseled on potential fertility loss resulting from gonadotoxic treatments, and referred to fertility specialists to discuss existing options and available results. Areas covered: Fertility preservation options have existed for over twenty years. The proposed fertility preservation approach depends on patient age, the urgency of required chemotherapy, and psychosocial factors such as financial concerns, especially in countries where techniques are not covered by social security. Efficacy in terms of pregnancy rates has been demonstrated with frozen-thawed embryos, oocytes and re-implanted ovarian tissue. Appropriate counseling by oncologists is on the increase, despite persistently low rates of referral to fertility specialists. Expert commentary: Access to oncofertility services is steadily improving, facilitated by the growing involvement of public healthcare systems and sustained efforts all over the world to establish specific oncofertility programs. Early referral to reproductive specialists before initiation of chemo/radiotherapy is crucial to success in the field of female fertility preservation. In the near future, efforts should focus on increasing patient referrals and establishing international registries on short- and long-term outcomes of fertility preservation strategies.
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Affiliation(s)
- Marie-Madeleine Dolmans
- a Gynecology Department , Cliniques Universitaires Saint Luc , Brussels , Belgium.,b Gynecology Research Laboratory, Institut de Recherche Expérimentale et Clinique (IREC) , Université Catholique de Louvain (UCL) , Brussels , Belgium
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Abir R, Fisch B, Fisher N, Samara N, Lerer-Serfaty G, Magen R, Herman-Edelstein M, Ben-Haroush A, Stein A, Orvieto R. Attempts to improve human ovarian transplantation outcomes of needle-immersed vitrification and slow-freezing by host and graft treatments. J Assist Reprod Genet 2017; 34:633-644. [PMID: 28315146 PMCID: PMC5427655 DOI: 10.1007/s10815-017-0884-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/24/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To investigate if needle-immersed vitrification or slow-freezing yields better implantation results for human ovarian tissue and which method benefits more when combined with the "improvement protocol" of host melatonin treatment and graft incubation with biological glue + vitamin E + vascular endothelial growth factor-A. METHODS Human ovarian tissue was preserved by needle-immersed vitrification or slow-freezing and transplanted into immunodeficient mice, either untreated (groups A and C, respectively) or treated with the improvement protocol (groups B and D, respectively). Grafted and ungrafted slices were evaluated by follicle counts, apoptosis assay and immunohistochemistry for Ki67 and platelet endothelial cell adhesion molecule (PECAM). RESULTS Follicle number in the recovered grafts was limited. The number of atretic follicles was significantly higher after vitrification with/without the improvement protocol and slow-freezing than that after slow-freezing + the improvement protocol. Stroma cell apoptosis was the lowest in the group D. PECAM staining showed a peripheral and diffuse pattern in the group D (mostly normal follicular morphology) and a diffuse pattern in all other groups (few follicles, mostly atretic), with significantly higher diffuse levels in the vitrification groups. Ki67 staining was identified in all normal follicles. Follicles did not survive transplantation in the vitrification groups. CONCLUSIONS Ovarian sample preparation with slow-freezing + the improvement protocol appears to yield better implantation outcomes than needle-immersed vitrification with/without the improvement protocol. The real quality of frozen tissue can be assessed only after grafting and not after thawing/warming.
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Affiliation(s)
- Ronit Abir
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel.
| | - Benjamin Fisch
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Noa Fisher
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Nivin Samara
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
- In Vitro Fertilization Unit, Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center, 6423906, Tel Aviv, Israel
| | - Galit Lerer-Serfaty
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Roei Magen
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Faculty of Health Sciences, Goldman Medical School, Ben Gurion University of the Negev, Beer Sheva, 8410501, Israel
| | - Michal Herman-Edelstein
- Department of Nephrology, Rabin Medical Center, Felsenstein Research Center 49100 and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Avi Ben-Haroush
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Anat Stein
- Infertility and IVF Unit, Beilinson Women Hospital, Rabin Medical Center, Petach Tikva, 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Raoul Orvieto
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
- Infertility and IVF Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat Gan, 52621, Israel
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Laronda MM, McKinnon KE, Ting AY, Le Fever AV, Zelinski MB, Woodruff TK. Good manufacturing practice requirements for the production of tissue vitrification and warming and recovery kits for clinical research. J Assist Reprod Genet 2016; 34:291-300. [PMID: 27900615 DOI: 10.1007/s10815-016-0846-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/14/2016] [Indexed: 11/28/2022] Open
Abstract
Products that are manufactured for use in a clinical trial, with the intent of gaining US Food and Drug Administration (FDA) approval for clinical use, must be produced under an FDA approved investigational new drug (IND) application. We describe work done toward generating reliable methodology and materials for preserving ovarian cortical tissue through a vitrification kit and reviving this tissue through a warming and recovery kit. We have described the critical steps, procedures, and environments for manufacturing products with the intent of submitting an IND. The main objective was to establish an easy-to-use kit that would ensure standardized procedures for quality tissue preservation and recovery across the 117 Oncofertility Consortium sites around the globe. These kits were developed by breaking down the components and steps of a research protocol and recombining them in a way that considers component stability and use in a clinical setting. The kits were manufactured utilizing current good manufacturing practice (cGMP) requirements and environment, along with current good laboratory practices (cGLP) techniques. Components of the kit were tested for sterility and endotoxicity, and morphological endpoint release criteria were established. We worked with the intended down-stream users of these kits for development of the kit instructions. Our intention is to test these initial kits, developed and manufactured here, for submission of an IND and to begin clinical testing for preserving the ovarian tissue that may be used for future restoration of fertility and/or hormone function in women who have gonadal dysgenesis from gonadotoxic treatment regimens or disease.
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Affiliation(s)
- Monica M Laronda
- Division of Reproductive Biology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kelly E McKinnon
- Division of Reproductive Biology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alison Y Ting
- Division of Reproductive and Developmental Science, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA
| | - Ann V Le Fever
- Mathews Center for Cellular Therapy, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Mary B Zelinski
- Division of Reproductive and Developmental Science, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, USA.,Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Teresa K Woodruff
- Division of Reproductive Biology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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