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Zhang C, Yang D, Ding D, Fan Y, Yang H, Wang J, Zou H, Rao B, Wang Q, Ye T, Yu M, Zhang Z. Melatonin application during cryopreservation improves the development and clinical outcomes of human vitrified-warmed oocytes. Cryobiology 2024; 115:104902. [PMID: 38734365 DOI: 10.1016/j.cryobiol.2024.104902] [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: 01/11/2024] [Revised: 04/10/2024] [Accepted: 05/07/2024] [Indexed: 05/13/2024]
Abstract
In this clinical study, we investigated the potential of melatonin (MT) supplementation in the freeze-thaw medium used for cryopreserved human oocytes. In total, 152 patients who underwent in vitro fertilization between January 2020 and December 2022 were included and categorized into different groups as follows: the donor group, comprising 108 patients who donated their oocytes, with 34 patients using a vitrification and warming medium supplemented with MT (D-MT subgroup) and 74 patients using conventional medium without MT (D-0 subgroup); and the autologous group, comprising 38 patients who used their own oocytes, with 19 patients using medium supplemented with MT (A-MT subgroup) and 19 patients using medium without MT (A-0 subgroup). After thawing, the surviving oocytes in the D-MT and A-MT subgroups and D-0 and A-0 subgroups were cultured in a fertilization media with and without 10-9 MMT for 2.5 h, respectively, followed by intracytoplasmic sperm injection insemination, embryo culture, and transfer. The survival, cleavage, high-quality embryo, clinical pregnancy, ongoing pregnancy, and implantation rates were significantly higher in the D-MT subgroup than in the D-0 subgroup (all P < 0.05). Similarly, the survival, fertilization, high-quality embryo, and high-quality blastocyst rates were significantly higher in the A-MT subgroup than in the A-0 subgroup (all P < 0.05). These findings indicate that MT addition during cryopreservation can enhance the development of vitrified-warmed human oocytes and improve clinical outcomes.
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Affiliation(s)
- Chao Zhang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dandan Yang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ding Ding
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yongqi Fan
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Han Yang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Biomedical Engineering, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jing Wang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Huijuan Zou
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Bihua Rao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qiushuang Wang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tingting Ye
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Min Yu
- Department of Obstetrics and Gynecology, The 901, Hospital of Joint Logistics Support Force of PLA, No. 424 Changjiang West Road, Shushan District, Hefei, 230032, Anhui, China.
| | - Zhiguo Zhang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Biomedical Engineering, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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Amir A, Yehudit N, Pasquale P, Roy A. The Effect of Cryoprotectants Concentration on Ice Crystal Propagation Velocity. Biopreserv Biobank 2023; 21:547-553. [PMID: 36383132 DOI: 10.1089/bio.2022.0144] [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] [Indexed: 11/17/2022] Open
Abstract
Background: Two physicochemical effects occur during vitrification: nucleation and crystallization. Nucleation is a statistical occurrence by its nature. Thus, the more water molecules that are present the higher are the chances for nucleation to occur. Crystallization is a first-order transition where a water molecule is incorporated into ice crystal. Intracellular viscosity, which is the combination of water, salts, and cryoprotectants (CPs), affects both the nucleation and crystal growth rates. Ice velocity is inversely correlated with the viscosity and directly proportional to the function of the system's supercooling. However, little is known about the speed of ice crystal propagation in vitrification solutions containing different concentrations of CPs. Methods: This article describes the ice crystal propagation velocity while referring to vitrification. Ice crystal propagation velocity was measured in solutions containing different CP (dimethyl sulfoxide [DMSO], propylene glycol [PG], ethylene glycol [EG], and glycerol) concentrations at a supercooled temperature. The different CPs solutions were inserted into 0.25 mL straws and placed in different temperatures of an alcohol bath (Tc) at supercooling temperatures of -8°C to -10°C. Results: We found that ice crystal propagation is inversely correlated to CP concentrations. Interestingly, PG showed, with statistically significant results, lower ice crystal growth velocities up to concentrations of 30% (v/v), compared with DMSO, and EG at the same concentrations. The combination of EG with PG showed better results (0.25 mm/s) than EG with DMSO (0.39 mm/s) in terms of decreasing the ice crystal growth velocity. When the concentration was increased to 40% (v/v), EG showed the lowest ice crystal propagation velocity (0.09 mm/s), although not significantly different than PG and glycerol but significantly lower than DMSO (0.13 mm/s). Conclusion: These results suggest that current vitrification solutions are not optimized. Based on our results, we suggest that combining PG with EG has advantages over the combination of DMSO and EG, which might promote successful cell and tissue vitrification.
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Affiliation(s)
| | | | - Patrizio Pasquale
- Division Reproductive Endocrinology & Infertility, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Arav Roy
- A.A. Technology, Tel Aviv, Israel
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Casciani V, Monseur B, Cimadomo D, Alvero R, Rienzi L. Oocyte and embryo cryopreservation in assisted reproductive technology: past achievements and current challenges. Fertil Steril 2023; 120:506-520. [PMID: 37290552 DOI: 10.1016/j.fertnstert.2023.06.005] [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: 02/09/2023] [Revised: 05/27/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023]
Abstract
Cryopreservation has revolutionized the treatment of infertility and fertility preservation. This review summarizes the milestones that paved the way to the current routinary clinical implementation of this game-changing practice in assisted reproductive technology. Still, evidence to support "the best practice" in cryopreservation is controversial and several protocol adaptations exist that were described and compared here, such as cumulus-intact vs. cumulus-free oocyte cryopreservation, artificial collapse, assisted hatching, closed vs. open carriers, and others. A last matter of concern is whether cryostorage duration may impact oocyte/embryo competence, but the current body of evidence in this regard is reassuring. From social and clinical perspectives, oocyte and embryo cryopreservation has evolved from an afterthought when assisted reproduction was intended for immediate pregnancy with supernumerary embryos of secondary interest to its current purpose, which primarily is to preserve fertility long-term and more comprehensively allow for family planning. However, the initial consenting process, which still is geared to short-term fertility care, may no longer be relevant when the individuals that initially preserved the tissues have completed their reproductive journey. A more encompassing counseling model is required to address changing patient values over time.
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Affiliation(s)
- Valentina Casciani
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Brent Monseur
- Stanford Fertility and Reproductive Health, Stanford University, Sunnyvale, California
| | - Danilo Cimadomo
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy
| | - Ruben Alvero
- Stanford Fertility and Reproductive Health, Stanford University, Sunnyvale, California
| | - Laura Rienzi
- IVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy; Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy.
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Arav A. Cryopreservation by Directional Freezing and Vitrification Focusing on Large Tissues and Organs. Cells 2022; 11:1072. [PMID: 35406636 PMCID: PMC8997870 DOI: 10.3390/cells11071072] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 02/01/2023] Open
Abstract
The cryopreservation of cells has been in routine use for decades. However, despite the extensive research in the field, cryopreservation of large tissues and organs is still experimental. The present review highlights the major studies of directional freezing and vitrification of large tissues and whole organs and describes the different parameters that impact the success rate of large tissue and organ cryopreservation. Key factors, such as mass and heat transfer, cryoprotectant toxicity, nucleation, crystal growth, and chilling injury, which all have a significant influence on whole-organ cryopreservation outcomes, are reviewed. In addition, an overview of the principles of directional freezing and vitrification is given and the manners in which cryopreservation impacts large tissues and organs are described in detail.
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Affiliation(s)
- Amir Arav
- A.A Cash Technology, 59 Shlomzion Hamalca, Tel Aviv 62266, Israel
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The Impact of Oocyte Vitrification on Offspring: a Systematic Review. Reprod Sci 2022; 29:3222-3234. [DOI: 10.1007/s43032-022-00868-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
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Wilde M, Huguelet P, Alaniz VI. Transgender Medicine and Hormone Therapy: What the Gynecologist Needs to Know. Clin Obstet Gynecol 2021; 64:739-756. [PMID: 34292172 DOI: 10.1097/grf.0000000000000646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The transgender community comprises individuals with diverse identities in both gender and sexual orientation. Unfortunately, many face discrimination and harassment within our society-including within the medical system. There is an overall lack of provider training in transgender specific health which has led to health disparities and inequities within this population. This chapter aims to elucidate the medical needs unique to transgender and gender nonconforming individuals and thus enable medical providers to meet those needs with competency and compassion.
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Affiliation(s)
- Melyssa Wilde
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
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Embryology outcomes after oocyte vitrification with super-cooled slush nitrogen are similar to outcomes with conventional liquid nitrogen: a randomized controlled trial. Fertil Steril 2021; 117:106-114. [PMID: 34654569 DOI: 10.1016/j.fertnstert.2021.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether the use of slush nitrogen (SN), a super-cooled form of nitrogen with a temperature from -207 to -210 °C, can improve oocyte survival after vitrification and warming compared with conventional liquid nitrogen (LN). DESIGN Randomized controlled trial. SETTING Academic-affiliated private practice. PATIENT(S) A total of 556 metaphase II oocytes from 32 oocyte donor cycles were included. INTERVENTION(S) Donor oocytes were block randomized to undergo vitrification with either SN or LN. Vitrification was followed by warming, fertilization with donor sperm, embryo culture to the blastocyst stage, and preimplantation genetic testing for aneuploidy via trophectoderm biopsy with targeted next-generation sequencing. MAIN OUTCOME MEASURE(S) The primary outcome was oocyte survival after vitrification and warming. Secondary outcomes included rates of fertilization, usable blastocyst formation, and whole chromosome aneuploidy. RESULT(S) Half of the metaphase II oocytes (n = 278) were randomized to undergo vitrification with SN, whereas the other half (n = 278) were randomized to undergo vitrification with LN. There were no statistically significant differences noted in oocyte survival rate (85.3% vs. 86.3%), fertilization rate (84.0% vs. 80.0%), rate of usable blastocyst formation (54.3% vs. 55.7%), or rate of whole chromosome aneuploidy (9.4% vs. 11.7%) between the SN and LN arms, respectively. CONCLUSION(S) The implementation of an SN oocyte vitrification protocol resulted in similar embryology outcomes compared with LN. The use of SN did not lead to any demonstrable improvement in oocyte survival after vitrification and warming. CLINICAL TRIAL REGISTRATION NUMBER NCT04342364.
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Cryopreservation of Gametes and Embryos and Their Molecular Changes. Int J Mol Sci 2021; 22:ijms221910864. [PMID: 34639209 PMCID: PMC8509660 DOI: 10.3390/ijms221910864] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/18/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022] Open
Abstract
The process of freezing cells or tissues and depositing them in liquid nitrogen at -196 °C is called cryopreservation. Sub-zero temperature is not a physiological condition for cells and water ice crystals represent the main problem since they induce cell death, principally in large cells like oocytes, which have a meiotic spindle that degenerates during this process. Significantly, cryopreservation represents an option for fertility preservation in patients who develop gonadal failure for any condition and those who want to freeze their germ cells for later use. The possibility of freezing sperm, oocytes, and embryos has been available for a long time, and in 1983 the first birth with thawed oocytes was achieved. From the mid-2000s forward, the use of egg vitrification through intracytoplasmic sperm injection has improved pregnancy rates. Births using assisted reproductive technologies (ART) have some adverse conditions and events. These risks could be associated with ART procedures or related to infertility. Cryopreservation generates changes in the epigenome of gametes and embryos, given that ART occurs when the epigenome is most vulnerable. Furthermore, cryoprotective agents induce alterations in the integrity of germ cells and embryos. Notably, cryopreservation extensively affects cell viability, generates proteomic profile changes, compromises crucial cellular functions, and alters sperm motility. This technique has been widely employed since the 1980s and there is a lack of knowledge about molecular changes. The emerging view is that molecular changes are associated with cryopreservation, affecting metabolism, cytoarchitecture, calcium homeostasis, epigenetic state, and cell survival, which compromise the fertilization in ART.
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Johnston M, Fuscaldo G, Richings NM, Gwini SM, Catt S. Employer-Sponsored Egg Freezing: Carrot or Stick? AJOB Empir Bioeth 2021; 13:33-47. [PMID: 34219623 DOI: 10.1080/23294515.2021.1941413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Since 2014, many companies have followed the lead of Apple and Facebook and now offer financial support to female employees to access egg freezing. Australian companies may soon make similar offers. Employer-sponsored egg freezing (ESEF) has raised concerns and there is academic debate about whether ESEF promotes reproductive autonomy or reinforces the 'career vs. family' dichotomy. Despite the growing availability of ESEF and significant academic debate, little is known about how ESEF is perceived by the public. The aim of this study was to explore women's attitudes toward ESEF. METHODS Women aged 18-60 years who resided in Victoria, Australia were invited to complete an online, cross-sectional survey investigating views toward egg freezing. Associations between participant demographics and their views about ESEF were assessed using multinominal logistic regression, adjusted for age and free text comments were analyzed using thematic analysis. RESULTS The survey was completed by 656 women, median age 28 years (range: 18-60 years). Opinions on the appropriateness of employers offering ESEF were divided (Appropriate: 278, 42%; Inappropriate: 177, 27%; Unsure: 201, 31%). There was significantly less support for ESEF among older participants and those employed part-time (p < 0.05). While some participants saw the potential for ESEF to increase women's reproductive and career options, others were concerned that ESEF could pressure women to delay childbearing and exacerbate existing inequities in access to ARTs. CONCLUSIONS Our analysis revealed that while some women identified risks with ESEF, for many women ESEF is not viewed as theoretically wrong, but rather it may be acceptable under certain conditions; such as with protections around reproductive freedoms and assurances that ESEF is offered alongside other benefits that promote career building and family. We suggest that there may be a role for the State in ensuring that these conditions are met.
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Affiliation(s)
- Molly Johnston
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia.,Monash Bioethics Centre, Monash University, Clayton, Australia
| | - Giuliana Fuscaldo
- Barwon Health, University Hospital Geelong, Geelong, Australia.,Eastern Health Clinical School, Monash University, Australia
| | | | - Stella May Gwini
- Barwon Health, University Hospital Geelong, Geelong, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Sally Catt
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
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Aseptic capillary vitrification of human spermatozoa: Cryoprotectant-free vs. cryoprotectant-included technologies. Cryobiology 2021; 99:95-102. [PMID: 33422478 DOI: 10.1016/j.cryobiol.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/02/2021] [Accepted: 01/05/2021] [Indexed: 11/23/2022]
Abstract
The protocol of aseptic cryoprotectant-free vitrification on human spermatozoa is well documented. However, data about the effect of permeable cryoprotectants at this procedure is limited. Presented study aimed to test the aseptic capillary vitrification technologies using permeable cryoprotectant-included or cryoprotectant-free media. Thirty-two normal samples were included and analyzed after vitrification in three different media and thawing. Three treatment groups were formed: Group 1, basic medium; Group 2, basic medium with 0.25 M sucrose; Group 3, basic medium with glycerol. Before plunging into liquid nitrogen, capillaries were filled by 10 μl of spermatozoa suspension and isolated from liquid nitrogen by location in hermetically closed 0.25 ml straws. Progressive motility, plasma membrane integrity, total motility/viability after 24, 48 and 72 h in vitro culture, apoptosis and mitochondrial membrane potential (ΔΨm) were determined after thawing at 42 °C. Progressive motility of spermatozoa in groups 1, 2, 3 was 24.9 ± 1.7%, 34.5 ± 2.8% and 34.0 ± 1.4%, respectively (P1-2,3<0.05). The plasma membrane integrity of spermatozoa in groups 2 and 3 (48.4 ± 2.9% and 45.5 ± 3.9%, respectively) was higher than in Group 1 (33.3 ± 2.1%, P < 0.05). After 24 h, 48 h and 72 h in vitro culture, the total motility and viability of spermatozoa in Group 1 was significantly lower than Group 2 and Group 3. The apoptosis rate in Group 3 (44.5 ± 3.0%) and Group 2 (47.7 ± 4.1%) were lower than in Group 1 (52.5 ± 4.4%; P < 0.05). ΔΨm rates in Group 3 and Group 2 were higher than in Group 1 (P < 0.05) with no statistical differences between this parameter in Group 2 and Group 3 (P > 0.1). In conclusion, supplementation of medium for aseptic capillary technology for cryoprotectant-free vitrification of human spermatozoa by permeable cryoprotectant does not improve the quality of spermatozoa after warming.
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Johnston M, Fuscaldo G, Richings NM, Gwini S, Catt S. Cracked open: exploring attitudes on access to egg freezing. Sex Reprod Health Matters 2020; 28:1758441. [PMID: 32458753 PMCID: PMC7887973 DOI: 10.1080/26410397.2020.1758441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Egg freezing (EF) technology has improved significantly over the last decade, giving women more choice over their reproductive futures. Despite this advance, EF brings forth contentious ethical and regulatory issues. Policies controlling access to EF vary around the world and there is a lack of consensus about who should have access and what criteria are relevant in making these decisions. This study aimed to identify views of women about access to EF for both "medical" and "non-medical" risks to infertility. An online survey was administered to women aged between 18 and 60 years in Victoria, Australia between April and May 2018. A total of 1,066 individuals initiated the survey. The median age of the participants was 28 years and 81% were <40 years old. Almost all participants (98%) supported access to medical EF in situations where treatments (e.g. chemotherapy) or illnesses threaten fertility. Support for access to EF for non-medical indications was lower; 75% supported EF for "lack of suitable partner", followed by "financial insecurity to raise a child" (72%) and "career/educational advancement" (65%). Older respondents (aged ≥40 years) were less likely than their younger counterparts to support all indications for non-medical EF. Our findings indicate broad support for EF. However, the variation in support between indications for non-medical EF suggests that individuals do not think about access to EF simply in terms of medical necessity. To reflect public views, future policy may need to consider access to EF beyond the medical/non-medical distinction.
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Affiliation(s)
- Molly Johnston
- PhD candidate, Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia, 3168
| | - Giuliana Fuscaldo
- Associate Professor, Eastern Health Clinical School, Monash University, Box Hill, Australia; University Hospital Geelong, Australia
| | - Nadine Maree Richings
- Teaching Associate, Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - StellaMay Gwini
- Adjunct Lecturer, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia; University Hospital Geelong, Australia; Centre for Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), School of Medicine, Deakin University, Geelong, Australia
| | - Sally Catt
- Senior Lecturer, Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
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Zahmel J, Jänsch S, Jewgenow K, Sandgreen DM, Skalborg Simonsen K, Colombo M. Maturation and fertilization of African lion (Panthera leo) oocytes after vitrification. Cryobiology 2020; 98:146-151. [PMID: 33248046 DOI: 10.1016/j.cryobiol.2020.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/19/2022]
Abstract
The African lion is an excellent model species for the highly endangered Asiatic lion. African lions reproduce well in zoos, leading to the fact that occasionally ovaries and testis are available for in-vitro experiments. We previously performed in-vitro maturation (IVM) and fertilization of lion oocytes and were able to produce advanced embryos after intracytoplasmic sperm injection (ICSI) with cryopreserved sperm. Here we examined whether our in-vitro method is also applicable after vitrification of immature oocytes. Oocytes of four lionesses (5-7 years old) were obtained after euthanasia and immediately processed on site. Half of the oocytes (n = 60) were subjected to IVM for a total of 32-34 h at 39 °C, 5% CO2 and humidified air atmosphere. The second group (59 oocytes) was vitrified instantly using the Cryotop method. Following 6 days of storage in liquid nitrogen, oocytes were warmed and subjected to IVM as well. Mature oocytes of both groups were fertilized with frozen-thawed African lion sperm using ICSI. Maturation rate was 55% and 49.2% for the control and vitrified group, respectively. In the control group, three oocytes cleaved and another three were arrested at the pronuclei stage. Due to the low fertilization result, a sperm sample of another male was used for the vitrified group. Of the vitrified oocytes 7 cleaved and 9 more oocytes stopped at pronuclei stage. All embryos of the vitrified group did not develop beyond 4 cell stage. This is the first time that African lion in-vitro-derived embryos have been produced following oocyte vitrification.
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Affiliation(s)
- Jennifer Zahmel
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Alfred-Kowalke-Str. 17, 10315, Berlin, Germany.
| | - Stefanie Jänsch
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Alfred-Kowalke-Str. 17, 10315, Berlin, Germany.
| | - Katarina Jewgenow
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Alfred-Kowalke-Str. 17, 10315, Berlin, Germany.
| | | | | | - Martina Colombo
- Dip. Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università Degli Studi di Milano, Via Celoria 10, 20133, Milano, Italy.
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Colombo M, Zahmel J, Binder C, Herbel J, Luvoni GC, Jewgenow K. Ovary cold storage and shipment affect oocyte yield and cleavage rate of cat immature vitrified oocytes. Cryobiology 2020; 98:181-186. [PMID: 33171197 DOI: 10.1016/j.cryobiol.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 01/23/2023]
Abstract
In feline species, cooled transport of ovaries can be employed without detrimental effects to retrieve immature oocytes intended for in vitro embryo production purposes. Indeed, this is the most common way to collect gametes from gonads of wild, valuable animals after they die or are castrated far from specialized laboratories. However, fresh retrieved gametes are generally used, and their cryosensitivity is not known. This study employed ovariectomy-derived domestic cat gonads as a model for wild felids, and aimed to compare the yield and developmental competence of Cryotop-vitrified oocytes (VOs) collected and cryopreserved right after ovary excision (In loco-VOs) or after 24 h cooled transport of ovaries (Shipped-VOs). The number of collected oocytes was higher in In loco-VOs than in Shipped-VOs (mean ± SD: 8 ± 3.36 vs 5.6 ± 3.1, p = 0.05). In vitro embryo production resulted in similar maturation (35% for both vitrified groups, p = 1) and fertilization rates (In loco-VOs: 29.1%; Shipped-VOs: 22.2%; p = 0.295), but showed a difference in cleavage (In loco-VOs: 25.6%; Shipped-VOs: 14.5%; p = 0.0495). No differences were found in further embryo development. Taken together, results suggested that delayed oocyte vitrification after cooled transport of organs was feasible and allowed embryo development. However, the number of collected oocytes and the cleavage rate of matured oocytes were higher when oocyte vitrification was performed without delay after ovary excision, and this should be considered in gamete conservation programs for endangered felids.
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Affiliation(s)
- Martina Colombo
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Via Celoria 10, 20133 Milan, Italy.
| | - Jennifer Zahmel
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Alfred-Kowalke-Str. 17, D-10315, Berlin, Germany.
| | - Claudia Binder
- Obstetrics and Reproduction, Department for Small Animals and Horses, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Johannes Herbel
- Obstetrics and Reproduction, Department for Small Animals and Horses, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Gaia Cecilia Luvoni
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Via Celoria 10, 20133 Milan, Italy.
| | - Katarina Jewgenow
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Alfred-Kowalke-Str. 17, D-10315, Berlin, Germany.
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Colombo M, Zahmel J, Jänsch S, Jewgenow K, Luvoni GC. Inhibition of Apoptotic Pathways Improves DNA Integrity but Not Developmental Competence of Domestic Cat Immature Vitrified Oocytes. Front Vet Sci 2020; 7:588334. [PMID: 33178729 PMCID: PMC7596218 DOI: 10.3389/fvets.2020.588334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/08/2020] [Indexed: 12/11/2022] Open
Abstract
Being a model for endangered wild felids, cryopreservation protocols for domestic cat oocytes are under continuous development. Immature vitrified oocytes (VOs) are a valuable resource for fertility preservation programs, but they often degenerate after warming and their in vitro development is poor. Since the exact mechanisms are not clear, this study assessed whether vitrification might trigger two apoptotic markers (DNA fragmentation and caspase activity, Experiment I) and the effects of a chemical inhibitor (i.e., the pan-caspase inhibitor Z-VAD-FMK) on the same markers (Experiment II) and on VOs in vitro development (Experiment III). The overarching aim was to check whether apoptosis inhibition might be a strategy to improve cat oocytes cryotolerance. In Experiment I, vitrification induced DNA fragmentation and increased caspase activity in VOs incubated for 24 h after warming (DNA fragmentation: 59.38%; caspase activity: 414.6 ± 326.8) compared to a fresh control (9.68%; 199.6 ± 178.3; p = 0.02). In Experiment II, the addition of Z-VAD-FMK to vitrification-warming and incubation media decreased DNA fragmentation and caspase activity (8.82%; 243.7 ± 106.9) compared to control (untreated) VOs (69.44%; 434.5 ± 248.3; p < 0.001). In Experiment III, Z-VAD-FMK brought maturation rates of treated VOs close to those of fresh oocytes (53.13 and 65.38%, respectively, p = 0.057), but there were no differences in VOs embryo development (cleavage rates; Z-VAD-FMK-treated VOs: 34.38%; control VOs: 31.78%; p = 0.69). In summary, vitrification increased apoptotic markers in cat VOs, and while Z-VAD-FMK was able to hinder DNA damage and caspase activity, its addition was not determinant for embryo development. To make the best use of VOs, other oocyte in vitro maturation and embryo culture strategies, such as the addition of other inhibitors or their prolonged use, should be investigated.
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Affiliation(s)
- Martina Colombo
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Milan, Italy
| | - Jennifer Zahmel
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Stefanie Jänsch
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Katarina Jewgenow
- Department of Reproduction Biology, Leibniz-Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Gaia Cecilia Luvoni
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Milan, Italy
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15
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On Ice: The impact of vitrification on the use of eggs in fertility treatment. Emerg Top Life Sci 2020; 3:713-717. [PMID: 32915218 DOI: 10.1042/etls20190062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/27/2019] [Accepted: 10/01/2019] [Indexed: 11/17/2022]
Abstract
The possibility to freeze sperm and embryos has long been available to men and women facing infertility as a result of an illness or medical treatment. However, the ability to successfully cryopreserve human eggs is comparatively recent. The introduction and increasing use of egg vitrification from the mid-2000s onwards, alongside the use of intracytoplasmic sperm injection, has seen improved ongoing clinical pregnancy rates compared with slow freezing methods. Despite concerns, the technology has been widely embraced by the scientific community and in recent years has been applied in a greater variety of contexts. In this short perspective paper, we consider two specific applications for the vitrification of human eggs in routine assisted reproduction practice: social egg freezing and the use of frozen eggs in egg donation. We suggest that vitrification is transforming the reproductive landscape in novel and complex ways and that we must be alert to the challenges, complexities and ethics of such developments, especially for those who may be excluded or marginalised by these techniques.
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16
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Calagna G, Della Corte L, Giampaolino P, Maranto M, Perino A. Endometriosis and strategies of fertility preservation: a systematic review of the literature. Eur J Obstet Gynecol Reprod Biol 2020; 254:218-225. [PMID: 33011504 DOI: 10.1016/j.ejogrb.2020.09.045] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/16/2022]
Abstract
Endometriosis is a common chronic inflammatory disorder, often causing both pain and infertility. It is estimated that 25-50 % of patients undergoing fertility treatments have had endometriosis as it involves an impairment of the ovarian reserve. For these reasons, endometriosis has been highlighted as a condition that may require a fertility preservation procedure, while being benign in nature. The aim of this review is to summarize the current evidence on fertility preservation techniques for patients affected by endometriosis, focusing on the main characteristics of the different approaches. A systematic review of literature was performed by searching in the main electronic databases (MEDLINE, EMBASE, Web of Science, Scopus, ClinicalTrial.gov, OVID and Cochrane Library), from their inception to February 2020 for studies testing fertility preservation (FP) techniques. Only scientific publications in English were included. Risk of Bias Assessment was performed. Eight articles were included in the study: 3 case reports (one paper reporting 2 cases), 1 prospective longitudinal analysis with only 1 reported case with criteria for inclusion in the review, 2 retrospective observational studies and 2 retrospective cohort studies. The results of our analysis showed embryo (1 article), oocyte (4 articles) and ovarian tissue cryopreservation (3 articles) as preservation methods proposed in international literature for patients with endometriosis. Only few authors reported details on successive outcomes. After ovarian tissue transplantation, 1 pregnancy with IVF and 1 case of endocrine function/ovulation recovery were described; six of 16 endometriotic patients, who underwent embryo cryopreservation, experienced livebirths after successive embryo-transfer; in a large series of 485 patients performing oocyte cryopreservation, an overall cumulative live-birth rate/patient of 46.4 % (225 babies) was reported. Based on the risk of premature ovarian failure related to endometriosis, the offer of FP techniques to these patients has significantly increased, as well as the reported experiences in recent medical literature. However, further studies concerning risks, benefits, effectiveness and cost-effectiveness are needed.
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Affiliation(s)
- Gloria Calagna
- Department of Obstetrics and Gynecology, "Villa Sofia Cervello" University of Palermo, Palermo, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
| | | | - Marianna Maranto
- Department of Obstetrics and Gynecology, "Villa Sofia Cervello" University of Palermo, Palermo, Italy
| | - Antonino Perino
- Department of Obstetrics and Gynecology, "Villa Sofia Cervello" University of Palermo, Palermo, Italy
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17
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Fertility preservation options for transgender and gender-nonconforming individuals. Curr Opin Obstet Gynecol 2020; 31:170-176. [PMID: 30870185 DOI: 10.1097/gco.0000000000000537] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To provide an overview of the current state of knowledge of fertility risks of gender-affirming therapy, review fertility preservation options for transgender individuals and ways to minimize gender dysphoria during fertility treatment, and identify gaps in knowledge. RECENT FINDINGS Recent studies have corroborated older data that gender-affirming hormone therapy creates histopathological changes in the gonads; however, the newer data suggests that some function of the gametes may be preserved. One study in transgender men reported successful in-vitro maturation of testosterone-exposed oocytes with normal spindle structures, and recent studies in transgender women reveal early spermatogenesis in estradiol-exposed testes and some recovery of semen parameters following cessation of hormones. Particular attention has recently been given to fertility preservation in transgender adolescents, revealing unmet informational needs in this population and very few are actually pursuing fertility preservation, even with counseling. SUMMARY There is currently a paucity of data on the fertility effects of gender-affirming hormones, necessitating fertility preservation counseling prior to initiation of therapy. Several modifications can be made to fertility preservation protocols and procedures to decrease gender dysphoria or distress in transgender individuals, but outcome data is still lacking. Achieving high-quality data collection will likely require cooperation across multiple institutions.
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18
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Hudson N, Culley L, Herbrand C, Pavone V, Pennings G, Provoost V, Coveney C, Funes SL. Reframing egg donation in Europe: new regulatory challenges for a shifting landscape. HEALTH POLICY AND TECHNOLOGY 2020. [DOI: 10.1016/j.hlpt.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Tao Y, Sanger E, Saewu A, Leveille MC. Human sperm vitrification: the state of the art. Reprod Biol Endocrinol 2020; 18:17. [PMID: 32145746 PMCID: PMC7060631 DOI: 10.1186/s12958-020-00580-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/28/2020] [Indexed: 12/18/2022] Open
Abstract
Sperm cryopreservation has been widely used in assisted reproductive technology (ART) and has resulted in millions of live births. Two principal approaches have been adopted: conventional (slow) freezing and vitrification. As a traditional technique, slow freezing has been successfully employed and widely used at ART clinics whereas the latter, a process to solidify liquid into an amorphous or glassy state, may become a faster alternative method of sperm cryopreservation with significant benefits in regard to simple equipment and applicability to fertility centers. Sperm vitrification has its own limitations. Firstly, small volume of load is usually plunged to liquid nitrogen to achieve high cooling rate, which makes large volume sample cryopreservation less feasible. Secondly, direct contact with liquid nitrogen increases the potential risk of contamination. Recently, new carriers have been developed to facilitate improved control over the volume and speed, and new strategies have been implemented to minimize the contamination risk. In summary, although sperm vitrification has not yet been applied in routine sperm cryopreservation, its potential as a standard procedure is growing.
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Affiliation(s)
- Yong Tao
- Ottawa Fertility Center, 100-955 Green Valley Crescent, Ottawa, ON K2C 3V4 Canada
| | - Erika Sanger
- Ottawa Fertility Center, 100-955 Green Valley Crescent, Ottawa, ON K2C 3V4 Canada
| | - Arpornrad Saewu
- Ottawa Fertility Center, 100-955 Green Valley Crescent, Ottawa, ON K2C 3V4 Canada
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20
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Arav A. From cryo-preservation to dry-preservation of reproductive cells. Theriogenology 2020; 150:263-267. [PMID: 32088027 DOI: 10.1016/j.theriogenology.2020.01.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 01/28/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Amir Arav
- FertileSafe, 11 Haharash, Ness Ziona, Israel.
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21
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Colombo M, Morselli MG, Apparicio M, Luvoni GC. Granulosa cells in three-dimensional culture: A follicle-like structure for domestic cat vitrified oocytes. Reprod Domest Anim 2020; 55 Suppl 2:74-80. [PMID: 31913547 DOI: 10.1111/rda.13597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/04/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022]
Abstract
Follicle-like structures are three-dimensional matrices joint with living cells that allow the in vitro development of female gametes in more physiological conditions. They have been shown to be beneficial to fresh oocytes in different species, and in this study, domestic cat (Felis silvestris catus) granulosa cells were used to create a functional follicle-like structure aimed at supporting the in vitro maturation of conspecific vitrified oocytes, key players of fertility preservation programmes that usually struggle to acquire their full developmental competence after warming. Cat granulosa cells were cultured for up to 6 days in three-dimensional barium alginate microcapsules (i.e. follicle-like structures) or in two-dimensional monolayers, and their steroidogenic ability (estradiol and progesterone secretion) was assessed to confirm their functionality. The same systems were used (on day 2 or 6 of granulosa cells culture) for the in vitro maturation (IVM) of Cryotop® vitrified immature cat oocytes and compared with microdrops of IVM medium without cells (control). Granulosa cells were able to maintain their functionality in vitro in both the conditions, even if with a different extent of hormonal secretion along culture (p = .02). Vitrified oocytes resumed meiosis at higher rates when cultured with 2 days old granulosa cells (p = .03), but full maturation rates slightly raised when granulosa cells were cultured longer, albeit without differences with the control group. This study paved the road for the creation of enriched culture systems in the domestic cat, but innovations are strongly needed for vitrified oocytes that deserve better chances to develop in vitro.
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Affiliation(s)
- Martina Colombo
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Milan, Italy
| | - Maria Giorgia Morselli
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Milan, Italy
| | - Maricy Apparicio
- Programa de Mestrado em Ciência Animal, Universidade de Franca (UNIFRAN), Franca, Brasil.,Departamento de Medicina Veterinária Preventiva e Reprodução Animal, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Jaboticabal, Brasil
| | - Gaia Cecilia Luvoni
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Milan, Italy
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22
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Slow Freezing Versus Vitrification of Mouse Ovaries: from Ex Vivo Analyses to Successful Pregnancies after Auto-Transplantation. Sci Rep 2019; 9:19668. [PMID: 31873164 PMCID: PMC6928220 DOI: 10.1038/s41598-019-56182-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/14/2019] [Indexed: 12/23/2022] Open
Abstract
Slow freezing (SF) is the reference method for ovarian tissue cryopreservation. Vitrification (VT) constitutes an alternative but controversial method. This study compares SF and VT (open [VTo] and closed [VTc] systems) in terms of freezing damage and fertility restoration ability. In vitro analyses of C57Bl/6 SF or VTo-ovaries, immediately after thawing/warming or after culture (cult), revealed that event though follicular density was similar between all groups, nuclear density was decreased in VTo-ovaries compared to CT-ovaries (CT = 0.50 ± 0.012, SF = 0.41 ± 0.03 and VTo = 0.29 ± 0.044, p < 0.01). Apoptosis was higher in VTo-cult ovaries compared to SF-cult ovaries (p < 0.001) whereas follicular Bmp15 and Amh gene expression levels were decreased in the ovaries after culture, mostly after VTo (p < 0.001). Natural mating after auto-transplantation of SF, VTo and VTc-ovaries revealed that most mice recovered their oestrous cycle. Fertility was only restored with SF and VTo ovaries (SF: 68%; VTo: 63%; VTc: 0%; p < 0.001). Mice auto-transplanted with SF and VTo-ovaries achieved the highest number of pregnancies. In conclusion, in vitro, no differences between SF and VTo were evident immediately after thawing/warming but VTo ovaries displayed alterations in apoptosis and follicular specific proteins after culture. In vivo, SF and VTo ovary auto-transplantation fully restored fertility whereas with VTc-ovary auto-transplantation no pregnancies were achieved.
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23
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Arav A, Patrizio P. Techniques of Cryopreservation for Ovarian Tissue and Whole Ovary. CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2019; 13:1179558119884945. [PMID: 31839716 PMCID: PMC6893924 DOI: 10.1177/1179558119884945] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/02/2019] [Indexed: 01/24/2023]
Abstract
Cryopreservation of ovarian tissue has been considered experimental for many years, but very recently the American Society of Reproductive Medicine is reviewing the process and perhaps soon will remove the label of “experimental” and recognize it as an established method for preserving female fertility when gonadotoxic treatments cannot be delayed or in patients before puberty or when there is desire to cryopreserve more than just few oocytes. This article discusses in detail the 3 methodologies used for cryopreservation: (a) slow freezing, (b) directional freezing, and (c) vitrification.
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Affiliation(s)
| | - Pasquale Patrizio
- FertileSafe Ltd, Ness Ziona, Israel.,Yale Fertility Center, Yale University, New Haven, CT, USA
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24
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Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril 2019; 112:1022-1033. [DOI: 10.1016/j.fertnstert.2019.09.013] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 02/08/2023]
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25
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Baram S, Myers SA, Yee S, Librach CL. Fertility preservation for transgender adolescents and young adults: a systematic review. Hum Reprod Update 2019; 25:694-716. [DOI: 10.1093/humupd/dmz026] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/21/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
BACKGROUND
Many transgender individuals choose to undergo gender-affirming hormone treatment (GAHT) and/or sex reassignment surgery (SRS) to alleviate the distress that is associated with gender dysphoria. Although these treatment options often succeed in alleviating such symptoms, they can also negatively impact future reproductive potential.
OBJECTIVE AND RATIONALE
The purpose of this systematic review was to synthesize the available psychosocial and medical literature on fertility preservation (FP) for transgender adolescents and young adults (TAYAs), to identify gaps in the current research and provide suggestions for future research directions.
SEARCH METHODS
A systematic review of English peer-reviewed papers published from 2001 onwards, using the preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P) guidelines, was conducted. Four journal databases (Ovid MEDLINE, PubMed Medline, Ovid Embase and Ovid PsychINFO) were used to identify all relevant studies exploring psychosocial or medical aspects of FP in TAYAs. The search strategy used a combination of subject headings and generic terms related to the study topic and population. Bibliographies of the selected articles were also hand searched and cross-checked to ensure comprehensive coverage. All selected papers were independently reviewed by the co-authors. Characteristics of the studies, objectives and key findings were extracted, and a systematic review was conducted.
OUTCOMES
Included in the study were 19 psychosocial-based research papers and 21 medical-based research papers that explore fertility-related aspects specific for this population. Key psychosocial themes included the desire to have children for TAYAs; FP discussions, counselling and referrals provided by healthcare providers (HCPs); FP utilization; the attitudes, knowledge and beliefs of TAYAs, HCPs and the parents/guardians of TAYAs; and barriers to accessing FP. Key medical themes included fertility-related effects of GAHT, FP options and outcomes. From a synthesis of the literature, we conclude that there are many barriers preventing TAYAs from pursuing FP, including a lack of awareness of FP options, high costs, invasiveness of the available procedures and the potential psychological impact of the FP process. The available medical data on the reproductive effects of GAHT are diverse, and while detrimental effects are anticipated, the extent to which these effects are reversible is unknown.
WIDER IMPLICATIONS
FP counselling should begin as early as possible as a standard of care before GAHT to allow time for informed decisions. The current lack of high-quality medical data specific to FP counselling practice for this population means there is a reliance on expert opinion and extrapolation from studies in the cisgender population. Future research should include large-scale cohort studies (preferably multi-centered), longitudinal studies of TAYAs across the FP process, qualitative studies of the parents/guardians of TAYAs and studies evaluating the effectiveness of different strategies to improve the attitudes, knowledge and beliefs of HCPs.
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Affiliation(s)
- Shira Baram
- Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada
- Department of Obstetrics and Gynecology, University of Toronto, 27 King’s College Circle, Toronto, Ontario M5S, Canada
| | - Samantha A Myers
- Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada
- McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada
| | - Samantha Yee
- Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada
| | - Clifford L Librach
- Create Fertility Centre, 790 Bay Street, Suite 1100, Toronto, Ontario M5G 1N8, Canada
- Department of Obstetrics and Gynecology, University of Toronto, 27 King’s College Circle, Toronto, Ontario M5S, Canada
- Department of Physiology, University of Toronto, 27 King’s College Circle, Toronto, Ontario M5S, Canada
- Institute of Medical Science, University of Toronto, 27 King’s College Circle, Toronto, Ontario M5S, Canada
- Department of Obstetrics and Reproductive Endocrinology, Sunnybrook Health Sciences Centre; 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada
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26
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Colombo M, Morselli MG, Tavares MR, Apparicio M, Luvoni GC. Developmental Competence of Domestic Cat Vitrified Oocytes in 3D Enriched Culture Conditions. Animals (Basel) 2019; 9:E329. [PMID: 31181674 PMCID: PMC6616943 DOI: 10.3390/ani9060329] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 01/20/2023] Open
Abstract
Cryoinjuries severely affect the competence of vitrified oocytes (VOs) to develop into embryos after warming. The use of culture conditions that provide physical and chemical support and resemble the in vivo microenvironment in which oocytes develop, such as 3D scaffolds and coculture systems, might be useful to improve VOs outcomes. In this study, an enriched culture system of 3D barium alginate microcapsules was employed for the in vitro embryo production of domestic cat VOs. Cryotop vitrified-warmed oocytes were in vitro matured for 24 h in the 3D system with or without fresh cumulus-oocyte complexes (COCs) in coculture, whereas a control group of VOs was cultured in traditional 2D microdrops of medium. After in vitro fertilization, presumptive embryos were cultured in 3D or 2D systems according to the maturation conditions. Vitrified oocytes were able to mature and develop into embryos in 3D microcapsules (17.42 ± 11.83%) as well as in 2D microdrops (14.96 ± 8.80%), but the coculture with companion COCs in 3D resulted in similar proportions of VOs embryo development (18.39 ± 16.67%; p = 1.00), although COCs presence allowed for blastocyst formation (0.95 ± 2.52%). In conclusion, embryos until late developmental stages were obtained from cat VOs, and 3D microcapsules were comparable to 2D microdrops, but improvements in post-warming conditions are still needed.
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Affiliation(s)
- Martina Colombo
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Via Celoria, 10, 20133 Milano, Italy.
| | - Maria Giorgia Morselli
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Via Celoria, 10, 20133 Milano, Italy.
| | - Mariana Riboli Tavares
- Departamento de Medicina Veterinária Preventiva e Reprodução Animal, Universidade Estadual Paulista (UNESP), Via de Acesso Prof. Paulo Donato Castellane s/n, Jaboticabal 14884-900, Brazil.
| | - Maricy Apparicio
- Departamento de Medicina Veterinária Preventiva e Reprodução Animal, Universidade Estadual Paulista (UNESP), Via de Acesso Prof. Paulo Donato Castellane s/n, Jaboticabal 14884-900, Brazil.
| | - Gaia Cecilia Luvoni
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare "Carlo Cantoni", Università degli Studi di Milano, Via Celoria, 10, 20133 Milano, Italy.
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Abstract
There are an estimated 1.4 million transgender adults in the United States, and lack of providers knowledgeable in transgender care is a barrier to health care. Obstetricians and Gynecologists can help increase access in part by becoming competent in gender-affirming hormone therapy. For transgender men, testosterone protocols can be extrapolated from those used for hypogonadal cisgender men. Unfortunately, there are not any high-quality, long-term prospective studies on the effectiveness and safety of different testosterone regimens specifically in transgender men, but the available data suggest that gender-affirming testosterone therapy is safe and effective with proper screening and monitoring.
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Moravek MB, Appiah LC, Anazodo A, Burns KC, Gomez-Lobo V, Hoefgen HR, Frias OJ, Laronda MM, Levine J, Meacham LR, Pavone ME, Quinn GP, Rowell EE, Strine AC, Woodruff TK, Nahata L. Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium. J Adolesc Health 2019; 64:563-573. [PMID: 30655118 PMCID: PMC6478520 DOI: 10.1016/j.jadohealth.2018.10.297] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/18/2018] [Accepted: 10/09/2018] [Indexed: 12/31/2022]
Abstract
Infertility is known to decrease quality of life among adults. In some cases, infertility is caused by medical conditions and/or treatments prescribed in childhood, and using methods to protect or preserve fertility may expand future reproductive possibilities. Structured programs to offer counseling about infertility risk and fertility preservation options are essential in the care of pediatric patients facing fertility-threatening conditions or treatments, yet multiple barriers to program development exist. This report was developed from the institutional experiences of members of the Pediatric Initiative Network of the Oncofertility Consortium, with the intent of providing guidance for health care providers aiming to establish programs at institutions lacking pediatric fertility preservation services. The mechanics of building a fertility preservation program are discussed, including essential team members, target populations, fertility preservation options (both established and experimental), survivorship issues, research opportunities, and ethical considerations. Common barriers to program development and utilization, including low referral rates and financial concerns, are also discussed, and recommendations made for overcoming such barriers.
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Affiliation(s)
- Molly B Moravek
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Michigan, Ann Arbor, Michigan.
| | - Leslie C Appiah
- The Ohio State University/Nationwide Children’s Hospital, Columbus, Ohio;,James Cancer Center, Columbus, Ohio
| | - Antoinette Anazodo
- Sydney Children’s Hospital, Sydney, Australia;,Prince of Wales Hospital, Sydney, Australia;,University of New South Wales, Sydney, Australia
| | - Karen C Burns
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Veronica Gomez-Lobo
- Washington Hospital Center/Children’s National Medical Center/Georgetown University, Washington, DC
| | | | | | - Monica M. Laronda
- Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois;,Northwestern University, Chicago, Illinois
| | | | - Lillian R Meacham
- Aflac Cancer Center/Children’s Healthcare of Atlanta/Emory University, Atlanta, Georgia
| | | | | | - Erin E. Rowell
- Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois;,Northwestern University, Chicago, Illinois
| | - Andrew C Strine
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | - Leena Nahata
- The Ohio State University/Nationwide Children’s Hospital, Columbus, Ohio
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Arav A, Natan Y. The Near Future of Vitrification of Oocytes and Embryos: Looking into Past Experience and Planning into the Future. Transfus Med Hemother 2019; 46:182-187. [PMID: 31244586 DOI: 10.1159/000497749] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/03/2019] [Indexed: 11/19/2022] Open
Abstract
Currently vitrification is the method of choice for low-temperature preservation of oocytes and embryos. However, that was not the case until about 10 years ago when freezing methods were used relatively successfully for embryos and investigated (unsuccessfully) for oocyte preservation. In this paper we will review the history of oocyte and embryo cryopreservation and look into ways and methods for overcoming and improving the vitrification method since it suffers from inherent disadvantages since it is a cumbersome, time-consuming and costly procedure.
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Castiglione Morelli MA, Iuliano A, Schettini SCA, Petruzzi D, Ferri A, Colucci P, Viggiani L, Cuviello F, Ostuni A. NMR metabolomics study of follicular fluid in women with cancer resorting to fertility preservation. J Assist Reprod Genet 2018; 35:2063-2070. [PMID: 30069850 PMCID: PMC6240554 DOI: 10.1007/s10815-018-1281-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/24/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the possible application of metabolomics to identify follicular fluid changes in cancer patients undergoing fertility preservation. Although metabolomics have been applied already in cancer studies, this is the first application on follicular fluid of cancer patients. METHODS We selected for the study ten patients with breast cancer and lymphoma who resorted to oocyte cryopreservation to preserve fertility and ten healthy women undergoing in vitro fertilization treatments. Follicular fluid was collected at the time of oocytes retrieval. Metabolomic analysis of follicular fluids was performed by 1H-nuclear magnetic resonance (NMR) spectroscopy in combination with multivariate analysis to interpret the spectral data. Univariate statistical analysis was applied to find correlations between patients' features and metabolites identified by NMR. RESULTS Partial least squares discriminant analysis allowed to discriminate samples from cancer patients and healthy controls. Univariate statistical analysis found significant correlations between patients' features and metabolites identified by NMR. This finding allowed to identify biomarkers to differentiate both healthy controls from cancer patients and the two different classes of oncological patients. CONCLUSION The follicular fluids of cancer patients display significant metabolic alterations in comparison to healthy subjects. NMR-based metabolomics could be a valid prognostic tool for identifying and selecting the best cryopreserved oocytes and improving the outcome prediction in cancer women undergoing in vitro fertilization.
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Affiliation(s)
| | - Assunta Iuliano
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | | | - Donatina Petruzzi
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Angela Ferri
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Paola Colucci
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Licia Viggiani
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy
| | - Flavia Cuviello
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy
| | - Angela Ostuni
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy.
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Silber SJ, DeRosa M, Goldsmith S, Fan Y, Castleman L, Melnick J. Cryopreservation and transplantation of ovarian tissue: results from one center in the USA. J Assist Reprod Genet 2018; 35:2205-2213. [PMID: 30255455 PMCID: PMC6289920 DOI: 10.1007/s10815-018-1315-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 09/11/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To report the results of cryopreserved ovary tissue transplantation for leukemia and other cancers, in a single US center. Methods One hundred eight females between age 6 and (median age 24) 35 were referred for possible ovary tissue cryopreservation over a 20-year period, with either slow freeze or vitrification. Thus far 13 patients returned up to 18 years later to have their tissue transplanted back. Results All 13 patients had return of ovarian function 5 months post transplant with regular menstrual cycling. AMH rose to very high levels as the FSH declined to normal. Four months later, the AMH again declined to very low levels. Nonetheless, the grafts remained functional for up to 5 years or longer. Ten of the 13 (77%) became spontaneously pregnant at least once, resulting in 13 healthy babies. A total of 24 healthy babies have been born 11 from fresh transplanted ovarian tissue and 13 from cryopreserved transplanted ovarian tissue. Conclusions (1) Ovary tissue cryopreservation is a robust method for preserving a woman’s fertility. (2) Cortical tissue pressure may be a key regulator of primordial follicle arrest, recruitment, and ovarian longevity. (3) This is the only such series yet reported in the USA.
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Affiliation(s)
- Sherman J Silber
- Infertility Center of St. Louis, 224 South Woods Mill Road, Saint Louis, MO, 63017, USA.
| | - Michael DeRosa
- Infertility Center of St. Louis, 224 South Woods Mill Road, Saint Louis, MO, 63017, USA
| | - Sierra Goldsmith
- Infertility Center of St. Louis, 224 South Woods Mill Road, Saint Louis, MO, 63017, USA
| | - Yuting Fan
- Whitehead Institute, Massachusetts Institute of Technology, Cambridge, MA, USA.,Sun Yat-sen University of Medical Sciences, Guangzhou, Guangdong, China
| | - Leilani Castleman
- Infertility Center of St. Louis, 224 South Woods Mill Road, Saint Louis, MO, 63017, USA
| | - Jeffrey Melnick
- St. Luke's Hospital Pathology, 232 South Woods Mill Road, St. Louis, MO, 63017, USA
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Fisch B, Abir R. Female fertility preservation: past, present and future. Reproduction 2018; 156:F11-F27. [DOI: 10.1530/rep-17-0483] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/23/2018] [Indexed: 12/19/2022]
Abstract
Anti-cancer therapy, particularly chemotherapy, damages ovarian follicles and promotes ovarian failure. The only pharmacological means for protecting the ovaries from chemotherapy-induced injury is gonadotrophin-releasing hormone agonist, but its efficiency remains controversial; ovarian transposition is used to shield the ovary from radiation when indicated. Until the late 1990s, the only option for fertility preservation and restoration in women with cancer was embryo cryopreservation. The development of other assisted reproductive technologies such as mature oocyte cryopreservation andin vitromaturation of oocytes has contributed to fertility preservation. Treatment regimens to obtain mature oocytes/embryos have been modified to overcome various limitations of conventional ovarian stimulation protocols. In the last decades, several centres have begun cryopreserving ovarian samples containing primordial follicles from young patients before anti-cancer therapy. The first live birth following implantation of cryopreserved-thawed ovarian tissue was reported in 2004; since then, the number has risen to more than 130. Nowadays, ovarian tissue cryopreservation can be combined within vitromaturation and vitrification of oocytes. The use of cryopreserved oocytes eliminates the risk posed by ovarian implantation of reseeding the cancer. Novel methods for enhancing follicular survival after implantation are presently being studied. In addition, researchers are currently investigating agents for ovarian protection. It is expected that the risk of reimplantation of malignant cells with ovarian grafts will be overcome with the putative development of an artificial ovary and an efficient follicle class- and species-dependentin vitrosystem for culturing primordial follicles.
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An G, Zou Z, Flannigan R, Liu J, Du H, Fu X, Guo F, Zhang W. Outcome of Oocyte Vitrification Combined with Microdissection Testicular Sperm Extraction and Aspiration for Assisted Reproduction in Men. Med Sci Monit 2018; 24:1379-1386. [PMID: 29511156 PMCID: PMC5853179 DOI: 10.12659/msm.909026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background As a safety and efficacy protocol, oocyte vitrification has been widely used in IVF treatment. The aim of this study was to evaluate the outcome of ICSI-ET utilizing vitrified oocytes with sperm obtained from non-obstructive azoospermia (NOA) patients via micro-TESE. Material/Methods A total of 150 NOA patients underwent micro-TESE. Ten patients were unable to ejaculate and refused to accept TESA at the time of oocyte retrieval; later, these patients underwent TESA. A total of 174 obstructive azoospermia (OA) patients underwent TESA. Vitrified oocytes were used with micro-TESE in 35 cycles (group 1), and TESA in 10 cycles (group 2). Fresh oocytes were used with micro-TESE in 38 cycles (group 3) and TESA in 174 cycles (group 4). Results The overall sperm retrieval rate of the 150 NOA patients was 48.7% (73/150). A total of 257 cycles of ICSI-ET were conducted with testicular spermatozoa; 212 cycles utilized fresh oocytes and 45 cycles utilized vitrified oocytes. No differences were observed with fertilization (73.8%, 77.2%,72.8%, 73.6%), implantation (33.3%, 34.7%, 33.8%, 37.5%), or clinical pregnancy rates (51.4%, 60%, 52.6%, 51.7%) for groups 1 through 4, respectively (P>0.05). Developmental competence was greatest among couples using sperm obtained via TESA rather than micro-TESE, not dependent on whether vitrified or fresh oocytes were utilized. Fertilization, implantation, and clinical pregnancy rates did not differ between using fresh vs. vitrified oocytes, nor did they differ between using testicular sperm derived from men with NOA vs. men with OA. Conclusions Vitrified oocytes combined with micro-TESE showed similar clinical efficacy when compared with fresh oocytes.
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Affiliation(s)
- Geng An
- Reproductive Medicine Center, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Zihao Zou
- Department of Urology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Ryan Flannigan
- Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Jianqiao Liu
- Reproductive Medicine Center, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Hongzi Du
- Reproductive Medicine Center, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Xin Fu
- Reproductive Medicine Center, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Feixiang Guo
- Reproductive Medicine Center, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
| | - Wen Zhang
- Reproductive Medicine Center, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland)
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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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Amidi F, Khodabandeh Z, Nori Mogahi MH. Comparison of The Effects of Vitrification on Gene Expression of Mature Mouse Oocytes Using Cryotop and Open Pulled Straw. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2018; 12:61-67. [PMID: 29334209 PMCID: PMC5767935 DOI: 10.22074/ijfs.2018.5112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 07/02/2017] [Indexed: 11/04/2022]
Abstract
Background Oocyte cryopreservation is an essential part of the assisted reproductive technology (ART), which was recently introduced into clinical practice. This study aimed to evaluate the effects of two vitrification systems-Cryotop and Open Pulled Straw (OPS)-on mature oocytes gene expressions. MATERIALS AND METHODS In this experimental study, the survival rate of metaphase II (MII) mouse oocytes were assessed after cryopreservation by vitrification via i. OPS or ii. Cryotop. Then we compared the fertilization rate of oocytes produced via these two methods. In the second experiment, we determined the effects of the two vitrification methods on the expression of Hspa1a, mn-Sod, and ß-actin genes in vitrified-warmed oocytes. Denuded MII oocytes were vitrified in two concentrations of vitrification solution (VS1 and VS2) by Cryotop and straw. We then compared the results using the two vitrification methods with fresh control oocytes. RESULTS mn-Sod expression increased in the vitrified-warmed group both in OPS and Cryotop compared with the controls. We only detected Hspa1a in VS1 and control groups using Cryotop. The survival rate of the oocytes was 91.2% (VS1) and 89.2% (VS2) in the Cryotop groups (P=0.902) and 85.5% (VS1) and 83.6% (VS2) in the OPS groups (P=0.905). There were no significant differences between the Cryotop and the OPS groups (P=0.927). The survival rate in the Cryotop or the OPS groups was, nevertheless, significantly lower than the control group (P<0.001). The fertilization rates of the oocytes were 39% (VS1) and 34% (VS2) in the Cryotop groups (P=0.902) and 29 %( VS1) and 19.7% (VS2) in the OPS groups (P=0.413). The fertilization rates were achieved without significant differences among the Cryotop and OPS groups (P=0.755). CONCLUSION Our results indicated that Cryotop vitrification increases both cooling and warming rates, but both Cryotop and OPS techniques have the same effect on the mouse oocytes after vitrification.
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Affiliation(s)
- Fardin Amidi
- Department of Anatomical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Khodabandeh
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz Institute for Stem Cells and Regenerative Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Ho JR, Woo I, Louie K, Salem W, Jabara SI, Bendikson KA, Paulson RJ, Chung K. A comparison of live birth rates and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos. J Assist Reprod Genet 2017; 34:1359-1366. [PMID: 28718080 DOI: 10.1007/s10815-017-0995-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Prior studies suggest that pregnancy outcomes after autologous oocyte cryopreservation are similar to fresh in vitro fertilization (IVF) cycles. It is unknown whether there are differences in pregnancy and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos. METHODS This is a retrospective cohort study comparing pregnancy and perinatal outcomes between oocyte and embryo cryopreservation at a university-based fertility center. We included 42 patients and 68 embryo transfers in patients who underwent embryo transfer after elective oocyte preservation (frozen oocyte-derived embryo transfer (FOET)) from 2005 to 2015. We compared this group to 286 patients and 446 cycles in women undergoing cryopreserved embryo transfer (frozen embryo transfer (FET)) from 2012 to 2015. RESULTS Five hundred fourteen transfer cycles were included in our analysis. The mean age was lower in the FOET vs FET group (34.3 vs 36.0 years), but there were no differences in ovarian reserve markers. Thawed oocytes had lower survival than embryos (79.1 vs 90.1%); however, fertilization rates were similar (76.2 vs 72.8%). In the FOET vs FET groups, clinical pregnancies were 26.5 and 30%, and live birth rates were 25 and 25.1%. Miscarriages were higher in the FET group, 8.1 vs 1.5%. There were no differences in perinatal outcomes between the two groups. The mean gestational age at delivery was 39.1 vs 38.6 weeks, mean birth weight 3284.2 vs 3161.1 gms, preterm gestation rate 5.9 vs 13.4%, and multiple gestation rate 5.9 vs 11.6%. CONCLUSIONS In our study, live birth rates and perinatal outcomes were not significantly different in patients after oocyte and embryo cryopreservation.
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Affiliation(s)
- Jacqueline R Ho
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA.
| | - Irene Woo
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
| | - Kristin Louie
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
| | - Wael Salem
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
| | - Sami I Jabara
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
- Kaiser Los Angeles Medical Center, Reproductive Endocrinology and Infertility, 4900 Sunset Blvd, Los Angeles, CA, 90027, USA
| | - Kristin A Bendikson
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
| | - Richard J Paulson
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
| | - Karine Chung
- Obstetrics and Gynecology, University of Southern California, 2020 Zonal Ave IRD 534, Los Angeles, CA, 90033, USA
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Liu M, Zhou W, Chu D, Fu L, Sha W, Liu S, Li Y. A modified vitrification method reduces spindle and chromosome abnormalities. Syst Biol Reprod Med 2017; 63:199-205. [PMID: 28277744 DOI: 10.1080/19396368.2017.1285370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Development of an effective system for oocyte-cryopreservation is of clinical relevance in reproductive medicine. However, oocyte-preservation is not as effective as embryo preservation. In this study, we used a 37°C pre-equilibrium temperature as part of a modified vitrification method for human oocyte cryopreservation. The effect of the new method on spindle configuration, chromosomal arrangement, and mitochondrial distribution was investigated in in vitro-matured human oocytes. A total of 101 in vitro-matured oocytes were randomly assigned for vitrification at pre-equilibrium temperature of 37°C (37°C Group, n=50) or at room temperature (RT Group, 22-24°C, n=51). The time needed for vitrification in the 37°C group was significantly shorter than that in the RT group. Defective spindles were found in 45.5% and 69.0% oocytes in the 37°C group and RT group, respectively (p < 0.05). Abnormal chromosomes were found in 47.7% and 71.4% oocytes, respectively (p < 0.05). There were no significant differences with respect to oocyte survival rate and mitochondrial distribution pattern between the two groups. These results indicate that vitrification at a pre-equilibrium temperature of 37°C may reduce the incidence of defective spindle configuration and chromosomal abnormalities in in-vitro-matured human oocytes. ABBREVIATIONS ICSI: intracytoplasmic sperm injection; FSH: follicle-stimulating hormone; MII: metaphase II; EG: ethylene glycol; PROH: 1,2-propanediol.
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Affiliation(s)
- Minghui Liu
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Wenhui Zhou
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Dapeng Chu
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Lei Fu
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Wei Sha
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Shan Liu
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
| | - Yuan Li
- a Medical Center for Human Reproduction , Beijing Chao-Yang Hospital, Capital Medical University , Beijing , China
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Nagy ZP, Anderson RE, Feinberg EC, Hayward B, Mahony MC. The Human Oocyte Preservation Experience (HOPE) Registry: evaluation of cryopreservation techniques and oocyte source on outcomes. Reprod Biol Endocrinol 2017; 15:10. [PMID: 28173814 PMCID: PMC5296964 DOI: 10.1186/s12958-017-0228-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/01/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This prospective, Phase IV, multicenter, observational registry of assisted reproductive technology clinics in the USA studied outcomes of first cycles using thawed/warmed cryopreserved (by slow-freezing/vitrification) oocytes (autologous or donor). METHODS Patients were followed up through implantation, clinical pregnancy, and birth outcomes. The main outcome measure was live birth rate (LBR), defined as the ratio of live births to oocytes thawed/warmed minus the number of embryos cryopreserved for each cycle, averaged over all thawing cycles. Clinical pregnancy rate (CPR) was also evaluated, and was defined as the presence of a fetal sac with heart activity, as detected by ultrasound scan performed on Day 35-42 after embryo transfer. RESULTS A total of 16 centers enrolled 204 patients; data from 193 patients were available for analyses. For donor oocytes, in the slow-freezing (n = 40) versus vitrification (n = 94) groups, respectively, CPR and LBR were significantly different: 32.4% versus 62.6%, and 25.0% versus 52.1%; outcomes from Day 3 transfers did not differ significantly. For vitrified oocytes, in the autologous (n = 46) versus donor (n = 94) group, respectively, CPR and LBR were significantly different: 30.0% versus 62.6% and 17.4% versus 52.1%. This was largely due to a significant difference in CPR with Day 5/6 transfers. CONCLUSIONS In two subgroup data analyses, in women who received cryopreserved oocytes from donors, CPR and LBR were significantly higher in cycles using oocytes cryopreserved via vitrification versus slow-freezing, reflecting differences in methodologies and more Day 5/6 transfers; in women who received vitrified oocytes, CPR and LBR were significantly higher in cycles using donor versus autologous oocytes with Day 5/6 transfers. TRIAL REGISTRATION ClinicalTrials.gov: NCT00699400 . Registered June 13, 2008.
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Affiliation(s)
- Zsolt Peter Nagy
- Reproductive Biology Associates, 1100 Johnson Ferry Rd #200, Atlanta, GA 30342 USA
| | - Robert E. Anderson
- Southern California Center for Reproductive Medicine, 361 Hospital Rd #333, Newport Beach, CA 92663 USA
| | - Eve C. Feinberg
- Fertility Centers of Illinois, 67 Park Ave W #190, Highland Park, IL 60035 USA
| | - Brooke Hayward
- 0000 0004 0412 6436grid.467308.eEMD Serono, Inc., One Technology Pl., Rockland, MA 02370 USA
| | - Mary C. Mahony
- 0000 0004 0412 6436grid.467308.eEMD Serono, Inc., One Technology Pl., Rockland, MA 02370 USA
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Abstract
Ovarian freezing and transplantation has garnered increasing interest as a potential way of preserving fertility in cancer patients as well as for women who just wish to delay childbearing. This chapter spells out our techniques of ovarian cortex vitrification and results for frozen compared to fresh ovarian cortex transplantation (in one single series from one center for the sake of consistency), as well as potentially provides insight into the mechanism behind ovarian follicle recruitment. This represents an effort to simplify and popularize an approach that has yielded favorable results (all cases recovered ovulation and 75% had successful spontaneous pregnancy) in one single, disciplined study. It should be clear that this is a review for the more general reader of our original scientific papers published in Reproductive BioMedicine Online, New England Journal of Medicine, Fertility and Sterility, Human Reproduction, Molecular Human Reproduction, and Journal of Assisted Reproduction and Genetics (JARG).
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Affiliation(s)
- Sherman Silber
- Infertility Center of St. Louis, 224 South Woods Mill Road, Suite 730, St. Louis, MO, 63017, USA.
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40
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Lavery SA, Islam R, Hunt J, Carby A, Anderson RA. The medical and ethical challenges of fertility preservation in teenage girls: a case series of sickle cell anaemia patients prior to bone marrow transplant. Hum Reprod 2016; 31:1501-7. [DOI: 10.1093/humrep/dew084] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/23/2016] [Indexed: 11/13/2022] Open
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Silber S. How ovarian transplantation works and how resting follicle recruitment occurs: a review of results reported from one center. ACTA ACUST UNITED AC 2016; 12:217-27. [PMID: 26900727 DOI: 10.2217/whe.15.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Ovarian freezing and transplantation has garnered increasing interest as a potential way of preserving fertility in cancer patients. This special report aims to identify the success rate of frozen compared with fresh ovarian cortex transplantation (in one single series from one center for the sake of consistency), as well as potentially provides insight into the mechanism behind ovarian follicle recruitment. A comparison of fresh versus frozen transplantation techniques is presented, highlighting the similarity and differences between the fresh and frozen transplantation procedures. Much of the literature is scattered case reports with different patient populations and different techniques. This represents an effort to simplify and popularize an approach that has yielded favorable results (all cases recovered ovulation and 75% had successful spontaneous pregnancy) in one single, disciplined study.
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Affiliation(s)
- Sherman Silber
- Infertility Center of St. Louis, 224 S. Woods Mill Road, Suite 730, St. Louis, MO 63017, USA.,Department of Obstetrics & Gynecology, University of Amsterdam, 1012 WX Amsterdam, The Netherlands.,Sun Yat-Sen Medical School, No.74 Zhongshan Rd.2, Guangzhou, P.R. China
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Coello A, Campos P, Remohí J, Meseguer M, Cobo A. A combination of hydroxypropyl cellulose and trehalose as supplementation for vitrification of human oocytes: a retrospective cohort study. J Assist Reprod Genet 2016; 33:413-421. [PMID: 26754749 DOI: 10.1007/s10815-015-0633-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/02/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This study aimed to determine whether the new formulation of vitrification solutions containing a combination of hydroxypropyl cellulose (HPC) and trehalose does not affect outcomes in comparison with using conventional solutions made of serum substitute supplement (SSS) and sucrose. METHODS Ovum donation cycles were retrospectively compared regarding the solution used for vitrification and warming of human oocytes. The analysis included 218 cycles (N = 2532 oocytes) in the study group (HPC + trehalose) and 214 cycles (N = 2353 oocytes) in the control group (SSS + sucrose). RESULTS No statistical differences were found in ovarian stimulation parameters and baseline characteristics of donors and recipients. The survival rate was 91.3% (95% confidence interval (CI) = 89.8-92.9) in the HPC + trehalose group vs. 92.1% (95% CI = 90.4-93.7) in the SSS + sucrose group (NS). The implantation rate (42.8%, 95% CI = 37.7-47.9 vs. 41.2%, 95% CI = 36.0-46.4), clinical pregnancy rate (CPR) per transfer (60.7%, 95% CI = 53.9-67.5 vs. 56.4%, 95% CI = 49.3-63.5), and ongoing pregnancy rate (OPR) per transfer (48.5%, 95% CI = 41.5-55.5 vs. 46.3%, 95% CI = 39.2-53.4) were similar for patients who received either HPC + trehalose-vitrified oocytes or SSS + sucrose-vitrified oocytes. Statistical differences were found when analyzing blastocyst rate both per injected oocyte (30.2%, 95% CI = 28.3-32.1 vs. 24.1%, 95% CI = 22.3-25.9) and per fertilized oocyte (40.8%, 95%CI = 38.5-43.1 vs. 33.2%, 95% CI = 30.8-35.5) (P < 0.0001). Delivery rate was comparable between groups (37.2%, 95% CI = 30.8-46.6 vs. 36.9%, 95% CI = 30.4-43.4; NS). CONCLUSIONS Our data demonstrate that HPC and trehalose are suitable and safe substitutes for serum and sucrose. Therefore, the new commercial media can be used efficiently in the vitrification of human oocytes avoiding viral and endotoxin contamination risk.
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Affiliation(s)
- Aila Coello
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Pilar Campos
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - José Remohí
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Marcos Meseguer
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain
| | - Ana Cobo
- Instituto Valenciano de Infertilidad (IVI), University of Valencia, Pl. Policía Local 3, Valencia, Spain.
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Hourvitz A, Yerushalmi G, Maman E, Raanani H, Elizur S, Brengauz M, Orvieto R, Dor J, Meirow D. Combination of ovarian tissue harvesting and immature oocyte collection for fertility preservation increases preservation yield. Reprod Biomed Online 2015; 31:497-505. [DOI: 10.1016/j.rbmo.2015.06.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 12/23/2022]
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Abstract
Objective: To evaluate the safety and risk of cryopreservation in female fertility preservation. Data sources: The data analyzed in this review were the English articles from 1980 to 2013 from journal databases, primarily PubMed and Google scholar. The criteria used in the literature search show as following: (1) human; embryo; cryopreservation/freezing/vitrification, (2) human; oocyte/immature oocyte; cryopreservation/ freezing/vitrification, (3) human; ovarian tissue transplantation; cryopreservation/freezing/vitrification, (4) human; aneuploidy/DNA damage/epigenetic; cryopreservation/freezing/vitrification, and (5) human; fertility preservation; maternal age. Study selection: The risk ratios based on survival rate, maturation rate, fertilization rate, cleavage rate, implantation rate, pregnancy rate, and clinical risk rate were acquired from relevant meta-analysis studies. These studies included randomized controlled trials or studies with one of the primary outcome measures covering cryopreservation of human mature oocytes, embryos, and ovarian tissues within the last 7 years (from 2006 to 2013, since the pregnancy rates of oocyte vitrification were significantly increased due to the improved techniques). The data involving immature oocyte cryopreservation obtained from individual studies was also reviewed by the authors. Results: Vitrifications of mature oocytes and embryos obtained better clinical outcomes and did not increase the risks of DNA damage, spindle configuration, embryonic aneuploidy, and genomic imprinting as compared with fresh and slow-freezing procedures, respectively. Conclusions: Both embryo and oocyte vitrifications are safe applications in female fertility preservation.
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Affiliation(s)
| | | | | | | | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
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Novella-Maestre E, Herraiz S, Rodríguez-Iglesias B, Díaz-García C, Pellicer A. Short-Term PTEN Inhibition Improves In Vitro Activation of Primordial Follicles, Preserves Follicular Viability, and Restores AMH Levels in Cryopreserved Ovarian Tissue From Cancer Patients. PLoS One 2015; 10:e0127786. [PMID: 26024525 PMCID: PMC4449215 DOI: 10.1371/journal.pone.0127786] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/19/2015] [Indexed: 12/25/2022] Open
Abstract
Introduction In vitro activation and growth of primordial dormant follicles to produce fertilizable oocytes would provide a useful instrument for fertility preservation. The employment of Phosphatase and TENsin homolog (PTEN) inhibitors, in combination with Protein kinase B (Akt) stimulating molecules, has been previously employed to increase follicular activation through the stimulation of the PTEN-Akt pathway. Methods We aim to establish improved in vitro activation also for cancer patients whose ovarian tissue has already been cryopreserved. Fresh and previously cryopreserved human ovarian cortex were exposed to short-term, low-concentration and ovary-specific treatment with only a PTEN inhibitor. Results Our in vitro activation protocol enhances the activation mechanisms of primordial follicles in both fresh and cryopreserved samples, and enlarges growing populations without inducing apoptosis in either follicles or the surrounding stroma. Treatment augments estradiol secretion and restores the expression levels of the previously diminished Anti-Müllerian hormone by means of cryopreservation procedures. Genomic modulation of the relative expression of PTEN pathway genes was found in treated samples. Conclusion The in vitro activation protocol offers new alternatives for patients with cryopreserved tissue as it increases the pool of viable activated follicles available for in vitro growth procedures. The combination of ovarian tissue cryopreservation and in vitro activation of primordial follicles, the main ovarian reserve component, will be a major advancement in fertility preservation.
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Affiliation(s)
- Edurne Novella-Maestre
- Unidad de Genética, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Grupo de investigación de Medicina Reproductiva. Instituto de Investigación Sanitario La Fe. Valencia, Spain
- Unidad de Preservación de la Fertilidad, Área de Salud de la Mujer. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sonia Herraiz
- Grupo de investigación de Medicina Reproductiva. Instituto de Investigación Sanitario La Fe. Valencia, Spain
- Unidad de Preservación de la Fertilidad, Área de Salud de la Mujer. Hospital Universitario y Politécnico La Fe, Valencia, Spain
- * E-mail:
| | - Beatriz Rodríguez-Iglesias
- Grupo de investigación de Medicina Reproductiva. Instituto de Investigación Sanitario La Fe. Valencia, Spain
- Unidad de Preservación de la Fertilidad, Área de Salud de la Mujer. Hospital Universitario y Politécnico La Fe, Valencia, Spain
- IGENOMIX, Parc Cientific Valencia University, Paterna, Valencia, Spain
| | - César Díaz-García
- Grupo de investigación de Medicina Reproductiva. Instituto de Investigación Sanitario La Fe. Valencia, Spain
- Unidad de Preservación de la Fertilidad, Área de Salud de la Mujer. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonio Pellicer
- Grupo de investigación de Medicina Reproductiva. Instituto de Investigación Sanitario La Fe. Valencia, Spain
- Unidad de Preservación de la Fertilidad, Área de Salud de la Mujer. Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Mahajan N. Fertility preservation in female cancer patients: An overview. J Hum Reprod Sci 2015; 8:3-13. [PMID: 25838742 PMCID: PMC4381379 DOI: 10.4103/0974-1208.153119] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 02/06/2015] [Accepted: 01/29/2015] [Indexed: 12/20/2022] Open
Abstract
Fertility preservation is becoming increasingly important to improve the quality of life in cancer survivors. Despite guidelines suggesting that discussion of fertility preservation should be done prior to starting cancer therapies, there is a lack of implementation in this area. A number of techniques are available for fertility preservation, and they can be used individually or together in the same patient to maximize efficiency. Oocyte and embryo cryopreservation are now established techniques but have their limitations. Ovarian tissue cryopreservation though considered experimental at present, has a wider clinical application and the advantage of keeping the fertility window open for a longer time. Both chemotherapy and radiotherapy have a major impact on reproductive potential and fertility preservation procedures should be carried out prior to these treatments. The need for fertility preservation has to be weighed against morbidity and mortality associated with cancer. There is thus a need for a multidisciplinary collaboration between oncologists and reproductive specialists to improve awareness and availability.
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Affiliation(s)
- Nalini Mahajan
- Department of Reproductive Medicine, Nova IVI Fertilit, New Delhi, India
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Reproductive options for female cancer patients: balancing hope and realistic expectation. Curr Opin Oncol 2015; 26:501-7. [PMID: 25046204 DOI: 10.1097/cco.0000000000000105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW To review currently available options in fertility preservation in cancer patients, report on emerging techniques, and highlight the importance of time sensitivity and recording of outcomes. RECENT FINDINGS Fertility preservation in cancer patients is a rapidly expanding area of medicine. Recent success with experimental techniques such as oocyte cryopreservation and ovarian tissue cryopreservation exemplify the need for follow-up data collection. SUMMARY Results of fertility outcomes in cancer patients should form an integral and important part of the pretreatment counselling process for cancer patients but limited published data from larger cohorts exist. The formation of a growing fertility preservation database would, therefore, allow ease of data analysis and more robust results.
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Silber S, Pineda J, Lenahan K, DeRosa M, Melnick J. Fresh and cryopreserved ovary transplantation and resting follicle recruitment. Reprod Biomed Online 2015; 30:643-50. [PMID: 25892498 DOI: 10.1016/j.rbmo.2015.02.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 02/12/2015] [Accepted: 02/17/2015] [Indexed: 01/01/2023]
Abstract
Ovary cryopreservation and transplantation has garnered increasing interest as a possible method to preserve fertility for cancer patients and to study ovarian resting follicle recruitment. Eleven consecutive women underwent fresh donor ovary transplantation, and 11 underwent cryopreserved ovary auto-transplantation in the same centre, with the same surgeon. Of the 11 fresh transplant recipients, who were all young but menopausal, nine women had normal ovarian cortex transplanted from an identical twin sister, and two had a fresh allograft from a non-identical sister. In the second group, 11 women with cancer had ovarian tissue cryopreserved before bone marrow transplant, and then after years of therapeutically induced menopause, underwent cryopreserved ovarian cortex autotransplantation. Recovery of ovarian function and follicle recruitment was assessed in all 22 recipients, and the potential for pregnancy was further investigated in 19 (11 fresh and 8 cryopreserved) with over 1-year follow-up. In all recipients, normal FSH levels and menstruation returned by about 150 days, and anti-Müllerian hormone reached much greater than normal concentrations by about 170 days. Anti-Müllerian hormone levels then fell below normal by about 240 days and remained at that lower level. Seventeen babies have been born to these 11 fresh and eight cryopreserved ovary transplant recipients.
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Affiliation(s)
- Sherman Silber
- Infertility Center of St Louis, St Luke's Hospital, 224 South Woods Mill Road, Saint Louis, MO 63017, USA.
| | - Jorge Pineda
- Infertility Center of St Louis, St Luke's Hospital, 224 South Woods Mill Road, Saint Louis, MO 63017, USA
| | - Kathleen Lenahan
- Infertility Center of St Louis, St Luke's Hospital, 224 South Woods Mill Road, Saint Louis, MO 63017, USA
| | - Michael DeRosa
- Infertility Center of St Louis, St Luke's Hospital, 224 South Woods Mill Road, Saint Louis, MO 63017, USA
| | - Jeffrey Melnick
- Department of Pathology, St Luke's Hospital, 232 South Woods Mill Road, St Louis, MO 63017, USA
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da Motta ELA, Bonavita M, Alegretti JR, Chehin M, Serafini P. Live birth after 6 years of oocyte vitrification in a survivor with breast cancer. J Assist Reprod Genet 2014; 31:1397-400. [PMID: 25145843 DOI: 10.1007/s10815-014-0314-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/01/2014] [Indexed: 12/11/2022] Open
Affiliation(s)
- Eduardo Leme Alves da Motta
- Huntington Reproductive Medicine, Av. República do Líbano, 529 Ibirapuera, São Paulo, SP, 04501-000, Brazil,
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50
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Arav A. Cryopreservation of oocytes and embryos. Theriogenology 2014; 81:96-102. [PMID: 24274414 DOI: 10.1016/j.theriogenology.2013.09.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/11/2013] [Accepted: 09/11/2013] [Indexed: 10/26/2022]
Abstract
Two hundred years have passed since the first description of supercooled water by Gey-Lussac to the recently high survival rates of embryo and oocytes after vitrification. This review discusses important milestones that have made vitrification the method of choice for oocytes and embryos cryopreservation. We will go through the first cells ever to survive low temperature exposure in the beginning of the last century, the finding of glycerol in the late 1940s and the first mouse and bovine embryos freezing in the 1970s. During the 1980s, embryo vitrification began and the time since is a tribute to the development of oocytes vitrification. Standardization and an automatic vitrification procedure are currently under development. The next evolutionary step in oocyte and embryo cryopreservation will be preserving them in the dry state at room temperature, allowing home storage for future use a reality.
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Affiliation(s)
- A Arav
- FertileSafe, Shlomzion Hamalca, Tel Aviv, Israel 62266.
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