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Li Y, Ruan X, Gu M, Du J, Jin F, Cheng J, Li Y, Jiang L, Wang Z, Yang Y, Zhang M, Mueck AO. Evaluating the safety and efficacy of cryopreserved ovarian tissue transplantation in leukemia patients with different bone marrow remission status using xenotransplantation. Front Endocrinol (Lausanne) 2024; 15:1364316. [PMID: 38590823 PMCID: PMC10999602 DOI: 10.3389/fendo.2024.1364316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Background Leukemia patients undergoing cryopreserved ovarian tissue transplantation (OTT) may carry a high risk of disease induction. Measurable residual disease (MRD) in bone marrow is linked to an elevated risk of relapse. It is controversial whether leukemia patients must be allowed to achieve measurable residual disease negative (MRD-negative) status instead of measurable residual disease positive (MRD-positive) status before ovarian tissue cryopreservation (OTC). Objective To explore the safety and efficacy of OTT in acute leukemia patients with different MRD status by using xenotransplantation. Method Cryopreserved ovarian tissue from 19 leukemia patients was thawed and xenotransplanted to ovariectomized BALB/C nude mice (n=36). The mice were divided into 2 groups based on the patient's MRD status before OTC: MRD-negative group (n=18) and MRD-positive group (n=18), additionally, a control group consisted of ovariectomized mice (n=9). Body weight was measured weekly and mortality, emaciation, and other abnormalities were recorded. Twenty-six weeks post-surgery, livers, spleens, uteruses, and ovarian grafts were removed for macroscopic and histological examinations to evaluate the efficacy of xenotransplantation and assess malignant cell contamination in mice. Results Follicle growth was visible in the ovarian grafts of the MRD-negative and MRD-positive groups. Compared with the ovariectomized group, a significant decrease in body weight (p<0.01) was noted, the uterine volume was notably larger, estradiol (E2) levels were significantly higher (p<0.01), and follicle-stimulating hormone (FSH) levels were significantly lower (p<0.001) in the other two groups. Mice in the MRD-positive group showed a significantly higher incidence of death (p<0.001) and emaciation (p<0.01), compared to the MRD-negative group. Histological observation revealed the presence of malignant cells in the grafts, livers, and spleens of 3 mice in the MRD-positive group. No abnormalities were observed in the mice from the MRD-negative group in both macroscopic and histological observations except one mouse was sacrificed for ascites unrelated to leukemia relapse. Conclusion For leukemia patients having ovarian tissue preserved in the first and only centralized human ovarian tissue cryobank in China, immunodeficient mice xenotransplantation can be a method to evaluate the safety and efficacy of OTT; the risk of malignant cell reimplantation due to OTT is higher in leukemia patients with MRD-positive status than those with MRD-negative status before OTC.
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Affiliation(s)
- Yanqiu Li
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women’s Health, University Women’s Hospital and Research Center for Women’s Health, University of Tuebingen, Tuebingen, Germany
| | - Muqing Gu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Fengyu Jin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yanglu Li
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lingling Jiang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zecheng Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yu Yang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Mingzhen Zhang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O. Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women’s Health, University Women’s Hospital and Research Center for Women’s Health, University of Tuebingen, Tuebingen, Germany
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Wu Q, Ru G, Xiao W, Wang Q, Li Z. Adverse effects of ovarian cryopreservation and auto-transplantation on ovarian grafts and quality of produced oocytes in a mouse model. Clin Sci (Lond) 2023; 137:1577-1591. [PMID: 37782233 PMCID: PMC10600147 DOI: 10.1042/cs20230483] [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: 05/16/2023] [Revised: 07/24/2023] [Accepted: 10/02/2023] [Indexed: 10/03/2023]
Abstract
The process of ovarian cryopreservation and transplantation is the only feasible fertility preservation method for prepubertal girls and female patients with cancer who cannot delay radiotherapy and chemotherapy. However, basic research on this technique is lacking. To better understand ovarian function and oocyte quality after ovarian tissue (OT) transplantation, we characterised the appearance, angiogenesis, and endocrine function of ovarian grafts in a murine model; the mitochondrial function and DNA damage in oocytes isolated from the OT; and the development of embryos after in vitro fertilisation. The results showed a decrease in oocyte numbers in the transplanted OT, abnormal endocrine function of ovarian grafts, as well as dysfunctional mitochondria and DNA damage in the oocytes, which could adversely affect subsequent embryonic development. However, these adverse phenotypes were partially or completely resolved within 21 days of transplantation, suggesting that ovulation induction and assisted pregnancy treatment should not be conducted too soon after OT transfer to ensure optimal patient and offspring outcomes.
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Affiliation(s)
- Que Wu
- Reproductive Center, First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou City, 515041, Guangdong, China
| | - Gaizhen Ru
- Reproductive Center, First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou City, 515041, Guangdong, China
| | - Wanfen Xiao
- Reproductive Center, First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou City, 515041, Guangdong, China
| | - Qian Wang
- Reproductive Center, First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou City, 515041, Guangdong, China
| | - Zhiling Li
- Reproductive Center, First Affiliated Hospital of Shantou University Medical College, Shantou University, Shantou City, 515041, Guangdong, China
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Eijkenboom L, Saedt E, Zietse C, Braat D, Beerendonk C, Peek R. Strategies to safely use cryopreserved ovarian tissue to restore fertility after cancer: A systematic review. Reprod Biomed Online 2022; 45:763-778. [DOI: 10.1016/j.rbmo.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
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Eijkenboom L, Mulder C, van der Reijden B, van Mello N, van Leersum J, Koorenhof-Scheele T, Braat D, Beerendonk C, Peek R. Purging human ovarian cortex of contaminating leukaemic cells by targeting the mitotic catastrophe signalling pathway. J Assist Reprod Genet 2021; 38:1571-1588. [PMID: 33725274 PMCID: PMC8266964 DOI: 10.1007/s10815-021-02081-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/19/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Is it possible to eliminate metastasised chronic myeloid leukaemia (CML) and acute myeloid leukaemia (AML) cells from ovarian cortex fragments by inhibition of Aurora B/C kinases (AURKB/C) without compromising ovarian tissue or follicles? METHODS Human ovarian cortex tissue with experimentally induced tumour foci of CML, AML and primary cells of AML patients were exposed to a 24h treatment with 1 μM GSK1070916, an AURKB/C inhibitor, to eliminate malignant cells by invoking mitotic catastrophe. After treatment, the inhibitor was removed, followed by an additional culture period of 6 days to allow any remaining tumour cells to form new foci. Ovarian tissue integrity after treatment was analysed by four different assays. Appropriate controls were included in all experiments. RESULTS Foci of metastasised CML and AML cells in ovarian cortex tissue were severely affected by a 24h ex vivo treatment with an AURKB/C inhibitor, leading to the formation of multi-nuclear syncytia and large-scale apoptosis. Ovarian tissue morphology and viability was not compromised by the treatment, as no significant difference was observed regarding the percentage of morphologically normal follicles, follicular viability, glucose uptake or in vitro growth of small follicles between ovarian cortex treated with 1 μM GSK1070916 and the control. CONCLUSION Purging of CML/AML metastases in ovarian cortex is possible by targeting the Mitotic Catastrophe Signalling Pathway using GSK1070916 without affecting the ovarian tissue. This provides a therapeutic strategy to prevent reintroduction of leukaemia and enhances safety of autotransplantation in leukaemia patients currently considered at high risk for ovarian involvement.
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MESH Headings
- Apoptosis/drug effects
- Aurora Kinase B/genetics
- Aurora Kinase C/genetics
- Aza Compounds/pharmacology
- Cell Line, Tumor
- Cell Survival/drug effects
- Cryopreservation
- Female
- Humans
- Indoles/pharmacology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Mitosis/drug effects
- Mitosis/genetics
- Neoplasm Metastasis
- Ovarian Follicle/drug effects
- Ovarian Follicle/growth & development
- Signal Transduction/drug effects
- Transplantation, Autologous/standards
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Affiliation(s)
- Lotte Eijkenboom
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Callista Mulder
- Department of Reproductive Biology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Bert van der Reijden
- Department of Laboratory Medicine, Laboratory of Haematology, Radboud Institute of Molecular Life Sciences, Nijmegen, The Netherlands
| | - Norah van Mello
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, The Netherlands
| | - Julia van Leersum
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Thessa Koorenhof-Scheele
- Department of Laboratory Medicine, Laboratory of Haematology, Radboud Institute of Molecular Life Sciences, Nijmegen, The Netherlands
| | - Didi Braat
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Catharina Beerendonk
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ronald Peek
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Lotz L, Barbosa PR, Knorr C, Hofbeck L, Hoffmann I, Beckmann MW, Antoniadis S, Dittrich R. The safety and satisfaction of ovarian tissue cryopreservation in prepubertal and adolescent girls. Reprod Biomed Online 2020; 40:547-554. [PMID: 32199797 DOI: 10.1016/j.rbmo.2020.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/12/2020] [Accepted: 01/14/2020] [Indexed: 01/18/2023]
Abstract
RESEARCH QUESTION Is ovarian tissue cryopreservation (OTC) for fertility preservation in prepubertal and adolescent girls safe, and who would benefit most from the procedure? DESIGN Survey and retrospective study including patients who had OTC under the age of 18 years in a single centre for fertility preservation. Serum anti-Müllerian hormone levels were measured as a marker for detection of diminished ovarian reserve. RESULTS Fifty-three from 102 women participated in the survey (12 deceased, 19 declined, 17 unreachable, 1 palliative). The average age at OTC was 14.8 ± 2.3 (range: 6-17) years and at survey 21.9 ± 4.3 (range: 16-33) years. Ovarian tissue retrieval (laparoscopy: n = 45, laparotomy: n = 8) was without complications in 52 cases. In 23 (53.5%) of the 43 women who were post-menarchal at OTC, transient amenorrhoea occurred. At survey, 15 women reported a regular menstrual cycle, 25 used oral contraceptives, 9 women reported hormone replacement therapy due to primary ovary insufficiency and 4 had amenorrhoea. Two patients reported the birth of a healthy child after IVF, while 51 patients are still childless, mostly due to their young age (mean: 21.2 years). To date, one patient has had transplantation of the ovarian tissue (17 years at cryopreservation). Forty-nine of the interviewees would again decide on OTC, while three argued against it on the basis of the previous financial cost; one woman was unsure. CONCLUSIONS Children with cancer may be at risk for gonadal insufficiency. OTC is practically the only technique that can be offered to young girls. The procedure is safe and well accepted.
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Affiliation(s)
- Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany.
| | - Patricia Reis Barbosa
- Department of Pediatric Surgery and Pediatric Orthopedics, Hospital St Hedwig, Hospital Barmherzige Brüder Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany
| | - Christian Knorr
- Department of Pediatric Surgery and Pediatric Orthopedics, Hospital St Hedwig, Hospital Barmherzige Brüder Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany
| | - Louisa Hofbeck
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Inge Hoffmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Sophia Antoniadis
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
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Mohammadi Z, Hayati Roodbari N, Parivar K, Salehnia M. Supplementation of Culture Media with Lysophosphatidic Acid Improves The Follicular Development of Human Ovarian Tissue after Xenotransplantaion into The Back Muscle of γ-Irradiated Mice. CELL JOURNAL 2019; 22:358-366. [PMID: 31863662 PMCID: PMC6947004 DOI: 10.22074/cellj.2020.6752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 04/23/2019] [Indexed: 01/26/2023]
Abstract
Objective The aim of the present study was to evaluate the effects of lysophosphatidic acid (LPA) supplementation
of human ovarian tissue culture media on tissue survival, follicular development and expression of apoptotic genes
following xenotransplantation.
Materials and Methods In this experimental study, human ovarian tissue was collected from eight normal female
to male transsexual individuals and cut into small fragments. These fragments were vitrified-warmed and cultured
for 24 hours in the presence or absence of LPA, then xenografted into back muscles of γ-irradiated mice. Two weeks
post-transplantation the morphology of the recovered tissues were evaluated by hematoxylin and eosin staining. The
expression of genes related to apoptosis (BAX and BCL2) were analyzed by real time revers transcription polymerase
chain reaction (RT-PCR) and detection of BAX protein was done by immunohistochemical staining.
Results The percent of normal and growing follicles were significantly increased in both grafted groups in comparison to
the non-grafted groups, however, these rates were higher in the LPA-treated group than the non-treated group (P<0.05).
There was a higher expression of the anti-apoptotic gene, BCL2, but a lower expression of the pro-apoptotic gene, BAX,
and a significant lower BAX/ BCL2 ratio in the LPA-treated group in comparison with non-treated control group (P<0.05).
No immunostaining positive cells for BAX were observed in the follicles and oocytes in both transplanted ovarian groups.
Conclusion Supplementation of human ovarian tissue culture medium with LPA improves follicular survival and
development by promoting an anti-apoptotic balance in transcription of BCL2 and BAX genes.
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Affiliation(s)
- Zeynab Mohammadi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nasim Hayati Roodbari
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Kazem Parivar
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mojdeh Salehnia
- Department of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Electronic Address:
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Ruan X, Cui Y, Du J, Jin J, Gu M, Chen S, Mueck AO. Randomized study to prove the quality of human ovarian tissue cryopreservation by xenotransplantation into mice. J Ovarian Res 2019; 12:46. [PMID: 31113493 PMCID: PMC6530171 DOI: 10.1186/s13048-019-0521-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 05/09/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To study the quality of our human ovarian tissue cryopreservation technique as performed in the first official "International Fertility Protection Centre" in China in patients with certain cancer types using a mouse model, and to find the best site for tissue transplantation in the mouse. Methods Thirty-six BALB/C female nude mice were randomly divided into 3 groups, group 1: control group; group 2: ovariectomized group; group 3: ovarian tissue transplantation group. Seventy-two pieces obtained from six ovarian tissue samples from each of three cancer patients were transplanted into the ovarian bursa cavity (OBC), the subcutaneous thigh (TS) and the subcutaneous neck (NS) and removed after 1.5 and 2.5 months, respectively. Follicular growth rate (FGR), total follicle surviving rate (TFSR), tissue recovery rate (TRR), antral follicles (AF), follicle stimulating hormone (FSH), estradiol (E2) and anti-Mullerian hormone (AMH) levels were measured. Results No significant differences in FGR, OBC, NS (p > 0.05); TFSR was 100% in OBC, NS and TS. No significant differences in TRR (p > 0.05); AF were found only in OBC; TFSR was 100% after transplantation; significantly higher FGR in the 2.5 months compared to the 1.5 months-group (p < 0.05). AMH- and E2-level in group 1 and 3 were significantly higher than in group 2 (p < 0.05); in contrast, FSH was significantly lower. Conclusions After transplantation in the mice, the thawed ovarian tissue survived and follicles developed. The ovarian fossa site was the best site for transplantation. Our animal experiments can verify that our human ovarian tissue cryopreservation technique can preserve the quality of ovarian tissue. This is the essential precondition for successful re-transplantation into the patients after performing chemo/radiotherapy to protect ovarian function and fertility.
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Affiliation(s)
- Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China. .,Department of Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tuebingen, Tuebingen, Germany.
| | - Yamei Cui
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Jing Jin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Muqing Gu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Suwen Chen
- Department of Family Planning, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China.,Department of Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tuebingen, Tuebingen, Germany
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Cunha Rossy K, Cordeiro Barbosa AE, da Conceição Guilherme B, Guimarães Silva CR, Pantoja Pereira CS, Silva Ferreira C, de Oliveira Bezerra DK, Melo Alves Dos Santos G, Soares da Costa FL, Magno de Morais HL, Barroso Dos Santos J, da Silva Siqueira L, Pucci Bueno Borges L, da Silva Cavalcante MJ, Santos Cunha M, Abrantes de Oliveira R, Dos Santos Albuquerque R, Soares Bezerra Júnior P, Machado Silva MA, Maia Teixeira PP. Histological evaluation of sheep ovarian tissue after laparoscopic partial ovariectomy. Anim Reprod Sci 2019; 204:165-170. [PMID: 30952544 DOI: 10.1016/j.anireprosci.2019.03.021] [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: 08/01/2018] [Revised: 03/20/2019] [Accepted: 03/28/2019] [Indexed: 11/19/2022]
Abstract
In the present study, there was assessment of the damage to tissue caused by partial laparoscopic ovariectomy using bipolar forceps in sheep. Fragments of ovaries of six sheep were removed using bipolar forceps by making a transverse section in the middle third of the organ via three-portals that were made using laparoscopy. The fragments were subjected to standard histological examinations and the lesions attributed to the procedure were investigated using an optical microscope and Image J software. The results were assessed using an analysis of variance and the Tukey test. All the laminae had minimal tissue damage. The mean amount of highly damaged tissue was 1.8%, and of partially damaged tissue was 5.6%. The mean total area of healthy tissue in the fragments was 94.4%. The results of the study indicate this procedure can be conducted withvery little tissue damage occurring. The use of this procedure, therefore, can be incorporated in future reproductive studies without altering the functions of the in situ ovarian tissues.
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Affiliation(s)
- Kayan Cunha Rossy
- Institute of Veterinary Medicine, Federal University of Pará - UFPA, Castanhal, Pará, 68740970, Brazil.
| | | | | | | | | | - Chayanne Silva Ferreira
- Institute of Veterinary Medicine, Federal University of Pará - UFPA, Castanhal, Pará, 68740970, Brazil
| | | | | | | | | | | | - Luciana da Silva Siqueira
- Institute of Veterinary Medicine, Federal University of Pará - UFPA, Castanhal, Pará, 68740970, Brazil
| | - Luísa Pucci Bueno Borges
- Institute of Veterinary Medicine, Federal University of Pará - UFPA, Castanhal, Pará, 68740970, Brazil
| | | | - Michel Santos Cunha
- Institute of Veterinary Medicine, Federal University of Pará - UFPA, Castanhal, Pará, 68740970, Brazil
| | | | | | | | - Marco Augusto Machado Silva
- School of Veterinary and Animal Science, Federal University of Goiás - UFG, Samambaia, Goiás, 74690900, Brazil
| | - Pedro Paulo Maia Teixeira
- Institute of Veterinary Medicine, Federal University of Pará - UFPA, Castanhal, Pará, 68740970, Brazil
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Salama M, Isachenko E, Ludwig S, Einzmann T, Rahimi G, Mallmann P, Isachenko V. A successful multidisciplinary approach for treatment and for preserving the reproductive potential in a rare case of acute lymphocytic leukemia during pregnancy. Gynecol Endocrinol 2019; 35:115-118. [PMID: 30179055 DOI: 10.1080/09513590.2018.1498833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Leukemia in pregnancy is a rare condition with the prevalence of 1 in 75,000-100,000 pregnancies. In this case report, we present a successful multidisciplinary management strategy for treatment and for preserving the reproductive potential in a rare case of acute lymphocytic leukemia (ALL) during pregnancy. Several complex challenges existed and necessitated a multidisciplinary approach with strong coordination and collaboration between oncologists, gynecologists, reproductive cryobiologists, obstetricians, and neonatologists in order to improve the maternal and fetal outcome. Pregnancy in the second trimester is neither a contraindication for ALL treatment nor for emergency fertility preservation via ovarian tissue extraction and further cryopreservation.
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Affiliation(s)
- Mahmoud Salama
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
- b Oncofertility Consortium, Feinberg School of Medicine, Northwestern University , Chicago , IL , USA
| | - Evgenia Isachenko
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
| | - Sebastian Ludwig
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
| | - Thomas Einzmann
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
| | - Gohar Rahimi
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
| | - Peter Mallmann
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
| | - Vladimir Isachenko
- a Department of Obstetrics and Gynecology Medical Faculty , University of Cologne , Cologne , Germany
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Fernandes DP, Pimentel MML, Santos FAD, Praxedes ÉA, Brito PDDE, Lima MA, Lelis ICNG, Macedo MFDE, Bezerra MB. Hematological and biochemical profile of BALB/c nude and C57BL/6 SCID female mice after ovarian xenograft. AN ACAD BRAS CIENC 2018; 90:3941-3948. [PMID: 30379274 DOI: 10.1590/0001-3765201820180586] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 07/19/2018] [Indexed: 11/22/2022] Open
Abstract
Hematological and biochemical profile studies help to evaluate functional changes of animals used in experiments. The aim of this study was to determine the hematological and biochemical profile of immunosuppressed BALB/c nude and C57BL/6 SCID mice after bovine ovarian xenotransplantation. Therefore, a total of 74 female mice were divided into four groups: non-xenotransplanted animals, xenotransplanted animals, xenotransplanted animals treated with eCG and xenotransplanted animals treated with FSH + LH. After anesthesia, blood samples were collected and hematologic and biochemical values were evaluated. The results showed no significant differences (p ≤ 0.05) for hematological parameters between the control group and the treatment groups of both strains. However, considering the biochemical profile, it was observed an increase of AST concentrations (p ≤ 0.05) in both strains and a decrease of ALT concentrations (p ≤ 0.05) only in C57BL/6 SCID strain of the groups subjected to hormonal treatment compared with those non subjected. Additionally, the values of the renal enzymes, urea and creatinine, did not differ (p ≤ 0.05) between the groups. Our findings suggest that the xenotransplantation procedure as well as the hormonal dosages had no significant effect on the well-being of the animals considering the evaluated hematological and biochemical profile.
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Affiliation(s)
- Denilsa P Fernandes
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Muriel M L Pimentel
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Fernanda A Dos Santos
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Érika A Praxedes
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Parmênedes D DE Brito
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Mikael A Lima
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Ivana C N G Lelis
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Michelly F DE Macedo
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
| | - Marcelo B Bezerra
- Laboratório de Transplantes Gonadais e Produção In Vitro de Embriões/LTG-PIVE, Departamento de Ciências Animais, Universidade Federal Rural do Semi-Árido/UFERSA, Avenida Francisco Mota, 572, 59625-900 Mossoró, RN, Brazil
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11
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Praxedes ÉCG, Lima GL, Bezerra LGP, Santos FA, Bezerra MB, Guerreiro DD, Rodrigues APR, Domingues SFS, Silva AR. Development of fresh and vitrified agouti ovarian tissue after xenografting to ovariectomised severe combined immunodeficiency (SCID) mice. Reprod Fertil Dev 2018; 30:459-468. [PMID: 28784201 DOI: 10.1071/rd17051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 07/12/2017] [Indexed: 11/23/2022] Open
Abstract
The aim of the present study was to evaluate the development of fresh and vitrified agouti ovarian tissue after xenografting to C57Bl/6 severe combined immunodeficiency (SCID) female mice. Ovaries were obtained from five female agoutis and divided into 16 fragments. Five fragments were transplanted immediately to ovariectomised SCID mice and the others were vitrified, stored for 2 weeks and transplanted only after rewarming. Tissue fragments were transplanted under the kidney capsule in recipients. The return of ovarian activity in recipients was monitored by the observation of external signs of oestrus and vaginal cytology over a period of 40 days after transplantation, after which the grafts were removed and evaluated for morphology, cell proliferation and the occurrence of DNA fragmentation. Ovarian activity returned in four of five mice that received fresh ovarian tissue from agoutis and in one of six mice that had received vitrified tissue a mean (±s.e.m.) 20.6±8.6 days after xenotransplantation. After graft removal, a predominance of primordial and primary follicles was observed in all grafts. Vitrification reduced cell proliferation and increased the occurrence of DNA fragmentation in grafted agouti ovarian tissue. In conclusion, the present study demonstrates that xenografted agouti ovarian tissue, fresh or vitrified, is able to promote the return of ovarian activity in ovariectomised SCID C57B1/6 mice. However, improvements to vitrification protocols for agouti ovarian tissue are necessary.
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Affiliation(s)
- Érica C G Praxedes
- Laboratory of Animal Germplasm Conservation, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Gabriela L Lima
- Department of Animal Sciences, Instituto Federal de Educação, Ciência e Tecnologia do Ceará (IFCE), CE-292, KM 15, Gisélia Pinheiro, 63115-500, Crato-CE, Brazil
| | - Luana G P Bezerra
- Laboratory of Animal Germplasm Conservation, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Fernanda A Santos
- Laboratory of Gonadal Transplantation and Embryo Production, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Marcelo B Bezerra
- Laboratory of Gonadal Transplantation and Embryo Production, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Denise D Guerreiro
- Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), Faculdade de Veterinária, Universidade do Ceará, Av. Paranjana 1700, Campus do Itaperi, 60714-903, Fortaleza, CE, Brazil
| | - Ana P R Rodrigues
- Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), Faculdade de Veterinária, Universidade do Ceará, Av. Paranjana 1700, Campus do Itaperi, 60714-903, Fortaleza, CE, Brazil
| | - Sheyla F S Domingues
- Laboratory of Amazon Wild Animals Biology and Medicine, Universidade Federal do Pará, Jaderlândia, 68746-360,Castanhal, PA, Brazil
| | - Alexandre R Silva
- Laboratory of Animal Germplasm Conservation, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
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Raffel N, Lotz L, Hoffmann I, Liebenthron J, Söder S, Beckmann MW, Dittrich R. Repetitive Maturation of Oocytes From Non-Stimulated Xenografted Ovarian Tissue From a Prepubertal Patient Indicating the Independence of Human Ovarian Tissue. Geburtshilfe Frauenheilkd 2017; 77:1304-1311. [PMID: 29269958 PMCID: PMC5734935 DOI: 10.1055/s-0043-122601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 01/03/2023] Open
Abstract
Introduction
Modern anti-cancer strategies have distinctly increased survival rates; nevertheless, often accompanied by sterility. Currently, the only option for preserving fertility in prepubertal females is to cryopreserve ovarian tissue and re-transplant frozen-thawed tissue to restore fertility after treatment. Our aim was to report the occurrence of repetitive antral follicle formation and oocyte maturation in a prepubescent ovarian tissue xenograft without exogenous hormone stimulation.
Material and Methods
Frozen-thawed ovarian tissue from a 6-year-old patient suffering from nephroblastoma was xenotransplanted in oophorectomized severe combined immunodeficiency (SCID) mice to evaluate follicle development.
Ergebnisse
Repetitive follicle development to the antral stage occurred in the same xenograft of prepubertal ovarian tissue without exogenous hormone administration; 37 days after retrieving a maturing oocyte (this first retrieval has been previously published), another, completely mature oocyte was harvested from the xenograft. Subsequent histological evaluation of the grafted tissue showed primordial follicles, nearly all stages of developing follicles, as well as large atretic ones. Many clusters with dormant primordial follicles were also present.
Conclusion
Xenotransplanted prepubertal ovarian tissue has the potential for repetitive oocyte retrieval cycles without administering exogenous hormones. The results indicate that the human ovarian tissue might be able to synchronize the hypothalamus-hypophysis-axes of the mouse to the physiological human cycle; this should be investigated in future studies.
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Affiliation(s)
- Nathalie Raffel
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Inge Hoffmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Jana Liebenthron
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Bonn, Bonn, Germany
| | - Stephan Söder
- Institute of Pathology, University Hospital of Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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von Wolff M, Germeyer A, Liebenthron J, Korell M, Nawroth F. Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part II: fertility preservation techniques. Arch Gynecol Obstet 2017; 297:257-267. [PMID: 29181578 PMCID: PMC5762782 DOI: 10.1007/s00404-017-4595-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/10/2017] [Indexed: 12/24/2022]
Abstract
Purpose In addition to guidelines focusing on scientific evidence, practical recommendations on fertility preservation are also needed. Methods A selective literature search was performed based on the clinical and scientific experience of the authors. This article (Part II) focuses on fertility preservation techniques. Part I, also published in this journal, provides information on disease prognosis, disease-specific therapy, and risks for loss of fertility. Results Ovarian stimulation including double stimulation and freezing of oocytes is the best-established therapy providing live birth chances in women < 35 years with high ovarian reserve of around 30–40%. Ovarian tissue freezing is especially useful in young women with good ovarian, if spontaneous conception is favoured and if < 1 week until chemotherapy is provided. Data on success rates are still limited, but this further evolving technique will possibly reach similar success rates as ovarian stimulation. GnRH agonists seem to reduce the risk of premature ovarian failure up to 50%; however, the effect is possibly not long-lasting. Ovarian transposition can easily be combined with freezing of ovarian tissue and is the preferred technique before pelvic radiotherapy. Other techniques, such as in vitro maturation, are limited to women with high ovarian reserve and remain less effective. In addition, procedures such as in vitro growth of follicles, etc. are still experimental. Conclusions Fertility preservation in women provides realistic chances of becoming pregnant. The choice of technique needs to be based on the time required, the woman’s age, its risks and efficacy, and the individual preference of the patient.
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Affiliation(s)
- Michael von Wolff
- Division of Gynaecological Endocrinology and Reproductive Medicine, Medical University of Berne, Berne, Switzerland.
- Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's hospital, Inselspital Bern, Effingerstrasse 102, 3010, Bern, Switzerland.
| | - A Germeyer
- Department of Gynaecological Endocrinology and Fertility Disorders, Medical University of Heidelberg, Heidelberg, Germany
| | - J Liebenthron
- Department of Gynaecological Endocrinology and Reproductive Medicine, Medical University of Bonn, Bonn, Germany
| | - M Korell
- Department of Obstetrics and Gynaecology, Johanna Etienne Hospital of Neuss, Neuss, Germany
| | - F Nawroth
- Centre for Infertility, Prenatal Medicine, Endocrinology and Osteology, Amedes Hamburg, Hamburg, Germany
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Demirel MA, Acar DB, Ekim B, Çelikkan FT, Alkan KK, Salar S, Erdemli EA, Özkavukçu S, Yar SS, Kanca H, Baştan A. The evaluation of xenotransplantation of feline ovarian tissue vitrified by needle immersed vitrification technique into male immunodeficient mice. Cell Tissue Bank 2017; 19:133-147. [DOI: 10.1007/s10561-017-9663-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
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Salama M, Isachenko V, Isachenko E, Rahimi G, Mallmann P. Advances in fertility preservation of female patients with hematological malignancies. Expert Rev Hematol 2017; 10:951-960. [PMID: 28828900 DOI: 10.1080/17474086.2017.1371009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The most common forms of hematological malignancies that occur in female reproductive years are lymphoma and leukemia. Areas covered: Several aggressive gonadotoxic regimens such as alkylating chemotherapy and total body irradiation are used frequently in treatment of lymphoma and leukemia leading to subsequent iatrogenic premature ovarian failure and fertility loss. In such cases, female fertility preservation options should be offered in advance. Expert commentary: In order to preserve fertility of young women and girls with lymphoma and leukemia, several established, experimental, and debatable options can be offered before starting chemotherapy and radiotherapy. However, each of those female fertility preservation options has both advantages and disadvantages and may not be suitable for all patients. That is why a fertility preservation strategy should be individualized and tailored distinctively for each patient in order to be effective. Artificial human ovary is a novel experimental in vitro technology to produce mature oocytes that could be the safest option to preserve and restore fertility of young women and girls with hematological malignancies especially when other fertility preservation options are not feasible or contraindicated. Further research and studies are needed to improve the results of artificial human ovary and establish it in clinical practice.
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Affiliation(s)
- Mahmoud Salama
- a Department of Gynecology and Obstetrics, Medical Faculty , University of Cologne , Cologne , Germany
| | - Vladimir Isachenko
- a Department of Gynecology and Obstetrics, Medical Faculty , University of Cologne , Cologne , Germany
| | - Evgenia Isachenko
- a Department of Gynecology and Obstetrics, Medical Faculty , University of Cologne , Cologne , Germany
| | - Gohar Rahimi
- a Department of Gynecology and Obstetrics, Medical Faculty , University of Cologne , Cologne , Germany
| | - Peter Mallmann
- a Department of Gynecology and Obstetrics, Medical Faculty , University of Cologne , Cologne , Germany
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Hammarberg K, Kirkman M, Stern C, McLachlan RI, Gook D, Rombauts L, Vollenhoven B, Fisher JRW. Cryopreservation of reproductive material before cancer treatment: a qualitative study of health care professionals' views about ways to enhance clinical care. BMC Health Serv Res 2017; 17:343. [PMID: 28490359 PMCID: PMC5424377 DOI: 10.1186/s12913-017-2292-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 05/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer treatment can diminish fertility in women and men. The need for fertility preservation is growing as increasing numbers of people survive cancer. Cryostorage of reproductive material to preserve potential for conception for cancer survivors has moved from being experimental to being a part of clinical management of women and men who are diagnosed with cancer in their reproductive years. There is little existing evidence about how fertility preservation services can be enhanced to meet the complex needs of patients who are diagnosed with cancer in their reproductive years. The aim of this research was to inform clinical practice development by drawing on the collective experience and knowledge of staff at well-established clinics that offer fertility preservation before cancer treatment. METHODS A qualitative research model was adopted using semi-structured interviews with professionals involved in the care of people who freeze reproductive material before cancer treatment. In the state of Victoria, Australia, two large assisted reproductive technology (ART) centres have been providing fertility preservation services for more than two decades. An invitation to participate in a semi-structured interview about clinical care in the context of fertility preservation was emailed to past and current staff members. To capture diverse perspectives, informants were sought from all relevant professions: fertility specialists, andrologists, nurses, embryologists/scientists, counsellors, and administrative staff. Transcripts were analysed thematically. RESULTS Thirteen key informants were interviewed from August 2013 to February 2014. The identified themes relating to enhancing clinical care in a fertility preservation service were communication between oncology and ART specialists; managing urgency; managing patients' expectations; establishing and implementing protocols, systems, and data bases; and maintaining contact with patients. CONCLUSION The collective knowledge of this study's informants, who represent multidisciplinary teams with more than two decades' experience in fertility preservation, yields important insights into strategies that fertility preservation services can employ to promote the integration of oncology and fertility care, the psychosocial care of patients, data recording and monitoring, and reporting of outcomes.
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Affiliation(s)
- Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 549 St Kilda Rd, Melbourne, Victoria 3004 Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 549 St Kilda Rd, Melbourne, Victoria 3004 Australia
| | - Catharyn Stern
- Melbourne IVF, Melbourne, Victoria 3002 Australia
- Reproductive Services, Royal Women’s Hospital, Parkville, Victoria 3052 Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Robert I. McLachlan
- Monash IVF, Clayton, Victoria 3163 Australia
- Andrology Australia, Melbourne, Victoria 3163 Australia
- Hudson Institute of Medical Research, Clayton, Victoria 3163 Australia
| | - Debra Gook
- Melbourne IVF, Melbourne, Victoria 3002 Australia
- Reproductive Services, Royal Women’s Hospital, Parkville, Victoria 3052 Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Luk Rombauts
- Monash IVF, Clayton, Victoria 3163 Australia
- Hudson Institute of Medical Research, Clayton, Victoria 3163 Australia
- Monash Health, Clayton, Victoria 3163 Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria 3163 Australia
| | - Beverley Vollenhoven
- Monash IVF, Clayton, Victoria 3163 Australia
- Monash Health, Clayton, Victoria 3163 Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria 3163 Australia
| | - Jane R. W. Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 549 St Kilda Rd, Melbourne, Victoria 3004 Australia
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State-of-the-art fertility preservation in children and adolescents undergoing haematopoietic stem cell transplantation: a report on the expert meeting of the Paediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT) in Baden, Austria, 29-30 September 2015. Bone Marrow Transplant 2017; 52:1029-1035. [PMID: 28287638 DOI: 10.1038/bmt.2017.21] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 09/30/2016] [Indexed: 12/26/2022]
Abstract
Nowadays, allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a well-established treatment procedure and often the only cure for many patients with malignant and non-malignant diseases. Decrease in short-term complications has substantially contributed to increased survival. Therefore long-term sequelae are reaching the focus of patient care. One of the most important risks of stem cell transplant survivors is infertility. As well as in the field of allo-HSCT also the field of reproductive medicine has achieved substantial advances to offer potential options for fertility preservation in both boys and girls. Access to these procedures as well as their financing differs significantly throughout Europe. As all European children and adolescents should have the same possibility, the Paediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation organised an expert meeting in September 2015. This manuscript describes the recommendations for the diagnosis and pre-emptive procedures that should be offered to all children and adolescents in Europe who have to undergo an allo-HSCT.
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Devi L, Goel S. Fertility preservation through gonadal cryopreservation. Reprod Med Biol 2016; 15:235-251. [PMID: 29259441 PMCID: PMC5715865 DOI: 10.1007/s12522-016-0240-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/01/2016] [Indexed: 12/20/2022] Open
Abstract
Fertility preservation is an area of immense interest in today's society. The most effective and established means of fertility preservation is cryopreservation of gametes (sperm and oocytes) and embryos. Gonadal cryopreservation is yet another means for fertility preservation, especially if the gonadal function is threatened by premature menopause, gonadotoxic cancer treatment, surgical castration, or diseases. It can also aid in the preservation of germplasm of animals that die before attaining sexual maturity. This is especially of significance for valuable, rare, and endangered animals whose population is affected by high neonatal/juvenile mortality because of diseases, poor management practices, or inbreeding depression. Establishing genome resource banks to conserve the genetic status of wild animals will provide a critical interface between ex-situ and in-situ conservation strategies. Cryopreservation of gonads effectively lengthens the genetic lifespan of individuals in a breeding program even after their death and contributes towards germplasm conservation of prized animals. Although the studies on domestic animals are quite promising, there are limitations for developing cryopreservation strategies in wild animals. In this review, we discuss different options for gonadal tissue cryopreservation with respect to humans and to laboratory, domestic, and wild animals. This review also covers recent developments in gonadal tissue cryopreservation and transplantation, providing a systematic view and the advances in the field with the possibility for its application in fertility preservation and for the conservation of germplasm in domestic and wild species.
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Affiliation(s)
- Lalitha Devi
- Laboratory for the Conservation of Endangered Species, Centre for Cellular and Molecular BiologyCouncil for Scientific and Industrial ResearchUppal Road500 007HyderabadIndia
| | - Sandeep Goel
- Laboratory for the Conservation of Endangered Species, Centre for Cellular and Molecular BiologyCouncil for Scientific and Industrial ResearchUppal Road500 007HyderabadIndia
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Abstract
Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results.
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Affiliation(s)
- Mahmoud Salama
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 303 East Superior Street, Room 10-119, Chicago, IL 60611, USA
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Lopes CAP, Alves AMCV, Jewgenow K, Báo SN, de Figueiredo JR. Cryopreservation of canine ovarian cortex using DMSO or 1,3-propanediol. Theriogenology 2016; 86:1165-74. [DOI: 10.1016/j.theriogenology.2016.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 04/05/2016] [Indexed: 10/21/2022]
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Salama M, Isachenko V, Isachenko E, Rahimi G, Mallmann P. Updates in preserving reproductive potential of prepubertal girls with cancer: Systematic review. Crit Rev Oncol Hematol 2016; 103:10-21. [PMID: 27184425 DOI: 10.1016/j.critrevonc.2016.04.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/10/2016] [Accepted: 04/07/2016] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION With increasing numbers of adult female survivors of childhood cancers due to advances in early diagnosis and treatment, the issue of preserving the reproductive potential of prepubertal girls undergoing gonadotoxic treatments has gained greater attention. METHODS According to PRISMA guidelines, a systematic review of the literature was performed for all relevant full-text articles published in PubMed in English throughout the past 15 years to explore the significant updates in preserving the reproductive potential of prepubertal girls with cancer. RESULTS The two established fertility preservation options, embryo freezing and egg freezing, cannot be offered routinely to prepubertal girls as these options necessitate prior ovarian stimulation and subsequent mature oocytes retrieval that are contraindicated or infeasible before puberty. Therefore, the most suitable fertility preservation options to prepubertal girls are (1) ovarian tissue freezing and autotransplantation, (2) in vitro maturation, and (3) ovarian protection techniques. In this review, we discuss in detail those options as well as their success rates, advantages, disadvantages and future directions. We also suggest a new integrated strategy to preserve the reproductive potential of prepubertal girls with cancer. CONCLUSION Although experimental, ovarian tissue slow freezing and orthotopic autotransplantation may be the most feasible option to preserve the reproductive potential of prepubertal girls with cancer. However, this technique has two major and serious disadvantages: (1) the risk of reintroducing malignant cells, and (2) the relatively short lifespan of ovarian tissue transplants. Several medical and ethical considerations should be taken into account before applying this technique to prepubertal girls with cancer.
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Affiliation(s)
- Mahmoud Salama
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany; Department of Reproductive Medicine, Medical Division, National Research Center of Egypt, Egypt.
| | - Vladimir Isachenko
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany.
| | - Evgenia Isachenko
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany.
| | - Gohar Rahimi
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany.
| | - Peter Mallmann
- Department of Gynecology and Obstetrics, Medical Faculty, University of Cologne, Germany.
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22
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Zeng YC, Tang HR, Zeng LP, Chen Y, Wang GP, Wu RF. Assessment of the effect of different vitrification solutions on human ovarian tissue after short-term xenotransplantation onto the chick embryo chorioallantoic membrane. Mol Reprod Dev 2016; 83:359-69. [PMID: 26924442 DOI: 10.1002/mrd.22631] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/20/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Yu-Cui Zeng
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
| | - Hui-Ru Tang
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Section of Gynecological Endocrinology Medicine; Shenzhen China
| | - Li-Ping Zeng
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Section of Gynecological Endocrinology Medicine; Shenzhen China
| | - Yun Chen
- Department of Ultrasound; Peking University Shenzhen Hospital; Shenzhen China
| | - Guo-Ping Wang
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Section of Gynecological Endocrinology Medicine; Shenzhen China
| | - Rui-Fang Wu
- Department of Gynecology and Obstetrics; Peking University Shenzhen Hospital; Shenzhen China
- Key Laboratory of Gynecological Diagnostic Technology Research; Shenzhen China
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