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Sänger N, John J, Einenkel R, Schallmoser A. First report on successful delivery after retransplantation of vitrified, rapid warmed ovarian tissue in Europe. Reprod Biomed Online 2024; 49:103940. [PMID: 38744030 DOI: 10.1016/j.rbmo.2024.103940] [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: 12/21/2023] [Revised: 02/22/2024] [Accepted: 03/04/2024] [Indexed: 05/16/2024]
Abstract
RESEARCH QUESTION Cryopreservation of ovarian tissue is one feasible option to preserve female fertility prior to cancer treatment. The slow freezing protocol represents the current standard approach, while vitrification has been suggested as a promising alternative. This paper reports the follow-up and first successful delivery after retransplantation of vitrified, rapid warmed ovarian tissue in Europe. DESIGN After the patient received a diagnosis of breast cancer, ovarian tissue was removed laparoscopically and sent via overnight transportation to University Hospital Bonn for vitrification on site. The patient was treated with chemotherapy, leading to ovarian failure. After 2 years, retransplantation of the vitrified, rapid warmed tissue was conducted on site. RESULTS Two months after grafting, the patient reported regular menstrual cycles. After 1 further month a clinical pregnancy occurred, which ended in a spontaneous abortion at the 8th week of pregnancy. Six months after grafting, another naturally conceived pregnancy was determined, resulting in the birth of a healthy boy 14 months after retransplantation of the ovarian tissue. CONCLUSIONS Complementing the successful deliveries reported by the groups of Suzuki (Japan) and Silber (USA) regarding vitrified tissue, the current results confirm the high potential of this cryopreservation method in a clinical routine setting as an alternative approach to the widespread slow freezing method.
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Affiliation(s)
- Nicole Sänger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Germany.
| | - Julia John
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Germany
| | - Rebekka Einenkel
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Germany
| | - Andreas Schallmoser
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Germany
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2
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Najafi A, Asadi E, Benson JD. Comparative effects of a calcium chelator (BAPTA-AM) and melatonin on cryopreservation-induced oxidative stress and damage in ovarian tissue. Sci Rep 2023; 13:22911. [PMID: 38129642 PMCID: PMC10739950 DOI: 10.1038/s41598-023-49892-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Oncology treatments cause infertility, and ovarian tissue cryopreservation and transplantation (OTCT) is the only option for fertility preservation in prepubertal girls with cancer. However, OTCT is associated with massive follicle loss. Here, we aimed to determine the effect of supplementation of slow freezing and vitrification media with BAPTA-AM and melatonin alone and in combination on ovarian tissue viability, reactive oxygen species (ROS) levels, total antioxidant capacity (TAC), and follicular morphology and viability. Our results indicated that BAPTA-AM and melatonin can significantly improve ovarian tissue viability and the TAC/ROS ratio and reduce ROS generation in frozen-thawed ovarian tissues in slow freezing and vitrification procedures. BAPTA-AM was also found to be less effective on TAC compared to melatonin in vitrified ovarian tissue. While supplementation of slow freezing and vitrification media with BAPTA-AM and/or melatonin could increase the percentage of morphologically intact follicles in cryopreserved ovarian tissues, the differences were not significant. In conclusion, supplementation of cryopreservation media with BAPTA-AM or melatonin improved the outcome of ovarian tissue cryopreservation in both vitrification and slow freezing methods. Our data provide some insight into the importance of modulating redox balance and intracellular Ca2+ levels during ovarian tissue cryopreservation to optimize the current cryopreservation methods.
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Affiliation(s)
- Atefeh Najafi
- Department of Biology, University of Saskatchewan, Saskatoon, SK, S7N 5E2, Canada
| | - Ebrahim Asadi
- Department of Biology, University of Saskatchewan, Saskatoon, SK, S7N 5E2, Canada
| | - James D Benson
- Department of Biology, University of Saskatchewan, Saskatoon, SK, S7N 5E2, Canada.
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3
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Jaeger P, Fournier C, Santamaria C, Fraison E, Morel-Journel N, Benchaib M, Salle B, Lornage J, Labrune E. Human ovarian cryopreservation: vitrification versus slow freezing from histology to gene expression. HUM FERTIL 2023; 26:1099-1107. [PMID: 36384420 DOI: 10.1080/14647273.2022.2136540] [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: 11/25/2021] [Accepted: 03/17/2022] [Indexed: 11/18/2022]
Abstract
Cryopreservation of ovarian tissue is one of the strategies offered to girls and women needing gonadotoxic treatment to preserve their fertility. The reference method to cryopreserve is slow freezing; vitrification is an alternative method. The aim was to evaluate which of the two is the best method for human ovarian tissue cryopreservation. Each ovary was divided into three groups: (i) fresh; (ii) slow freezing; and (iii) vitrification. An evaluation of the follicular density, quality and the expression six genes (CYP11A, STAR, GDF9, ZP3, CDK2, CDKN1A) were performed. We observed no significant difference in follicular density within these three groups. Slow freezing altered the primordial follicles compared to the fresh tissue (31.8% vs 55.9%, p = 0.046). The expression of genes involved in steroidogenesis varied after cryopreservation compared to the fresh group; CYP11A was under-expressed in slow freezing group (p = 0.01), STAR was under-expressed in the vitrification group (p = 0.01). Regarding the expression of genes involved in cell cycle regulation, CDKN1A was significantly under-expressed in both freezing groups (slow freezing: p = 0.0008; vitrification: p = 0.03). Vitrification had no effect on the histological quality of the follicles at any stage of development compared to fresh tissue. There was no significant difference in gene expression between the two techniques.
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Affiliation(s)
- Pauline Jaeger
- Service de médecine de la reproduction et préservation de la fertilité - CECOS, Hospices Civils de Lyon, Bron, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
- INSERM U1208, SBRI, Bron, France
| | - Cyrielle Fournier
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
| | | | - Eloise Fraison
- Service de médecine de la reproduction et préservation de la fertilité - CECOS, Hospices Civils de Lyon, Bron, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
- INSERM U1208, SBRI, Bron, France
| | | | - Mehdi Benchaib
- Service de médecine de la reproduction et préservation de la fertilité - CECOS, Hospices Civils de Lyon, Bron, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
- INSERM U1208, SBRI, Bron, France
| | - Bruno Salle
- Service de médecine de la reproduction et préservation de la fertilité - CECOS, Hospices Civils de Lyon, Bron, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
- Université Calude Bernard, Faculté de médecine et de maieutique Lyon Sud, Pierre Bénite, France
| | - Jacqueline Lornage
- Service de médecine de la reproduction et préservation de la fertilité - CECOS, Hospices Civils de Lyon, Bron, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
- INSERM U1208, SBRI, Bron, France
| | - Elsa Labrune
- Service de médecine de la reproduction et préservation de la fertilité - CECOS, Hospices Civils de Lyon, Bron, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France
- INSERM U1208, SBRI, Bron, France
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Schallmoser A, Einenkel R, Färber C, Hüren V, Emrich N, John J, Sänger N. Comparison of angiogenic potential in vitrified vs. slow frozen human ovarian tissue. Sci Rep 2023; 13:12885. [PMID: 37558708 PMCID: PMC10412559 DOI: 10.1038/s41598-023-39920-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023] Open
Abstract
Vitrification of ovarian tissue is a promising alternative approach to the traditional slow freezing method. Few empirical investigations have been conducted to determine the angiogenic profiles of these two freezing methods. In this study we aimed to answer the question whether one of the cryopreservation methods should be preferred based on the secretion of angiogenic factors. Tissue culture with reduced oxygen (5%) was conducted for 48 h with samples of fresh, slow frozen/thawed and vitrified/rapid warmed ovarian cortex tissue from 20 patients. From each patient, tissue was used in all three treatment groups. Tissue culture supernatants were determined regarding cytokine expression profiles of angiogenin, angiopoietin-2, epidermal growth factor, basic fibroblast growth factor, heparin binding epidermal growth factor, hepatocyte growth factor, Leptin, Platelet-derived growth factor B, placental growth factor and vascular endothelial growth factor A via fluoroimmunoassay. Apoptotic changes were assessed by TUNEL staining of cryosections and supplemented by hematoxylin and eosin and proliferating cell nuclear antigen staining. Comparing the angiogenic expression profiles of vitrified/rapid warmed tissue with slow frozen/thawed tissue samples, no significant differences were observed. Detection of apoptotic DNA fragmentation via TUNEL indicated minor apoptotic profiles that were not significantly different comparing both cryopreservation methods. Vitrification of ovarian cortical tissue does not appear to impact negatively on the expression profile of angiogenic factors and may be regarded as an effective alternative approach to the traditional slow freezing method.
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Affiliation(s)
- Andreas Schallmoser
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - Rebekka Einenkel
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Cara Färber
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Vanessa Hüren
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Norah Emrich
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Julia John
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Nicole Sänger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
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Marschalek J, Hager M, Wanderer S, Ott J, Frank M, Schneeberger C, Pietrowski D. Different Impacts of Cryopreservation in Endothelial and Epithelial Ovarian Cells. Int J Mol Sci 2023; 24:12225. [PMID: 37569601 PMCID: PMC10418832 DOI: 10.3390/ijms241512225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of our laboratory-based study was to investigate the extent of delayed-onset cell death after cryopreservation in endothelial and epithelial cell lines of ovarian origin. We found differences in percentages of vital cells directly after warming and after cultivation for 48 to 72 h. A granulosa cell line of endothelial origin (KGN) and an epithelial cell line (OvCar-3) were used. In both DMSO-containing and DMSO-free protocols, significant differences in vitality rates between the different cell lines when using open and closed vitrification could be shown (DMSO-containing: KGN open vs. OvCar open, p = 0.001; KGN closed vs. OvCar closed, p = 0.001; DMSO-free: KGN open vs. OvCar open, p = 0.001; KGN closed vs. OvCar closed, p = 0.031). Furthermore, there was a marked difference in the percentage of vital cells immediately after warming and after cultivation for 48 to 72 h; whereas the KGN cell line showed a loss of cell viability of 41% using a DMSO-containing protocol, the OvCar-3 cell loss was only 11% after cultivation. Using a DMSO-free protocol, the percentages of late-onset cell death were 77% and 48% for KGN and OvCar-3 cells, respectively. Our data support the hypothesis that cryopreservation-induced damage is cell type and cryoprotective agent dependent.
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Affiliation(s)
- Julian Marschalek
- Department of Obstetrics and Gynecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; (J.M.); (M.H.); (J.O.); (M.F.); (C.S.)
| | - Marlene Hager
- Department of Obstetrics and Gynecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; (J.M.); (M.H.); (J.O.); (M.F.); (C.S.)
| | - Sophie Wanderer
- FH Campus Wien, University of Applied Science, 1100 Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; (J.M.); (M.H.); (J.O.); (M.F.); (C.S.)
| | - Maria Frank
- Department of Obstetrics and Gynecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; (J.M.); (M.H.); (J.O.); (M.F.); (C.S.)
| | - Christian Schneeberger
- Department of Obstetrics and Gynecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; (J.M.); (M.H.); (J.O.); (M.F.); (C.S.)
| | - Detlef Pietrowski
- Department of Obstetrics and Gynecology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; (J.M.); (M.H.); (J.O.); (M.F.); (C.S.)
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6
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GÖKHAN A, ÇAVUŞOĞLU T, KILIÇ KD, ŞİRİN C, TOMRUK C, YİĞİTTÜRK G, ERBAŞ O, YILDIRIM SÖZMEN E, BAKA M. Effects of vitrification solution supplemented with platelet-rich plasma in rat ovarian tissue cryopreservation. Turk J Med Sci 2023; 53:1281-1292. [PMID: 38813015 PMCID: PMC10763808 DOI: 10.55730/1300-0144.5694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 10/26/2023] [Accepted: 04/04/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim The subject of this study was to investigate the utility of platelet-rich plasma (PRP) in the cryopreservation process to reduce cryodamage and increase tissue viability. Materials and methods Twenty-one female Wistar rats were randomly allocated to three groups. In Group 1 (G1), rats were not subjected to vitrification (n = 7). Group 2 (G2) was the vitrification group in which PRP was added to the basic vitrification solution (n = 7). Group 3 (G3) was the vitrification group in which fetal bovine serum was added to the basic vitrification solution (n = 7). Warmed tissues were evaluated with histochemical (HC) and immunohistochemical (IHC) staining, the TUNEL method, immunofluorescence (IF) staining, and biochemical analyses. Results The percentages of IHC staining, TUNEL method positivity, and IF staining were significantly higher in G2 compared to both G1 and G3 (P < 0.05). G2 ovaries exhibited a significant increase in both malondialdehyde and catalase values in comparison to G1 (P < 0.05). In HC staining, degenerations in primary and secondary follicles and in ovarian tissue were more common in the PRP-supplemented group. The calcium used in PRP activation was suspected to have increased the degeneration and prevented the possible positive effects of PRP. Conclusion To the best of our knowledge, PRP-supplemented vitrification solution was used for the first time in the literature in this study in whole rat ovarian tissue vitrification. If PRP is to be used as a component in vitrification solution for rat ovarian tissue, the use of lower amounts of calcium or different methods in PRP activation, or the use of nonactivated PRP, should be considered from the beginning.
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Affiliation(s)
- Aylin GÖKHAN
- Department of Histology and Embryology, Faculty of Medicine, Ege University, İzmir,
Turkiye
| | - Türker ÇAVUŞOĞLU
- Department of Histology and Embryology, Faculty of Medicine, İzmir Bakırçay University, İzmir,
Turkiye
| | - Kubilay Doğan KILIÇ
- Department of Histology and Embryology, Faculty of Medicine, Ege University, İzmir,
Turkiye
| | - Cansın ŞİRİN
- Department of Histology and Embryology, Faculty of Medicine, Ege University, İzmir,
Turkiye
| | - Canberk TOMRUK
- Department of Histology and Embryology, Republic of Turkiye Ministry of Health Samsun Education and Research Hospital, Samsun,
Turkiye
| | - Gürkan YİĞİTTÜRK
- Department of Histology and Embryology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla,
Turkiye
| | - Oytun ERBAŞ
- Department of Physiology, Faculty of Medicine, Demiroğlu Bilim University, İstanbul,
Turkiye
| | - Eser YILDIRIM SÖZMEN
- Department of Medical Biochemistry, Faculty of Medicine, Ege University, İzmir,
Turkiye
| | - Meral BAKA
- Department of Histology and Embryology, Faculty of Medicine, Ege University, İzmir,
Turkiye
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7
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Behl S, Joshi VB, Larson NB, Young MC, Bilal M, Walker DL, Khan Z, Granberg CF, Chattha A, Zhao Y. Vitrification versus slow freezing of human ovarian tissue: a systematic review and meta-analysis of histological outcomes. J Assist Reprod Genet 2023; 40:455-464. [PMID: 36542310 PMCID: PMC10033773 DOI: 10.1007/s10815-022-02692-w] [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: 09/12/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022] Open
Abstract
A systematic review and meta-analysis of pertinent literature published from 2006 to January 2022 were conducted to study and compare vitrification and slow freezing, the two prominent methods of ovarian tissue cryopreservation. The primary outcome measures for this study were (1) proportion of intact primordial follicles, (2) proportion of intact stromal cells, (3) proportion of DNA fragmentation in primordial follicles, and (4) mean primordial follicle density. This meta-analysis of 19 studies revealed a significantly greater proportion of intact stromal cells in vitrified tissue versus slow-frozen tissue. No significant differences upon pooled analyses were observed between the two cryopreservation methods with respect to the proportion of intact primordial follicles, proportion of DNA fragmentation, or mean primordial follicle density. Due to differences seen in stromal cell viability, vitrification may be a preferred option to preserve histology of tissue. However, more work should be done to compare the two freezing techniques with less heterogeneity caused by patients, samples, and protocols.
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Affiliation(s)
- Supriya Behl
- Children's Research Center, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA
| | - Vidhu B Joshi
- Charles Widger School of Law, Villanova University, Villanova, PA, USA
| | - Nicholas B Larson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, USA
| | - Maia C Young
- Mayo Clinic Alix School of Medicine, Rochester, MN, 55905, USA
| | - Muhammad Bilal
- Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA
| | - David L Walker
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA
| | - Zaraq Khan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA
| | - Candace F Granberg
- Department of Urology, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA
| | - Asma Chattha
- Division of Pediatric and Adolescent Gynecology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA
| | - Yulian Zhao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA.
- Division of Clinical Core Laboratory Services, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, MN, 55905, Rochester, USA.
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8
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Yildiz S, Bildik G, Benlioglu C, Turan V, Dilege E, Ozel M, Kim S, Oktem O. Breast cancer treatment and ovarian function. Reprod Biomed Online 2023; 46:313-331. [PMID: 36400663 DOI: 10.1016/j.rbmo.2022.09.014] [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: 06/13/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 02/07/2023]
Abstract
The aim of this study was to provide an update on ovarian function and the mechanisms of gonadal damage after exposure to chemotherapy in breast cancer survivors. The alkylating agents are toxic to both primordial and growing follicles. However, anti-metabolite drugs are more likely to destroy preantral and antral follicles. Younger patients are more likely to have a higher ovarian reserve, and therefore, more likely to retain some residual ovarian function after exposure to gonadotoxic regimens. However, there can be significant variability in ovarian reserve among patients of the same age. Furthermore, patients with critically diminished ovarian reserve may continue to menstruate regularly. Therefore age and menstrual status are not reliable indicators of good ovarian reserve and might give a false sense of security and result in an adverse outcome if the patient is consulted without considering more reliable quantitative markers of ovarian reserve (antral follicle count and anti-Müllerian hormone) and fertility preservation is not pursued. In contrast to well-documented ovarian toxicity of older chemotherapy regimens, data for newer taxane-containing protocols have only accumulated in the last decade and data are still very limited regarding the impact of targeted therapies on ovarian function.
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Affiliation(s)
- Sule Yildiz
- The Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koç University Hospital, Koç University School of Medicine, Istanbul, Turkey
| | - Gamze Bildik
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX 77054, USA
| | - Can Benlioglu
- Department of Obstetrics and Gynecology, Koç University Hospital, Istanbul, Turkey
| | - Volkan Turan
- Istanbul Tema Hospital, Assisted Reproduction Unit, Istanbul
| | - Ece Dilege
- Department of General Surgery, Koç University Hospital, Koç University School of Medicine, Istanbul, Turkey
| | - Melis Ozel
- Department of Gynecology and Obstetrics Klinikum Ingolstadt, Bavaria, Germany
| | - Samuel Kim
- Eden Centers for Advanced Fertility, Fullerton CA 92835, USA
| | - Ozgur Oktem
- The Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koç University Hospital, Koç University School of Medicine, Istanbul, Turkey.
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Anbari F, Khalili MA, Mahaldashtian M, Ahmadi A, Palmerini MG. Fertility preservation strategies for cancerous women: An updated review. Turk J Obstet Gynecol 2022; 19:152-161. [PMID: 35770454 PMCID: PMC9249358 DOI: 10.4274/tjod.galenos.2022.42272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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Borrás A, Manau D, Fabregues F, Peralta S, Calafell JM, Casals G, Saco A, Agustí I, Carmona F. Comparison between slow freezing and vitrification of ovarian tissue cryopreservation in assigned female at birth transgender people receiving testosterone therapy: data on histological and viability parameters. J Assist Reprod Genet 2022; 39:527-541. [PMID: 35098405 PMCID: PMC8956766 DOI: 10.1007/s10815-021-02386-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/20/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The use of fertility preservation (FP) techniques has significantly increased in recent years in the assigned female at birth (AFAB) transgender population. Oocyte cryopreservation is the established method for FP, but ovarian tissue cryopreservation may be considered an alternative option, especially during gender-affirming surgery (GAS). The slow freezing (SF) cryopreservation technique is the standard method for human ovarian tissue, but recently, several studies have shown good results with the vitrification (VT) technique. The objective of this study was to compare the effectiveness of VT and SF techniques in ovarian tissue from AFAB transgender people. METHODS This was a prospective study including 18 AFAB transgender people after GAS. Ovarian tissue pieces from each ovary were cryopreserved by SF and VT and compared with fresh tissue. Study by light microscopy (LM) assessed follicular morphology and density. The percentage of surviving and degenerated follicles was studied with the tissue viability test. Oocytes, granulosa cells and stroma were analysed separately by transmission electron microscopy. RESULTS The VT technique preserves follicle and stromal tissue as well as the SF method, but with some differences. Evaluation by LM showed better follicle preservation with VT, but the ultrastructural study showed the presence of minor damage with both techniques compared to fresh tissue. CONCLUSION Both cryopreservation techniques are accurate for maintaining the follicular population and stromal tissue. Further studies are needed to determine the impact of VT on ovarian tissue and the subsequent follicular activation mechanisms in AFAB ovarian tissue.
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Affiliation(s)
- Aina Borrás
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain
| | - Dolors Manau
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain ,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Francesc Fabregues
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain ,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sara Peralta
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain
| | - Josep Maria Calafell
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain
| | - Gemma Casals
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain ,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Adela Saco
- Department of Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain ,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inés Agustí
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain
| | - Francisco Carmona
- Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Carrer de Villarroel N° 170, 08036 Barcelona, Spain ,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Labrune E, Jaeger P, Santamaria C, Fournier C, Benchaib M, Rabilloud M, Salle B, Lornage J. Cellular and Molecular Impact of Vitrification Versus Slow Freezing on Ovarian Tissue. Tissue Eng Part C Methods 2021; 26:276-285. [PMID: 32323623 DOI: 10.1089/ten.tec.2020.0063] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To evaluate a vitrification protocol from histology to gene expression to slow freezing. Methods: Ovaries from 12 prepubertal ewes. The same ovary was cut into fragments, studied fresh, frozen, and vitrified. Follicle morphology by hematoxylin-eosin-safran staining, vitality by Trypan Blue, and apoptosis by marking cleaved caspase-3 were studied. The expression of gene: anti-Müllerian hormone (AMH), cytochrome p450 family 11 subfamily A member 1 (CYP11A), and steroidogenic acute regulatory protein (STAR; granulosa cells); growth differentiation factor 9 (GDF9) and zona pellucida glycoprotein 3 (ZP3; oocytes); and cyclin D2 (CCND2) and cyclin-dependent kinase inhibitor 1A (CDKN1A; cell cycle regulation), was evaluated by reverse transcription quantitative polymerase chain reaction. Results: The slow freezing protocol had a significant negative impact on intact primordial follicles compared with fresh tissue (37.6% vs. 62.5%, p = 0.003). More intact follicles after vitrification were observed compared with slow freezing (p = 0.037). The apoptotic primordial follicles were similar after slow freezing and vitrification (12.6% vs. 13.9%). Concerning granulosa cell genes, slow freezing led to a trend toward overexpression of AMH messenger RNA (mRNA; p = 0.07); while vitrification led to a significant overexpression of CYP11A mRNA (p = 0.003), and a trend toward an overexpression of STAR mRNA (p = 0.06). Concerning oocyte genes, both techniques did not lead to a difference of GDF9 and ZP3 mRNA. Concerning cell cycle genes, slow freezing led to a significant underexpression of CCND2 (p = 0.04); while vitrification did not lead to a difference for CCND2 and CDKN1A mRNA. Conclusion: Vitrification preserved follicular morphology better than slow freezing and led to gene overexpressed, while slow freezing led to gene underexpressed. Impact statement The preservation of female fertility and in particular the cryopreservation of ovarian tissue (OT) is a major public health issue aimed at improving the quality of life of patients after gonadotoxic treatments. The use of slow freezing of this OT, which is the reference technique, is not optimal due to tissue alteration. The alternative would be vitrification. This study compares these two techniques. We have highlighted that vitrification preserved follicular morphology better than slow freezing and led to gene overexpressed, while slow freezing led to gene underexpressed.
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Affiliation(s)
- Elsa Labrune
- Service de Médecine de la Reproduction, Hôpital Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Laennec, Université Claude Bernard, Lyon, France.,INSERM Unité 1208, Bron, France
| | - Pauline Jaeger
- Service de Médecine de la Reproduction, Hôpital Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Laennec, Université Claude Bernard, Lyon, France.,INSERM Unité 1208, Bron, France
| | | | - Cyrielle Fournier
- Faculté de Médecine Laennec, Université Claude Bernard, Lyon, France.,INSERM Unité 1208, Bron, France
| | - Mehdi Benchaib
- Service de Médecine de la Reproduction, Hôpital Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Laennec, Université Claude Bernard, Lyon, France.,INSERM Unité 1208, Bron, France
| | - Muriel Rabilloud
- Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Lyon, France.,Laboratoire Biostatistique Santé, UMR 5558, Lyon, France
| | - Bruno Salle
- Service de Médecine de la Reproduction, Hôpital Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Laennec, Université Claude Bernard, Lyon, France.,Faculté de Médecine Lyon Sud, Université Claude Bernard, Oullins, France
| | - Jacqueline Lornage
- Service de Médecine de la Reproduction, Hôpital Mère Enfant, Hospices Civils de Lyon, Bron, France.,Faculté de Médecine Laennec, Université Claude Bernard, Lyon, France.,INSERM Unité 1208, Bron, France
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12
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Lee S, Ozkavukcu S, Ku SY. Current and Future Perspectives for Improving Ovarian Tissue Cryopreservation and Transplantation Outcomes for Cancer Patients. Reprod Sci 2021; 28:1746-1758. [PMID: 33791995 PMCID: PMC8144135 DOI: 10.1007/s43032-021-00517-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/21/2021] [Indexed: 02/06/2023]
Abstract
Although advances in cancer treatment and early diagnosis have significantly improved cancer survival rates, cancer therapies can cause serious side effects, including ovarian failure and infertility, in women of reproductive age. Infertility following cancer treatment can have significant adverse effects on the quality of life. However, established methods for fertility preservation, including embryo or oocyte cryopreservation, are not always suitable for female cancer patients because of complicated individual conditions and treatment methods. Ovarian tissue cryopreservation and transplantation is a promising option for fertility preservation in pre-pubertal girls and adult patients with cancer who require immediate treatment, or who are not eligible to undergo ovarian stimulation. This review introduces various methods and strategies to improve ovarian tissue cryopreservation and transplantation outcomes, to help patients and clinicians choose the best option when considering the potential complexity of a patient's situation. Effective multidisciplinary oncofertility strategies, involving the inclusion of a highly skilled and experienced oncofertility team that considers cryopreservation methods, thawing processes and devices, surgical procedures for transplantation, and advances in technologies, are necessary to provide high-quality care to a cancer patient.
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Affiliation(s)
- Sanghoon Lee
- Moores Cancer Center, University of California San Diego, San Diego, CA, USA.
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - Sinan Ozkavukcu
- Center for Assisted Reproduction, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Seung-Yup Ku
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
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13
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Thuwanut P, Comizzoli P, Pimpin A, Srituravanich W, Sereepapong W, Pruksananonda K, Taweepolcharoen C, Tuntiviriyapun P, Suebthawinkul C, Sirayapiwat P. Influence of hydrogel encapsulation during cryopreservation of ovarian tissues and impact of post-thawing in vitro culture systems in a research animal model. Clin Exp Reprod Med 2021; 48:111-123. [PMID: 34024082 PMCID: PMC8176157 DOI: 10.5653/cerm.2020.04056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/31/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Using domestic cats as a biomedical research model for fertility preservation, the present study aimed to characterize the influences of ovarian tissue encapsulation in biodegradable hydrogel matrix (fibrinogen/thrombin) on resilience to cryopreservation, and static versus non-static culture systems following ovarian tissue encapsulation and cryopreservation on follicle quality. Methods In experiment I, ovarian tissues (n=21 animals; 567 ovarian fragments) were assigned to controls or hydrogel encapsulation with 5 or 10 mg/mL fibrinogen (5 or 10 FG). Following cryopreservation (slow freezing or vitrification), follicle viability, morphology, density, and key protein phosphorylation were assessed. In experiment II (based on the findings from experiment I), ovarian tissues (n=10 animals; 270 ovarian fragments) were encapsulated with 10 FG, cryopreserved, and in vitro cultured under static or non-static systems for 7 days followed by similar follicle quality assessments. Results In experiment I, the combination of 10 FG encapsulation/slow freezing led to greater post-thawed follicle quality than in the control group, as shown by follicle viability (66.9%±2.2% vs. 61.5%±3.1%), normal follicle morphology (62.2%±2.1% vs. 55.2%±3.5%), and the relative band intensity of vascular endothelial growth factor protein phosphorylation (0.58±0.06 vs. 0.42±0.09). Experiment II demonstrated that hydrogel encapsulation promoted follicle survival and maintenance of follicle development regardless of the culture system when compared to fresh controls. Conclusion These results provide a better understanding of the role of hydrogel encapsulation and culture systems in ovarian tissue cryopreservation and follicle quality outcomes using an animal model, paving the way for optimized approaches to human fertility preservation.
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Affiliation(s)
- Paweena Thuwanut
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pierre Comizzoli
- Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC, USA
| | - Alongkorn Pimpin
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Weerayut Srituravanich
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Wisan Sereepapong
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kamthorn Pruksananonda
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Charoen Taweepolcharoen
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Punkavee Tuntiviriyapun
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chanakarn Suebthawinkul
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Porntip Sirayapiwat
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Research Unit of Reproductive Medicine and Fertility Preservation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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14
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Galbinski S, Kowalewski LS, Grigolo GB, da Silva LR, Jiménez MF, Krause M, Frantz N, Bös-Mikich A. Comparison between two cryopreservation techniques of human ovarian cortex: morphological aspects and the heat shock response (HSR). Cell Stress Chaperones 2021; 27:97-106. [PMID: 35043289 PMCID: PMC8943117 DOI: 10.1007/s12192-022-01252-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 11/03/2022] Open
Abstract
This study was tailored to compare the cryopreservation of the human ovarian cortex using closed metal container vitrification or the slow-freezing technique. Superficial ovarian cortical tissue biopsies were collected from 12 participants who underwent gynaecological videolaparoscopy. The fragmented samples were allocated to three experimental conditions: (a) fresh ovarian tissue, (b) slow-freezing, and (c) vitrification with a metal closed container. After thawing or rewarming, cellular morphological analyses were performed to determine tissue viability. The cellular response to thermal stress was measured by a putative increase in the immune quantification of the heat shock protein 70 kDa (heat shock protein 70 kDa response - HSR) after a heat challenge (2 h exposure at 42 °C). Both the total number of intact follicles and the frequency of primordial follicles were higher in fresh ovarian tissue than in the preserved samples, regardless of the technique employed. There was a trend towards an increase in the absolute number of intact follicles in the tissue preserved by vitrification. After cryopreservation, a higher HSR was obtained after slow-freezing. These results indicate that both cryopreservation techniques present advantages and may be used as alternatives to ovarian tissue cryopreservation.
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Affiliation(s)
- Sérgio Galbinski
- Unidade de Reprodução Humana, Hospital Fêmina, Porto Alegre, RS, Brazil
- Programa de Pós-graduação em Ginecologia e Obstetrícia da Universidade Federal do Rio Grande do Sull, Porto Alegre, RS, Brazil
| | - Lucas Stahlhöfer Kowalewski
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gisele Bettú Grigolo
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Larissa Ramos da Silva
- Instituto de Ciencias Basicas da Saude, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mirela Foresti Jiménez
- Unidade de Reprodução Humana, Hospital Fêmina, Porto Alegre, RS, Brazil
- Programa de Pós-graduação em Ginecologia e Obstetrícia da Universidade Federal do Rio Grande do Sull, Porto Alegre, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Mauricio Krause
- Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Nilo Frantz
- Nilo Frantz Medicina Reprodutiva, Porto Alegre, RS, Brazil
| | - Adriana Bös-Mikich
- Instituto de Ciencias Basicas da Saude, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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15
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Widad S, Nurdiati DS, Ayuandari S, Hamurajib KC, Rahmana MDR, Alma NA, Dewanto A. Primordial follicle survival of goat ovarian tissue after vitrification and transplantation on chorioallanthoic membrane. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00044-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Ovarian tissue vitrification is an alternative fertility preservation procedure for young female patients prior to gonadotoxic treatment. Primordial follicle loss might be a potential issue for vitrification and transplantation procedures. This study aimed to evaluate primordial follicle density and deoxyribonucleic acid (DNA) fragmentation in each stage of the preservation procedure of goat ovarian tissue. Follicle density and DNA fragmentation were examined microscopically after staining with hematoxylin eosin and TUNEL assay, respectively. Both parameters were compared between fresh, fresh-transplanted, vitrification, and vitrification-transplanted groups.
Results
A significant decrease was observed in the primordial follicle proportion after vitrification and transplantation compared to the primordial follicle proportion in the fresh group (88.09% vs 52.42%, p < 0.05, 95% CI 11.54, 66.94). There was no significant difference in DNA fragmentations of primordial follicles between each group (p > 0.05).
Conclusions
The vitrification and transplantation process of goat ovarian strips could cause the primordial follicles loss and DNA damage of the follicles. However, primordial follicles loss and DNA damage were not significantly different in each procedure.
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16
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Herraiz S, Monzó S, Gómez-Giménez B, Pellicer A, Díaz-García C. Optimizing ovarian tissue quality before cryopreservation: comparing outcomes of three decortication methods on stromal and follicular viability. Fertil Steril 2020; 113:609-617.e3. [PMID: 32192593 DOI: 10.1016/j.fertnstert.2019.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/27/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate whether specific ovarian decortication techniques vary in promoting ovarian cortex cryopreservation and transplant outcomes. DESIGN Experimental design. SETTING University hospital. ANIMAL(S) Nonobese diabetic (NOD)/severe combined immunodeficiency (SCID) female mice. INTERVENTION(S) Human ovarian biopsy samples allocated to one of the following decortication procedures: scratching with scalpel blade (B), cutting with microsurgical scissors (M), separation with slicer (S), or no-separation (control, C). Parallel, in vivo experiment: decortication techniques combined with slow freezing (SF) and vitrification (VT) before xenograft into immunodeficient mice. MAIN OUTCOME MEASURE(S) Follicular counts, apoptosis, shear stress, Hippo pathway and inflammation. In vivo: recovered grafts analyzed for follicular counts, angiogenesis, proliferation, and fibrosis. RESULT(S) There were no differences in follicular density or number of damaged follicles between the decortication techniques in the in vitro study. Nevertheless, the M samples showed statistically significantly increased stromal damage compared with the controls and S samples, and up-regulation of Hsp60 shear stress gene expression. Decortication by both M and S inhibited the Hippo pathway, promoting gene expression changes. In the 21-day xenograft, total follicular density statistically significantly decreased compared with the nongrafted controls in all groups. Nevertheless, no differences were observed between the decortication techniques. Ovarian stroma vascularization was increased in the vitrified samples, but among the slow-freezing samples, the B samples had the lowest microvessel density. The M decorticated xenografts had increased fibrosis. CONCLUSION(S) Decortication with a slicer causes less damage to ovarian tissue than other commonly used methods although microsurgical scissors seem to preserve slightly increased follicular numbers. Nevertheless, blade decortication seems to be a reliable technique for maintaining acceptable follicular conditions without inducing serious stromal impairment.
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Affiliation(s)
- Sonia Herraiz
- IVI Foundation, Valencia, Spain; Reproductive Medicine Research Group, Valencia, Spain
| | - Susana Monzó
- Fertility Preservation Unit, Women's Health Area, La Fe University Hospital, Valencia, Spain
| | | | - Antonio Pellicer
- IVI Foundation, Valencia, Spain; Reproductive Medicine Research Group, Valencia, Spain; IVI-RMA Rome, Rome, Italy
| | - César Díaz-García
- Reproductive Medicine Research Group, Valencia, Spain; IVI-London, London, United Kingdom.
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17
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Vatansever D, İncir S, Bildik G, Taskiran C, Oktem O. In-vitro AMH production of ovarian tissue samples in culture correlates with their primordial follicle pool. Eur J Obstet Gynecol Reprod Biol 2020; 254:138-140. [PMID: 32971433 DOI: 10.1016/j.ejogrb.2020.09.002] [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: 01/26/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We aimed to investigate if there is a correlation between in-vitro AMH production and primordial follicle reserve of the ovarian cortical samples in culture. METHODS Seven patients undergoing laparoscopic excision of ovarian dermoid cysts were included in the study. 0.5 × 0.5 cm of ovarian cortical samples embedded within the cyst wall were removed and cultured for one day. Then, the cultured cortical pieces were fixed, paraffin-embedded and serially sectioned for histormorphometric analysis. AMH and estradiol (E2) production of the samples after one-day culture period were measured in the spent culture media. Primordial follicle density was expressed as the number of primordial follicles per mm2. Pearson correlation and linear regression analyses were applied. RESULTS The mean age of the patients was 29.2 ± 6.8 (ranging from 18 to 36). There was a negative correlation between age and PF density (r=-0.92, %95CI: -0.99 to -0.76, p < 0.001). In-vitro AMH level of the cortical samples was significantly associated with age (R2 = 0.67, p = 0.023), primordial follicle density (R2 = 0.71, p = 0.015). There was a borderline significance between in-vitro levels of AMH and E2 level (R2 = 0.55, p = 0.058). A similar comparison could not be made for secondary follicles (preantral and small antral follicles) because of their rarity in the histological sections analyzed. CONCLUSIONS This histomorphometric study provides evidence that in-vitro AMH production of the ovarian cortical samples reflects primordial follicle pool of the samples.
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Affiliation(s)
- Dogan Vatansever
- Koc University School of Medicine Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Said İncir
- Koc University Hospital Clinical Biochemistry, Istanbul, Turkey
| | - Gamze Bildik
- The Graduate School of Health Sciences, Koc University, Istanbul Turkey
| | - Cagatay Taskiran
- Koc University School of Medicine Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Ozgur Oktem
- Koc University School of Medicine Department of Obstetrics and Gynecology, Istanbul, Turkey; The Graduate School of Health Sciences, Koc University, Istanbul Turkey.
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18
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Lopes EPF, Rodrigues GQ, de Brito DCC, Rocha RMP, Ferreira ACA, de Sá NAR, Silva RFD, de Alcântara GLH, Alves BG, Figueiredo JRD, Zelinski M, Rodrigues APR. Vitrification of caprine secondary and early antral follicles as a perspective to preserve fertility function. Reprod Biol 2020; 20:371-378. [PMID: 32418820 DOI: 10.1016/j.repbio.2020.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/28/2020] [Accepted: 05/03/2020] [Indexed: 01/09/2023]
Abstract
The present study aimed to evaluate the structure, survival and development of isolated caprine (secondary-SEC and early antral-EANT) follicles, after vitrification in the presence of synthetic polymers and in vitro culture. Additionally, transzonal projections (TZPs) and p450 aromatase enzyme were evaluated. After isolation, SEC and EANT follicles were in vitro cultured for six days or vitrified. After one week, SEC and EANT follicles were warmed and also in vitro cultured for six days. Data revealed that the percentage of morphologically normal follicles was similar between fresh and vitrified follicles in both follicular categories and antrum formation rate was similar between fresh and vitrified SEC follicles. Fluorescence by calcein-AM did not show difference between fresh and vitrified (SEC and EANT) follicles, however, the trypan blue test showed low viability for vitrified follicles. The integrity of TZPs was not affected between fresh and vitrified SEC follicles, however, in vitrified EANT follicles, there were signs of TZPs loss. Regarding steroidogenic function, it was observed a positive staining for p450 aromatase enzyme in fresh and vitrified SEC and EANT follicles. It was concluded that SEC follicles seem to be more resistant to vitrification than EANT follicles, as shown by the trypan blue test and TZPs assay. Future studies may confirm this hypothesis, in order to consolidate the use of SEC and EANT follicles as an alternative to ovary cryopreservation.
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Affiliation(s)
- Everton Pimentel Ferreira Lopes
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | - Giovanna Quintino Rodrigues
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | - Danielle Cristina Calado de Brito
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | | | - Anna Clara Accioly Ferreira
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | - Naíza Arcângela Ribeiro de Sá
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | - Renato Félix da Silva
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | - Gabriel Las Heras de Alcântara
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | | | - José Ricardo de Figueiredo
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil
| | - Mary Zelinski
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Ana Paula Ribeiro Rodrigues
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceará, Fortaleza, CE, Brazil.
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19
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Hussein RS, Khan Z, Zhao Y. Fertility Preservation in Women: Indications and Options for Therapy. Mayo Clin Proc 2020; 95:770-783. [PMID: 32247351 DOI: 10.1016/j.mayocp.2019.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/25/2019] [Accepted: 10/14/2019] [Indexed: 01/21/2023]
Abstract
Fertility preservation (FP) is a vital issue for individuals in either reproductive or prepubescent stage of life when future fertility may be compromised. The objective of any FP intervention is to minimize or eliminate primary disease burden and to ensure maintaining or preserving reproductive health. Fertility potential can be affected by cancer therapy and numerous other factors, including advancing age, metabolic conditions, autoimmune diseases, specific surgical interventions, and sex affirmation procedures. A paradigm shift focusing on quality-of-life issues and long-term survivorship has emerged, especially because of advances in cancer diagnostics and treatment. Several FP techniques have been widely distributed, while others are still in the research stage. In addition, specific procedures and some potentially fertoprotective agents are being developed, aiming to minimize the hazards of gonadal damage caused by cancer therapy and decrease the need for more costly, invasive, and time-consuming FP methods. This review highlights the advances, indications, and options for FP, both experimental and well-established, in females of various age groups. An electronic search in PubMed, Embase, and Google Scholar databases was conducted, including retrospective studies, prospective clinical trials, meta-analyses, original reviews, and online abstracts published up to June 30, 2019. The search terms used included fertility preservation, oncofertility, embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation. The meeting proceedings of the American Society for Reproductive Medicine and the European Society of Human Reproduction and Embryology were also hand searched.
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Affiliation(s)
- Reda S Hussein
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN; Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Zaraq Khan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN; Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN
| | - Yulian Zhao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN; Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
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20
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Terraciano PB, Garcez TA, Berger M, Durli I, Kuhl CP, Batista VDO, Schneider RDA, Festa J, Pilar E, Ferreira C, Passos EP, Lima EC. Ovarian tissue vitrification is more efficient than slow freezing to preserve ovarian stem cells in CF-1 mice. JBRA Assist Reprod 2020; 24:13-19. [PMID: 31689043 PMCID: PMC6993165 DOI: 10.5935/1518-0557.20190057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the efficacy of protocols for mice ovary cryopreservation to compare the differences in Mouse Vasa Homologue expression (a germline cell marker) and ovarian viability after vitrification or slow freezing. METHODS Female CF1 mice aged 40-45 days were randomly divided into three groups: Control, vitrification or slow freezing. Their ovaries were surgically removed, rinsed in saline solution and cryopreserved. For vitrification, we used a commercial protocol and for slow freeze, we used 1.5 M ethylene glycol (EG) as cryoprotectant. After that, the ovaries were processed for histological an immunohistochemical analysis, and counting of primordial, primary, pre-antral and antral follicles. RESULTS No significant difference was found in the proportion of high-quality primordial, primary and pre-antral follicles after thawing/warming in the slow freezing and vitrification groups. The immunohistochemistry for MVH antibody demonstrated that the slow freeze group had a higher number of unmarked cells (p=0.012), indicating a harmful effect on the MVH expression in the ovarian tissue, where the cell structure is complex. CONCLUSION Although both protocols indicated similar results in the histological analysis of follicular counts, the vitrification protocol was significantly better to preserve ovarian stem cells, an immature germ cell population. These cells are able to self-renew having regeneration potential, and may be effective for the treatment of ovarian failure and consequently infertility.
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Affiliation(s)
- Paula Barros Terraciano
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Tuane Alves Garcez
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil
| | - Markus Berger
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Isabel Durli
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Cristiana Palma Kuhl
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Vitória de Oliveira Batista
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil
| | - Raquel de Almeida Schneider
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Jaquelline Festa
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil
| | - Emily Pilar
- Centro de Pesquisa Experimental, Unidade de Patologia Experimental, Hospital de Clínicas de Porto Alegre, Brasil
| | - Charles Ferreira
- Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Eduardo Pandolfi Passos
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil
| | - Elizabeth Cirne Lima
- Centro de Pesquisa Experimental, Laboratório de Embriologia e Diferenciação Celular, Hospital de Clínicas de Porto Alegre, Brasil.,Programa de Pós Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Brasil.,Departamento de Patologia Clínica, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul, Brasil
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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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22
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Lee S, Ryu KJ, Kim B, Kang D, Kim YY, Kim T. Comparison between Slow Freezing and Vitrification for Human Ovarian Tissue Cryopreservation and Xenotransplantation. Int J Mol Sci 2019; 20:ijms20133346. [PMID: 31288388 PMCID: PMC6651588 DOI: 10.3390/ijms20133346] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 11/16/2022] Open
Abstract
Two methods for the cryopreservation of human ovarian tissue were compared using a xenotransplantation model to establish a safe and effective cryopreservation method. Ovarian tissues were obtained from women who underwent benign ovarian surgery in the gynecology research unit of a university hospital. The tissues were transplanted into 112 ovariectomized female severe combined immunodeficient mice 4 weeks after slow freezing or vitrification cryopreservation. Tissues were retrieved 4 weeks later. Primordial follicular counts decreased after cryopreservation and xenotransplantation, and were significantly higher in the slow freezing group than in the vitrification group (p < 0.001). Immunohistochemistry and TUNEL assay showed that the Ki-67 and CD31 markers of follicular proliferation and angiogenesis were higher in the slow freezing group (p < 0.001 and p = 0.006, respectively) and DNA damage was greater in the vitrification group (p < 0.001). Western blotting showed that vitrification increased cellular apoptosis. Anti-Müllerian hormone expression was low in transplanted samples subjected to both cryopreservation techniques. Electron microscopy revealed primordial follicle deformation in the vitrification group. Slow freezing for ovarian tissue cryopreservation is superior to vitrification in terms of follicle survival and growth after xenotransplantation. These results will be useful for fertility preservation in female cancer patients.
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Affiliation(s)
- Sanghoon Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
| | - Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
| | - Boram Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
| | - Dahyeon Kang
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
| | - Yoon Young Kim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul 03080, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
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23
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Dolmans MM, Cordier F, Amorim CA, Donnez J, Vander Linden C. In vitro Activation Prior to Transplantation of Human Ovarian Tissue: Is It Truly Effective? Front Endocrinol (Lausanne) 2019; 10:520. [PMID: 31428051 PMCID: PMC6688053 DOI: 10.3389/fendo.2019.00520] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/15/2019] [Indexed: 01/12/2023] Open
Abstract
Research Question: What are the true benefits, if any, of disrupting the Hippo signaling pathway and stimulating the Akt pathway in xenotransplanted human ovarian tissue using an in vitro activation (IVA) approach? Design: Human ovarian tissue was retrieved from 18 young patients by laparoscopy and grafted to 54 severe combined immunodeficient mice. The experiment was conducted using fresh ovarian tissue (group I; n = 6 women), slow-frozen-thawed ovarian tissue (group II; n = 6 women), and vitrified-warmed ovarian tissue (group III; n = 6 women). Slow-freezing and vitrification procedures were performed according to Gosden's and Kawamura's protocols, respectively. The tissue (fresh, slow-frozen, and vitrified) was fragmented into small cubes (1 × 1 × 1 mm) to disrupt the Hippo signaling pathway and cultured or not in IVA medium for 48 h with Akt stimulators (PI3K stimulator and PTEN inhibitor), before being transplanted to the mice. All the grafts were maintained for 28 days. Results: (1) Follicular density: Follicular density decreased in all groups after transplantation, most significantly in the vitrification group. Culture with IVA had no impact. (2) Follicle activation: Addition of PI3K stimulator and PTEN inhibitor for 48 h prior to grafting did not significantly change the proportion of primordial follicles in any of the groups (fresh, slow-frozen, or vitrified tissue) compared to 48 h of control culture without these molecules. Particularly, vitrification and culture in IVA medium yielded no benefits in terms of growing follicle percentages or follicle proliferation rates. The large proportion of growing follicles in the vitrified tissue group after grafting may have been responsible for the higher rate of atresia. Conclusion: We were unable to demonstrate any significant benefits of cutting ovarian tissue into small cubes and applying IVA with Akt stimulators. The association of vitrification and transplantation was actually found to be the most deleterious combination with respect to the follicle reserve, and even worse when culture with Akt stimulators was performed.
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Affiliation(s)
- Marie-Madeleine Dolmans
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Department of Gynecology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
- *Correspondence: Marie-Madeleine Dolmans
| | - Florence Cordier
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- Department of Gynecology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Christiani A. Amorim
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Jacques Donnez
- Société de Recherche pour l'Infertilité, Brussels, Belgium
| | - Catherine Vander Linden
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
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24
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Gallardo M, Paulini F, Corral A, Balcerzyk M, Lucci CM, Ambroise J, Merola M, Fernandez-Maza L, Risco R, Dolmans MM, Amorim CA. Evaluation of a new freezing protocol containing 20% dimethyl sulphoxide concentration to cryopreserve human ovarian tissue. Reprod Biomed Online 2018; 37:653-665. [PMID: 30391164 DOI: 10.1016/j.rbmo.2018.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 11/17/2022]
Abstract
RESEARCH QUESTION Could a modification in the ovarian tissue freezing protocol improve follicle survival after cryopreservation and xenotransplantation? DESIGN Ovarian tissue was used from 13 adult patients, frozen either with our original protocol, or a modified version involving a higher concentration of dimethyl sulphoxide (DMSO), larger volume of cryopreservation solution and lower seeding temperature. After thawing, the ovarian fragments were xenotransplanted to six mice with severe combined immunodeficiency (SCID) for 3 weeks. RESULTS The proportion of primordial follicles decreased, and the proportion of growing follicles increased significantly (all P < 0.01) after cryopreservation and xenografting compared with fresh controls for both protocols. Follicle density, development, ultrastructure and function were similar between treatments. CONCLUSIONS This study showed that, although the higher DMSO concentration did not improve survival of preantral follicles, it did not seem to induce any major toxicity in the follicle population either.
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Affiliation(s)
- Miguel Gallardo
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte. B1.52.02, 1200, Brussels, Belgium; Ginemed Clínicas Sevilla, Calle Farmaceutico Murillo Herrera 3, Sevilla 41010, Spain
| | - Fernanda Paulini
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte. B1.52.02, 1200, Brussels, Belgium; Physiological Sciences Department, Institute of Biological Sciences, University of Brasília, Campus Universitário Darcy Ribeiro - Asa Norte, Brasília DF 70910, Brazil
| | - Ariadna Corral
- National Center for Accelerators, C/Thomas Alva Edison, 7, Seville 41092, Spain
| | - Marcin Balcerzyk
- National Center for Accelerators, C/Thomas Alva Edison, 7, Seville 41092, Spain
| | - Carolina M Lucci
- Physiological Sciences Department, Institute of Biological Sciences, University of Brasília, Campus Universitário Darcy Ribeiro - Asa Norte, Brasília DF 70910, Brazil
| | - Jérôme Ambroise
- Institut de Recherche Expérimentale et Clinique and Centre de Technologies Moléculaires Appliquées, Université Catholique de Louvain, Avenue Hippocrate 54, bte. B1.54.01, Brussels 1200, Belgium
| | - Marta Merola
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte. B1.52.02, 1200, Brussels, Belgium
| | | | - Rámon Risco
- National Center for Accelerators, C/Thomas Alva Edison, 7, Seville 41092, Spain; Engineering School of Seville, Camino de los Descubrimientos s/n, Seville 41092, Spain
| | - Marie-Madeleine Dolmans
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte. B1.52.02, 1200, Brussels, Belgium; Gynecology Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, Brussels 1200, Belgium
| | - Christiani A Amorim
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Mounier 52, bte. B1.52.02, 1200, Brussels, Belgium.
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25
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Leal ÉSS, Vieira LA, Sá NAR, Silva GM, Lunardi FO, Ferreira ACA, Campello CC, Alves BG, Cibin FWS, Smitz J, Figueiredo JR, Rodrigues APR. In vitro growth and development of isolated secondary follicles from vitrified caprine ovarian cortex. Reprod Fertil Dev 2018; 30:359-370. [PMID: 28768567 DOI: 10.1071/rd16487] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 06/17/2017] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to evaluate the viability, antrum formation and in vitro development of isolated secondary follicles from vitrified caprine ovarian cortex in a medium previously established for fresh isolated secondary follicles, in the absence (α-minimum essential medium (α-MEM+) alone) or presence of FSH and vascular endothelial growth factor (VEGF; α-MEM++FSH+VEGF). Ovarian fragments were distributed among five treatments (T1 to T5): fresh follicles were fixed immediately (T1), follicles from fresh tissue were cultured in vitro in α-MEM+ (T2) or α-MEM++FSH+VEGF (T3) and follicles from vitrified tissue were cultured in vitro in α-MEM+ (T4) or α-MEM++FSH+VEGF (T5). After 6 days of culture, treated follicles (T2, T3, T4 and T5) were evaluated for morphology, viability and follicular development (growth, antrum formation and proliferation of granulosa cells by Ki67 and argyrophilic nucleolar organiser region (AgNOR) staining). The levels of reactive oxygen species (ROS) in the culture media were also assessed. Overall, morphology of vitrified follicles was altered (P<0.05) compared with the fresh follicles. Follicular viability, antrum formation and ROS were similar between treatments (P>0.05). The average overall and daily follicular growth was highest (P<0.05) in T3. Granulosa cells in all treatments (T1, T2, T3, T4 and T5) stained positive for Ki67. However, fresh follicles from T3 had significantly higher AgNOR staining (P<0.05) compared with follicles of T1, T2, T4 and T5. In conclusion, secondary follicles can be isolated from vitrified and warmed ovarian cortex and survive and form an antrum when growing in an in vitro culture for 6 days.
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Affiliation(s)
- Érica S S Leal
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Luis A Vieira
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Naíza A R Sá
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Gerlane M Silva
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Franciele O Lunardi
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Anna C A Ferreira
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Cláudio C Campello
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Benner G Alves
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Francielli W S Cibin
- University Federal of Pampa, Uruguaiana-Rio Grande do Sul, Av. General Osório, 900 - São Jorge Bagé, RS - CE - 96400-100, Brazil
| | - Johan Smitz
- Follicle Biology Laboratory, Center for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - José R Figueiredo
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
| | - Ana P R Rodrigues
- Faculty of Veterinary Medicine, LAMOFOPA, PPGCV, State University of Ceará, Av. Dr Silas Munguba, 1700 - Campus of Itaperi, Fortaleza - CE - CEP 60741-903, Brazil
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26
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Guzel Y, Bildik G, Dilege E, Oktem O. Sphingosine-1-phosphate reduces atresia of primordial follicles occurring during slow-freezing and thawing of human ovarian cortical strips. Mol Reprod Dev 2018; 85:858-864. [PMID: 29995320 DOI: 10.1002/mrd.23043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/07/2018] [Indexed: 11/07/2022]
Abstract
We aimed in this study to explore if sphingosine-1-phosphate (S1P) reduces apoptosis of primordial follicles during cryopreservation of human ovarian cortical samples. Ovarian cortical tissue fragments obtained from young patients who underwent laparoscopic excision of benign ovarian cysts were used for the experiments. The samples were slow-frozen and thawed with and without S1P at 200 and 400 μM, cultured for 1 day, and then were fixed and processed for both histomorphological assessment and detection of apoptosis with immunohistochemistry using apoptosis marker cleaved caspase-3. Follicle counts were expressed as the mean number of follicles per mm2 . The mean number of primordial follicles and in vitro estradiol (E2) and anti-mullerian hormone (AMH) production of the slow-frozen and thawed samples were significantly reduced compared with fresh unfrozen samples. S1P treatment at 400 μM but not 200 μM concentration resulted in a significant increase in the number of surviving primordial follicles and in vitro E2 and AMH productions of the samples compared with their counterparts slow-frozen without S1P. We found that that there was a significant decrease in the number of primordial follicles with their oocytes stained positive for cleaved caspase-3 in the slow-frozen samples S1P 400 μM in comparison with the samples slow-frozen without S1P. These results suggest that S1P may ameliorate follicle atresia occurring in human ovarian cortical samples during cryopreservation.
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Affiliation(s)
- Yilmaz Guzel
- Department of Obstetrics and Gynecology, Istanbul Aydin University School of Medicine, Istanbul, Turkey
| | - Gamze Bildik
- Cellular and Molecular Medicine, Graduate School of Health Sciences, Koc University, Istanbul, Turkey
| | - Ece Dilege
- Department of Surgery, Koc University School of Medicine, Istanbul, Turkey
| | - Ozgur Oktem
- Cellular and Molecular Medicine, Graduate School of Health Sciences, Koc University, Istanbul, Turkey.,Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, School of Medicine, Koc University, Istanbul, Turkey
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27
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Dalman A, Deheshkar Gooneh Farahani NS, Totonchi M, Pirjani R, Ebrahimi B, Rezazadeh Valojerdi M. Slow freezing versus vitrification technique for human ovarian tissue cryopreservation: An evaluation of histological changes, WNT signaling pathway and apoptotic genes expression. Cryobiology 2017; 79:29-36. [PMID: 28987775 DOI: 10.1016/j.cryobiol.2017.09.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/28/2017] [Accepted: 09/30/2017] [Indexed: 12/20/2022]
Abstract
This study compared slow freezing and vitrification of ovarian tissue by evaluation of histological changes, WNT signaling pathway and apoptotic genes expression. Ovarian tissue was obtained from women aging 27-38 years old. Ovarian cortex from each patient was divided into three pieces and randomly grouped as slow freezing, vitrification and control groups for investigation of WNT signaling gene expression and β-CATENIN presence as well as histological studies. The stromal structure of all ovaries were preserved. The number of secondary follicles decreased in vitrified group (P < 0.05). WNT-3, β-CATENIN, FZD-2 and GSK-3β expressions were significantly higher in slow frozen and vitrified groups, compared to control group (P < 0.05). On the contrary, AXIN1 expression in slow frozen samples were significantly lower than that of the vitrified and control group. The expression of apoptotic genes, excluding CASP3, was significantly decreased in slow-frozen samples (P < 0.05). Conversely, BAX:BCL-2 percentage significantly increased in vitrification versus slow freezing and control(P < 0.05). Follicles in slow frozen samples displayed nuclear and cytoplasmic β-CATENIN staining, while control and vitrification groups only showed β-CATENIN protein in the cytoplasm. The presented data show that slow freezing results in a better preservation regardless of the type of follicle. Therefore, it is concluded that slow freezing is still an ideal method for ovary cryopreservation.
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Affiliation(s)
- Azam Dalman
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Mehdi Totonchi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Reihaneh Pirjani
- Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Ebrahimi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mojtaba Rezazadeh Valojerdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Anatomy, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
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28
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Shi Q, Xie Y, Wang Y, Li S. Vitrification versus slow freezing for human ovarian tissue cryopreservation: a systematic review and meta-anlaysis. Sci Rep 2017; 7:8538. [PMID: 28819292 PMCID: PMC5561141 DOI: 10.1038/s41598-017-09005-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/14/2017] [Indexed: 11/09/2022] Open
Abstract
Vitrification is a well-accepted procedure for cryopreservation of gametes and embryos. Less is known, however, about its performance in preserving ovarian tissue, for which slow freezing is the current convention. Increasing interest is being focused on vitrification, but there are as yet no standard protocols for its use with ovarian tissue. In part, this is because of the variety of cell types and complex nature of ovarian tissue. We performed a meta-analysis of 14 studies that compared vitrification with slow freezing for cryopreservation of ovarian tissue. In the pooled analysis, there was no significant difference between the two methods in terms of the proportion of intact primordial follicles, but vitrification was associated with significantly less DNA damage. Secondary endpoints included the number of stromal cells, significantly higher with vitrification, and primordial follicle density, which did not differ between the two methods. The present meta-analysis suggests that vitrification may be more effective than slow freezing, with less primordial follicular DNA strand breaks and better preservation of stromal cells. These advantages should lead to improved ovarian function after transplantation.
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Affiliation(s)
- Qingquan Shi
- Department of Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, 610000, China.,Key Laboratory of Birth Defects and Related Disease of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, 610000, China
| | - Yidong Xie
- Department of Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, 610000, China.,Key Laboratory of Birth Defects and Related Disease of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, 610000, China
| | - Yan Wang
- Department of Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, 610000, China.,Key Laboratory of Birth Defects and Related Disease of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, 610000, China
| | - Shangwei Li
- Department of Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, 610000, China. .,Key Laboratory of Birth Defects and Related Disease of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, 610000, China.
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Zhou XH, Zhang D, Shi J, Wu YJ. Comparison of vitrification and conventional slow freezing for cryopreservation of ovarian tissue with respect to the number of intact primordial follicles: A meta-analysis. Medicine (Baltimore) 2016; 95:e4095. [PMID: 27684791 PMCID: PMC5265884 DOI: 10.1097/md.0000000000004095] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Vitrification is the standard method for cryopreserving human oocytes and embryos, but its effects on ovarian tissue are uncertain. The purpose of this meta-analysis was to compare the proportion of intact primordial follicles in ovarian tissue cryopreserved with vitrification versus slow freezing. METHODS Medline, Cochrane, EMBASE, and Google Scholar databases were searched until November 11, 2014 using combinations of the search terms: ovarian tissue, cryopreservation, vitrification, follicle, follicles. Inclusion criteria were randomized controlled trails, two-arm prospective studies, and retrospective studies in which ovarian tissues were preserved by vitrification or conventional slow freezing. The primary outcome was the proportion of intact primordial follicles. RESULTS Six studies were included in the meta-analysis. The number of patients ranged from 3 to 20, and age ranged from 20 to 43 years. Total number of morphologically intact follicles ranged from 14 to 2058, among which 6 to 724 were primordial. The pooled odds ratio (OR) showed no significant difference in the proportion of intact primordial follicles after slow freezing or vitrification (OR = 1.228, 95% confidence interval [CI]: 0.769-1.961, P = 0.390). Sensitivity analysis using the leave-one-out approach indicated no considerable changes in the direction and magnitude of the pooled estimates when individual studies were excluded one at a time, indicating good reliability of the current analysis. CONCLUSIONS Vitrification and slow freezing produce equivalent results with respect to intact primordial follicles for the cryopreservation of human ovarian tissue. However, the included studies varied in the cryopreservation protocols used.
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Affiliation(s)
| | | | | | - Yi-Jun Wu
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
- Correspondence: Yi-Jun Wu, Department of General Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China (e-mail: )
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Fabbri R, Macciocca M, Vicenti R, Pasquinelli G, Caprara G, Valente S, Seracchioli R, Paradisi R. Long-term storage does not impact the quality of cryopreserved human ovarian tissue. J Ovarian Res 2016; 9:50. [PMID: 27557782 PMCID: PMC4995754 DOI: 10.1186/s13048-016-0261-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/16/2016] [Indexed: 11/13/2022] Open
Abstract
Background Ovarian tissue cryopreservation is an emerging technique, also addressed to very young cancer patients, for whom it is not possible to perform an ovarian stimulation for oocytes freezing, before gonadotoxic treatment. In this cases, ovarian tissue must be cryopreserved for a long period of time and it is very important to know if it maintains fertility function after a long period of storage. Here we aimed to assess the effect of long-term storage on preservation and viability of cryopreserved human ovarian tissue. Methods Descriptive study of three cases of cancer patients whose cryopreserved ovarian tissue remained stored for 18 years. Long-term stored tissue was examined by histological and immunohistochemical analysis, transmission electron microscopy, TUNEL assay and LIVE/DEAD viability/citotoxicity test. Results Ovarian tissue stored for 18 years showed a good morphology. Follicles presented negative staining for estrogen and progesterone receptors, positive staining for ki67 in granulosa cells and/or oocytes and for bcl2 in granulosa cells. Regarding stroma, patch/focal positive expression was found for estrogen receptor and ki67, diffusely positive expression for progesterone receptor and bcl2. After long-term storage, ultrastructural examination showed sub-cellular integrity of follicles and interstitial oedema foci. No apoptosis was observable by TUNEL assay. Stromal cell viability remained >97 % during the culture period. Conclusion The evaluation of different aspects of the tissue provides evidence that the storage time does not impact on tissue quality and gives hope especially to cancer girls, whose tissues could remain cryopreserved for a very long time.
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Affiliation(s)
- Raffaella Fabbri
- Gynecology and Physiopathology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital of Bologna, via Massarenti 13, 40138, Bologna, Italy
| | - Maria Macciocca
- Gynecology and Physiopathology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital of Bologna, via Massarenti 13, 40138, Bologna, Italy
| | - Rossella Vicenti
- Gynecology and Physiopathology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital of Bologna, via Massarenti 13, 40138, Bologna, Italy.
| | - Gianandrea Pasquinelli
- Surgical Pathology, Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Giacomo Caprara
- Histopathological and Molecular Diagnostic Unit of Solid Organ and Transplant, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Sabrina Valente
- Surgical Pathology, Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Physiopathology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital of Bologna, via Massarenti 13, 40138, Bologna, Italy
| | - Roberto Paradisi
- Gynecology and Physiopathology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital of Bologna, via Massarenti 13, 40138, Bologna, Italy
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31
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Fabbri R, Vicenti R, Macciocca M, Martino NA, Dell'Aquila ME, Pasquinelli G, Morselli-Labate AM, Seracchioli R, Paradisi R. Morphological, ultrastructural and functional imaging of frozen/thawed and vitrified/warmed human ovarian tissue retrieved from oncological patients. Hum Reprod 2016; 31:1838-49. [PMID: 27282911 DOI: 10.1093/humrep/dew134] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/18/2016] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION Which is the best method for human ovarian tissue cryopreservation: slow freezing/rapid thawing (SF/RT) or vitrification/warming (V/W)? SUMMARY ANSWER The conventional SF/RT protocol used in this study seems to better preserve the morpho-functional status of human cryopreserved ovarian tissue than the used open carrier V/W protocol. WHAT IS KNOWN ALREADY Cryopreservation of human ovarian tissue is generally performed using the SF/RT method. However, reduction in the follicular pool and stroma damage are often observed. An emerging alternative procedure is represented by V/W which seems to allow the maintenance of the morphological integrity of the stroma. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study including six patients affected by oncological diseases and enrolled from January to December 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS Ovarian tissue was laparoscopically harvested from the right and left ovaries and was cryopreserved using a routinary SF/RT protocol or a V/W method, involving tissue incubation in two solutions (containing propylene glycol, ethylene glycol and sucrose at different concentrations) and vitrification in an open system. For each patient, three pieces from each ovary were collected at the time of laparoscopy (fresh tissue) and after storage (SF/RT or V/W) and processed for light microscopy (LM) and transmission electron microscopy (TEM), to assess the morphological and ultrastructural features of follicles and stroma, and for laser scanning confocal microscopy (LSCM), to determine the functional energetic/redox stroma status. The preservation status of SF/RT and V/W ovarian tissues was compared with that of fresh ones, as well as between them. MAIN RESULTS AND THE ROLE OF CHANCE By LM and TEM, SF/RT and V/W samples showed cryodamage of small entity. Interstitial oedema and increased stromal cell vacuolization and chromatin clumping were observed in SF/RT samples; in contrast, V/W samples showed oocyte nuclei with slightly thickened chromatin and irregular shapes. The functional imaging analysis by LSCM revealed that the mitochondrial activity and intracellular reactive oxygen species levels were reduced both in SF/RT and in V/W samples compared with fresh samples. The study also showed progressive dysfunction of the mitochondrial activity going from the outer to the inner serial section of the ovarian cortex. The reduction of mitochondrial activity of V/W samples compared with fresh samples was significantly higher in the inner section than in the outer section. LIMITATIONS, REASONS FOR CAUTION The results report the bioenergetic and oxidative status assessment of fresh and cryopreserved human ovarian tissue by LSCM, a technique recently applied to tissue samples. The use of LSCM on human ovarian tissues after SF/RT or V/W is a new application that requires validation. The procedures for mitochondrial staining with functional probes and fixing are not yet standardized. Xenografting of the cryopreserved ovarian tissue in severe combined immunodeficient mice and in vitro culture have not yet been performed. WIDER IMPLICATIONS OF THE FINDINGS The identification of a cryopreservation method able to maintain the morpho-functional integrity of the ovarian tissue and a number of follicles comparable with those observed in fresh tissue might optimize results in clinical practice, in terms of recovery, duration of ovarian function and increased delivery outcomes after replanting. The SF/RT protocol allowed better morpho-functional tissue integrity than the V/W procedure. STUDY FUNDING/COMPETING INTERESTS Funding was provided by Fondazione del Monte di Bologna e Ravenna, Italy. Dr N.A.M. was granted by the project ONEV MIUR PONa3 00134-n.254/R&C 18 5 2011 and the project GR-2011-02351396 (Ministry of Health, Young Researchers Grant 2011/2012). There are no competing interests. TRIAL REGISTRATION NUMBER Clinical trial 74/2001/0 (approved:13 2 2002): 'Pilot study on cryopreservation of human ovarian tissue: morphological and immunohistochemical analysis before and after cryopreservation'.
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Affiliation(s)
- R Fabbri
- Gynecology and Pathophysiology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - R Vicenti
- Gynecology and Pathophysiology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - M Macciocca
- Gynecology and Pathophysiology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - N A Martino
- Department of Biosciences, Biotechnologies and Biopharmaceutics (DBBB), University of Bari Aldo Moro, Str. Prov. Casamassima Km 3, 70010 Valenzano, Bari, Italy Experimental Zooprophylactic Institute of Puglia and Basilicata, Via Manfredonia 20, 71121 Foggia, Italy
| | - M E Dell'Aquila
- Department of Biosciences, Biotechnologies and Biopharmaceutics (DBBB), University of Bari Aldo Moro, Str. Prov. Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - G Pasquinelli
- Surgical Pathology, Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - A M Morselli-Labate
- Gynecology and Pathophysiology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - R Seracchioli
- Gynecology and Pathophysiology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - R Paradisi
- Gynecology and Pathophysiology of Human Reproductive Unit, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
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Talevi R, Barbato V, Fiorentino I, Braun S, De Stefano C, Ferraro R, Sudhakaran S, Gualtieri R. Successful slush nitrogen vitrification of human ovarian tissue. Fertil Steril 2016; 105:1523-1531.e1. [PMID: 26902858 DOI: 10.1016/j.fertnstert.2016.01.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/26/2016] [Accepted: 01/29/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To study whether slush nitrogen vitrification improves the preservation of human ovarian tissue. DESIGN Control vs. treatment study. SETTING University research laboratory. PATIENT(S) Ovarian biopsies collected from nine women (aged 14-35 years) during laparoscopic surgery for benign gynecologic conditions. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Ovarian cortical strips of 2 × 5 × 1 mm were vitrified with liquid or slush nitrogen. Fresh and vitrified cortical strips were analyzed for cryodamage and viability under light, confocal, and transmission electron microscopy. RESULT(S) Compared with liquid nitrogen, vitrification with slush nitrogen preserves [1] follicle quality (grade 1 follicles: fresh control, 50%; liquid nitrogen, 27%; slush nitrogen, 48%); [2] granulosa cell ultrastructure (intact cells: fresh control, 92%; liquid nitrogen, 45%; slush nitrogen, 73%), stromal cell ultrastructure (intact cells: fresh control, 59.8%; liquid nitrogen, 24%; slush nitrogen, 48.7%), and DNA integrity (TUNEL-positive cells: fresh control, 0.5%; liquid nitrogen, 2.3%; slush nitrogen, 0.4%); and [3] oocyte, granulosa, and stromal cell viability (oocyte: fresh control, 90%; liquid nitrogen, 63%; slush nitrogen, 87%; granulosa cells: fresh control, 93%; liquid nitrogen, 53%; slush nitrogen, 81%; stromal cells: fresh control, 63%; liquid nitrogen, 30%; slush nitrogen, 52%). CONCLUSION(S) The histology, ultrastructure, and viability of follicles and stromal cells are better preserved after vitrification with slush nitrogen compared with liquid nitrogen.
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Affiliation(s)
- Riccardo Talevi
- Dipartimento di Biologia, Università di Napoli "Federico II", Complesso Universitario di Monte S Angelo, Napoli, Italy.
| | - Vincenza Barbato
- Dipartimento di Biologia, Università di Napoli "Federico II", Complesso Universitario di Monte S Angelo, Napoli, Italy
| | - Ilaria Fiorentino
- Dipartimento di Biologia, Università di Napoli "Federico II", Complesso Universitario di Monte S Angelo, Napoli, Italy
| | - Sabrina Braun
- Dipartimento di Biologia, Università di Napoli "Federico II", Complesso Universitario di Monte S Angelo, Napoli, Italy
| | - Cristofaro De Stefano
- Unità di Fisiopatologia della Riproduzione e Sterilità di Coppia, Azienda Ospedaliera San Giuseppe Moscati, Avellino, Italy
| | - Raffaele Ferraro
- Iatropolis, Genesis Day Surgery Sterilità della Coppia, Caserta, Italy
| | - Sam Sudhakaran
- Dipartimento di Biologia, Università di Napoli "Federico II", Complesso Universitario di Monte S Angelo, Napoli, Italy
| | - Roberto Gualtieri
- Dipartimento di Biologia, Università di Napoli "Federico II", Complesso Universitario di Monte S Angelo, Napoli, Italy
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Wang TR, Yan J, Lu CL, Xia X, Yin TL, Zhi X, Zhu XH, Ding T, Hu WH, Guo HY, Li R, Yan LY, Qiao J. Human single follicle growth in vitro from cryopreserved ovarian tissue after slow freezing or vitrification. Hum Reprod 2016; 31:763-73. [PMID: 26851603 DOI: 10.1093/humrep/dew005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 01/08/2016] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION What is the effect of human ovarian tissue cryopreservation on single follicular development in vitro? SUMMARY ANSWER Vitrification had a greater negative effect on growth and gene expression of human ovarian follicles when compared with fresh follicles. WHAT IS KNOWN ALREADY For human ovarian cortex cryopreservation, the conventional option is slow freezing while more recently vitrification has been demonstrated to maintain good quality and function of ovarian tissues. STUDY DESIGN, SIZE, DURATION Ovarian tissues were collected from 11 patients. For every patient, the ovarian cortex was divided into three samples: Fresh, slow-rate freezing (Slow) and vitrification (Vit). Tissue histology was performed and follicles were isolated for single-cell mRNA analysis and in vitro culture (IVC) in 1% alginate for 8 days. PARTICIPANTS/MATERIALS, SETTING, METHODS Follicle morphology was assessed with hematoxylin-eosin analysis. Follicles were individually embedded in alginate (1% w/v) and cultured in vitro for 8 days. Follicle survival and growth were assessed by microscopy. Follicle viability was observed after Calcein-AM and ethidium homodimer-I (Ca-AM/EthD-I) staining. Expression of genes, including GDF9 (growth differentiation factor 9), BMP15 (bone morphogenetic protein 15) and ZP3 (zona pellucida glycoprotein 3) in oocytes and AMH (anti-Mullerian hormone), FSHR (FSH receptor), CYP11A (cholesterol side-chain cleavage cytochrome P450) and STAR (steroidogenic acute regulatory protein) in GCs, was evaluated by single-cell mRNA analysis. MAIN RESULTS AND THE ROLE OF CHANCE A total of 129 follicles were separated from ovarian cortex (Fresh n = 44; Slow n = 40; Vit n = 45). The percentage of damaged oocytes and granulosa cells was significantly higher in both the Slow and Vit groups, as compared with Fresh control (P< 0.05). The growth of follicles in vitro was significantly delayed in the Vit group compared with the Fresh group (P< 0.05). Both slow freezing (P< 0.05) and vitrification (P< 0.05) down-regulated the mRNA levels of ZP3 and CYP11A compared with Fresh group, while there was no significant difference between the Slow and Vit groups (P> 0.05). Vitrification also down-regulates AMH mRNA levels compared with Fresh group (P< 0.05). LIMITATIONS, REASONS FOR CAUTION Only short-term IVC studies (8 days) are reported. Further study should be performed to examine and improve follicular development in a long-term culture system after cryopreservation. WIDER IMPLICATIONS OF THE FINDINGS This is the first comparison of gene expression and growth of single human ovarian follicles in vitro after either slow freezing or vitrification. With the decreased gene expression and growth during IVC, damage by cryopreservation still exists and needs to be minimized during the long-term IVC of follicles in the future for eventual clinical application. STUDY FUNDING/COMPETING INTERESTS This work was supported by the National Natural Science Foundation of China (31230047, 81571386, 81471508, 31429004 and 81501247), National Natural Science Foundation of Beijing (7142166) and Mega-projects of Science Research for the 12th five-year plan (2012ba132b05). There are no conflicts of interest to declare.
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Affiliation(s)
- Tian-ren Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 100004, China
| | - Jie Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China
| | - Cui-ling Lu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
| | - Xi Xia
- Center for Reproductive Medicine, Peking University Shenzhen Hospital, FuTian District, Shenzhen, Guangdong 518000, China
| | - Tai-lang Yin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
| | - Xu Zhi
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China
| | - Xiao-hui Zhu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
| | - Ting Ding
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
| | - Wei-hong Hu
- Department of Obstetrics and Gynecology, General Hospital of Chinese People's Armed Police Forces, Beijing 100191, China
| | - Hong-yan Guo
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China
| | - Li-ying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North HuaYuan Road, HaiDian District, Beijing 100191, China Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing 100191, China Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing 100191, China
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Mouttham L, Fortune JE, Comizzoli P. Damage to fetal bovine ovarian tissue caused by cryoprotectant exposure and vitrification is mitigated during tissue culture. J Assist Reprod Genet 2015; 32:1239-50. [PMID: 26249553 PMCID: PMC4554372 DOI: 10.1007/s10815-015-0543-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/14/2015] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The objective of this study is to characterize the impact of exposure to cryoprotectants followed by vitrification on primordial follicle survival and activation using a fetal bovine model. METHODS In the first study, fetal bovine cortical pieces were exposed to cryoprotectants with or without sucrose and cultured up to 7 days in the presence or absence of insulin. In the second study, cortical pieces were exposed to cryoprotectants with or without sucrose, vitrified, and cultured up to 7 days after warming in the presence or absence of insulin. Viability and morphology of follicles, as well as proliferation and/or DNA repair in ovarian tissue were analyzed. RESULTS When compared to non-exposed controls, normal follicular morphology was affected in groups exposed to cryoprotectants only immediately post-exposure and after 1 day of culture, but improved by day 3 and did not significantly differ by day 7. Similarly, normal follicular morphology was compromised in vitrified groups after warming and on day 1 compared to controls, but improved by days 3 and 7. Proliferation and/or DNA repair in ovarian tissue was not affected by vitrification in this model. Cryoprotectant exposure and vitrification of ovarian tissue did not impair the activation of primordial follicles in response to insulin, although activation was delayed relative to non-exposed controls. Interestingly, sucrose had no noticeable protective effect. CONCLUSION Vitrified fetal bovine ovarian tissue has the intrinsic capacity to mitigate the immediate damage to primordial follicles' morphology and retains the capacity to activate. These findings provide a basis for a successful cryopreservation protocol for ovarian cortical tissue in other species including humans.
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Affiliation(s)
- Lara Mouttham
- />Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC 20008 USA
- />Department of Biomedical Sciences, Cornell University, Ithaca, NY USA
| | - Joanne E. Fortune
- />Department of Biomedical Sciences, Cornell University, Ithaca, NY USA
| | - Pierre Comizzoli
- />Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC 20008 USA
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Sanfilippo S, Canis M, Smitz J, Sion B, Darcha C, Janny L, Brugnon F. Vitrification of human ovarian tissue: a practical and relevant alternative to slow freezing. Reprod Biol Endocrinol 2015; 13:67. [PMID: 26109179 PMCID: PMC4480989 DOI: 10.1186/s12958-015-0065-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 06/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cryopreservation of ovarian tissue can be used to preserve the fertility of patients who are about to receive treatment(s) that could compromise their future ovarian function. Here we evaluate the effectiveness of a vitrification protocol by carrying out a systematic comparison with a conventional slow-freezing method on human ovarian tissue. METHODS Human ovarian samples (mean age 28.0 ± 1.1 years) were processed in parallel for each cryopreservation procedure: vitrification and slow-freezing. Following warming/thawing, histological observations and a TUNEL assay in ovarian follicles were performed and compared to unfrozen control. RESULTS Both cryopreservation protocols gave comparable histological outcomes. Percentage of intact follicles was 83.6 % following vitrification in a 1.5 M 1,2-propanediol (PrOH), 1.5 M ethylene glycol (EG) and 0.5 M raffinose solution, 80.7 % after slow-freezing in 1.5 M PrOH and 0.025 M raffinose, and 99.6 % in fresh tissue. Follicle density was unchanged by vitrification (0.6 follicles/mm2) or slow-freezing (0.5 follicles/mm2) compared to fresh tissue (0.7 follicles/mm2). Percentage of follicles with DNA fragmentation was not statistically different in vitrified (20.8 %) or slow-frozen (31.3 %) tissues compared to the unfrozen control (35.0 %). There was no difference in proportion of stroma cells with DNA fragmentation in vitrified (6.4 %) and slow-frozen (3.7 %) tissues compared to unfrozen tissue (4.2 %). CONCLUSIONS This vitrification protocol enables good preservation of ovarian quality post-warming. The evaluation of endocrine function after vitrification need to be perform in a higher cohort to evaluate if this protocol may offer a relevant alternative to conventional slow-freezing for the cryopreservation of human ovarian tissue.
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Affiliation(s)
- Sandra Sanfilippo
- Centre international de chirurgie endoscopique, Clermont-Ferrand, France.
- CHU Clermont-Ferrand, CHU Estaing, Pôle gynécologie obstétrique et reproduction humaine - Assistance médicale à la procréation - CECOS, Clermont-Ferrand, France.
| | - Michel Canis
- Centre international de chirurgie endoscopique, Clermont-Ferrand, France.
- CHU Clermont-Ferrand, CHU Estaing, Pôle gynécologie obstétrique et reproduction humaine - Assistance médicale à la procréation - CECOS, Clermont-Ferrand, France.
| | - Johan Smitz
- Follicle biology laboratory, Vrije Universiteit Brussel, B - 1090, Jette, Belgium.
| | - Benoît Sion
- Laboratoire de physiologie, Université Clermont 1, UFR Pharmacie, Inserm U1107 NEURO-DOL, Clermont-Ferrand, France.
| | - Claude Darcha
- CHU Clermont-Ferrand, CHU Gabriel Montpied, Anatomie et cytologie pathologiques, Centre de biologie, Clermont-Ferrand, France.
| | - Laurent Janny
- CHU Clermont-Ferrand, CHU Estaing, Pôle gynécologie obstétrique et reproduction humaine - Assistance médicale à la procréation - CECOS, Clermont-Ferrand, France.
- Faculté de médecine, CNRS-UMR 6293/INSERM U1103, Laboratoire de génétique, reproduction et développement, Université d'Auvergne, Clermont-Ferrand, France.
| | - Florence Brugnon
- CHU Clermont-Ferrand, CHU Estaing, Pôle gynécologie obstétrique et reproduction humaine - Assistance médicale à la procréation - CECOS, Clermont-Ferrand, France.
- Faculté de médecine, CNRS-UMR 6293/INSERM U1103, Laboratoire de génétique, reproduction et développement, Université d'Auvergne, Clermont-Ferrand, France.
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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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Lunardi FO, Chaves RN, de Lima LF, Araújo VR, Brito IR, Souza CEA, Donato MAM, Peixoto CA, Dinnyes A, Campello CC, de Figueiredo JR, Rodrigues APR. Vitrified sheep isolated secondary follicles are able to grow and form antrum after a short period of in vitro culture. Cell Tissue Res 2015; 362:241-51. [DOI: 10.1007/s00441-015-2181-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/25/2015] [Indexed: 11/24/2022]
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Effects of varying tissue sizes on the efficiency of baboon ovarian tissue vitrification. Cryobiology 2014; 69:79-83. [DOI: 10.1016/j.cryobiol.2014.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/13/2014] [Accepted: 05/13/2014] [Indexed: 01/15/2023]
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Mathias FJ, D'Souza F, Uppangala S, Salian SR, Kalthur G, Adiga SK. Ovarian tissue vitrification is more efficient than slow freezing in protecting oocyte and granulosa cell DNA integrity. Syst Biol Reprod Med 2014; 60:317-22. [PMID: 24896655 DOI: 10.3109/19396368.2014.923542] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Ovarian tissue cryopreservation is the primary treatment modality currently available to women at risk of losing their ovarian function due to cytotoxic therapy. However, the impact of these techniques on the oocyte DNA integrity is not elucidated. Here we have investigated the effect of vitrification and conventional slow freezing of eight week old Swiss albino mouse ovarian tissues on the oocyte and granulosa cell DNA integrity using the comet assay. The intracellular levels of reactive oxygen species in oocytes was measured by 2',7'-dichlorodihydrofluorescein diacetate fluorescence. The cryopreservation of ovarian tissue by the slow freezing technique resulted in a significantly higher level of DNA fragmentation in oocytes in comparison to vitrification (p < 0.05) whereas DNA fragmentation in granulosa cells was significantly higher than the control (p < 0.01). Further, reactive oxygen species were significantly elevated in oocytes derived from slow freezing when compared to vitrification (p < 0.05). Therefore, we conclude that the ovarian tissue slow freeze-thawing makes the oocyte and granulosa cells more vulnerable to DNA damage whereas vitrification appears to be a safer method than slow freezing for ovarian tissue cryopreservation.
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Affiliation(s)
- Freya Jothsna Mathias
- Division of Clinical Embryology, Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University , Manipal , India
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Good preservation of stromal cells and no apoptosis in human ovarian tissue after vitrification. BIOMED RESEARCH INTERNATIONAL 2014; 2014:673537. [PMID: 24804230 PMCID: PMC3996294 DOI: 10.1155/2014/673537] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/14/2014] [Indexed: 11/25/2022]
Abstract
The aim of this study was to develop a vitrification procedure for human ovarian tissue cryopreservation in order to better preserve the ovarian tissue. Large size samples of ovarian tissue retrieved from 15 female-to-male transgender subjects (18–38 years) were vitrified using two solutions (containing propylene glycol, ethylene glycol, and sucrose at different concentrations) in an open system. Light microscopy, transmission electron microscopy, and TUNEL assay were applied to evaluate the efficiency of the vitrification protocol. After vitrification/warming, light microscopy showed oocyte nucleus with slightly thickened chromatin and irregular shape, while granulosa and stromal cells appeared well preserved. Transmission electron microscopy showed oocytes with slightly irregular nuclear shape and finely dispersed chromatin. Clear vacuoles and alterations in cellular organelles were seen in the oocyte cytoplasm. Stromal cells had a moderately dispersed chromatin and homogeneous cytoplasm with slight vacuolization. TUNEL assay revealed the lack of apoptosis induction by vitrification in all ovarian cell types. In conclusion after vitrification/warming the stromal compartment maintained morphological and ultrastructural features similar to fresh tissue, while the oocyte cytoplasm was slightly damaged. Although these data are encouraging, further studies are necessary and essential to optimize vitrification procedure.
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Herraiz S, Novella-Maestre E, Rodríguez B, Díaz C, Sánchez-Serrano M, Mirabet V, Pellicer A. Improving ovarian tissue cryopreservation for oncologic patients: slow freezing versus vitrification, effect of different procedures and devices. Fertil Steril 2014; 101:775-84. [DOI: 10.1016/j.fertnstert.2013.11.016] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/22/2013] [Accepted: 11/12/2013] [Indexed: 11/24/2022]
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Chung K, Donnez J, Ginsburg E, Meirow D. Emergency IVF versus ovarian tissue cryopreservation: decision making in fertility preservation for female cancer patients. Fertil Steril 2013; 99:1534-42. [PMID: 23517859 DOI: 10.1016/j.fertnstert.2012.11.057] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/24/2012] [Accepted: 11/27/2012] [Indexed: 11/25/2022]
Abstract
Hundreds of thousands of women in their reproductive years are diagnosed with cancer each year. As the number of female patients who survive cancer increases, the demand for effective and individualized fertility preservation options grows. Currently there are limited clinical options for fertility preservation, and the paucity of publications describing clinical experience and outcomes data has limited accessibility to these options. Decision making for patients diagnosed with cancer requires up-to-date knowledge of the efficacy and safety of available techniques. This article describes a step-by-step approach to evaluation of the cancer patient and presents an accumulation of clinical experience with challenges unique to patients with breast cancer and leukemia. Current data on reproductive outcomes of fertility preservation techniques are examined, demonstrating increasing evidence that these techniques are becoming effective enough to offer routinely to patients facing gonadotoxic cancer therapies, including those still considered to be "experimental."
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Affiliation(s)
- Karine Chung
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Bellew EA, Green DL, Law EW, Rizzuto PJ, McGaughey RW, Gallicano GI. Ovaries on Ice: Freezing Fertility in Preadolescent Female Cancer Patients. Biopreserv Biobank 2012; 10:485-92. [DOI: 10.1089/bio.2012.0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elizabeth A. Bellew
- Georgetown University School of Medicine, Washington, District of Columbia
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, District of Columbia
| | - Deanna L. Green
- Georgetown University School of Medicine, Washington, District of Columbia
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, District of Columbia
| | - Emily W. Law
- Georgetown University School of Medicine, Washington, District of Columbia
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, District of Columbia
| | - Patrick J. Rizzuto
- Georgetown University School of Medicine, Washington, District of Columbia
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, District of Columbia
| | | | - G. Ian Gallicano
- Georgetown University School of Medicine, Washington, District of Columbia
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, District of Columbia
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Santana LN, Van den Hurk R, Oskam IC, Brito AB, Brito DC, Domingues SF, Santos RR. Vitrification of Ovarian Tissue from Primates and Domestic Ruminants: An Overview. Biopreserv Biobank 2012; 10:288-94. [DOI: 10.1089/bio.2011.0048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luana N. Santana
- Laboratory of Wild Animal Biology and Medicine, Universidade Federal do Pará, Brazil
- Animal Science Post-graduation Program, Universidade Federal do Pará, Brazil
| | - Rob Van den Hurk
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | | | - Adriel B. Brito
- Laboratory of Wild Animal Biology and Medicine, Universidade Federal do Pará, Brazil
- Animal Science Post-graduation Program, Universidade Federal do Pará, Brazil
| | - Danielle C. Brito
- Laboratory of Wild Animal Biology and Medicine, Universidade Federal do Pará, Brazil
- Animal Science Post-graduation Program, Universidade Federal do Pará, Brazil
| | - Sheyla F.S. Domingues
- Laboratory of Wild Animal Biology and Medicine, Universidade Federal do Pará, Brazil
- Animal Science Post-graduation Program, Universidade Federal do Pará, Brazil
| | - Regiane R. Santos
- Laboratory of Wild Animal Biology and Medicine, Universidade Federal do Pará, Brazil
- Animal Science Post-graduation Program, Universidade Federal do Pará, Brazil
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Milenkovic M, Diaz-Garcia C, Wallin A, Brännström M. Viability and function of the cryopreserved whole rat ovary: comparison between slow-freezing and vitrification. Fertil Steril 2012; 97:1176-82. [PMID: 22341373 DOI: 10.1016/j.fertnstert.2012.01.123] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 01/06/2012] [Accepted: 01/25/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate four different protocols for cryopreservation of the whole rat ovary with intact vasculature to evaluate whether differences exist in post-thawing viability of the ovary after either vitrification or slow freezing. DESIGN Experimental study. SETTING Obstetrics and gynecology department. ANIMAL(S) Immature Sprague-Dawley female rats. INTERVENTION(S) Ovaries were isolated with the vascular tree intact up to the bifurcation of the abdominal aorta and were subsequently cannulated. The ovaries were flushed with increasing concentrations of the cryoprotectant dimethyl sulfoxide (DMSO) to either 1.5 or 7 M. The ovaries underwent cryopreservation by vitrification or passive slow freezing. MAIN OUTCOME MEASURE(S) After thawing, the ovaries were subjected to neutral red viability staining to assess the density of viable small follicles and for long-term (48 hours) incubation evaluation of steroid secretion, histology, and apoptosis assay. RESULT(S) The follicular viability was decreased in both vitrification groups and in the slow-freezing group with the high concentration of DMSO, as compared with fresh controls. Estradiol levels in the incubation medium followed the same pattern. Light microscopy revealed well-preserved morphology in all groups after 48 hours' incubation. Apoptosis was increased in both vitrified and cryopreserved ovaries. CONCLUSION(S) We have developed a new method that can be used in basic studies to improve cryopreservation protocols. Our initial findings suggest that a moderate concentration of the cryoprotectant DMSO is superior to a high DMSO concentration for both vitrification and slow freezing.
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Affiliation(s)
- Milan Milenkovic
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Demeestere I, Moffa F, Peccatori F, Poirot C, Shalom-Paz E. Multiple approaches for individualized fertility protective therapy in cancer patients. Obstet Gynecol Int 2011; 2012:961232. [PMID: 22253632 PMCID: PMC3255296 DOI: 10.1155/2012/961232] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/18/2011] [Indexed: 12/21/2022] Open
Abstract
In the last decade, fertility preservation has risen as a major field of interest, creating new interactions between oncologists and gynecologists. Various options, such as cryopreservation of ovarian tissue, have been developed and are currently routinely proposed in many centers. However, many of the options remain experimental and should be offered to patients only after adequate counseling. This paper addresses the efficiency and the potential of the different fertility preservation approaches.
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Affiliation(s)
- I. Demeestere
- Fertility Clinic, Universite Libre de Bruxelles (ULB), Hôpital Erasme, 1070 Brussels, Belgium
- Fertility Clinic, Universite Libre de Bruxelles (ULB), Campus Erasme, 1070 Brussels, Belgium
| | - F. Moffa
- Fertility Clinic, Universite Libre de Bruxelles (ULB), Hôpital Erasme, 1070 Brussels, Belgium
- Instituto Marquès, 08034 Barcelona, Spain
| | - F. Peccatori
- Department of Medicine, Division of Hematology Oncology, European Institute of Oncology, 20141 Milan, Italy
| | - C. Poirot
- UF de Biologie de la Reproduction, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris, France
| | - E. Shalom-Paz
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada H3A 2T5
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