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Dietl AK, Dittrich R, Hoffmann I, Denschlag D, Hanjalic-Beck A, Müller A, Beckmann MW, Lotz L. Does it make sense to refreeze ovarian tissue after unexpected occurrence of endometriosis when transplanting the tissue? J Ovarian Res 2022; 15:53. [PMID: 35513873 PMCID: PMC9074247 DOI: 10.1186/s13048-022-00972-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ovarian insufficiency is a major concern for long-term cancer survivors. Ovarian tissue cryopreservation for fertility preservation is an emerging technique that has proven successful over the past decade through transplantation of frozen-thawed ovarian tissue. Compared to other established techniques, such as oocyte freezing, ovarian tissue cryopreservation preserves actual organ function and thus the production of sex hormones. Endometriosis in perimenopausal women is rare, however it can be surprising diagnosis in the planned transplantation of cryopreserved ovarian tissue and the already thawed tissue may not be transplanted, so that it has to be refrozen. Results Ovarian function returned in the patient two months after transplantation, as shown by estrogen production. Ten months after the ovarian tissue transplantation mild stimulation with FSH was initiated in accordance with a low-dose protocol. When ultrasonography revealed a follicle 17 mm in size in the ovarian graft, hCG was added and after follicular puncture one oocyte was obtained. The oocyte could be fertilized by IVF and transferred to the uterus. On day 14 after embryo-transfer, a positive hCG-Level was detected and after an uncomplicated pregnancy a healthy child was delivered. Conclusions We report the first pregnancy and live birth achieved using transplantation of thawed and refrozen ovarian tissue in a woman treated by chemotherapy and subsequent endometriosis surgery. Refreezing of cryopreserved ovarian tissue is not a hindrance to successful transplantation of ovarian tissue. Against the background of increasing numbers of candidates for transplantation of ovarian tissue is expected that the combination chemotherapy followed by endometriosis will increase.
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Affiliation(s)
- Anna K Dietl
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Inge Hoffmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | | | - Aida Hanjalic-Beck
- Center for Gynecologic Endocrinology and Reproductive Medicine, Freiburg, Germany
| | - Andreas Müller
- Department of Obstetrics and Gynecology, Municipal-Hospital, Karlsruhe, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
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Sugishita Y, Meng L, Suzuki-Takahashi Y, Nishimura S, Furuyama S, Uekawa A, Tozawa-Ono A, Migitaka-Igarashi J, Koizumi T, Seino H, Natsuki Y, Kubota M, Koike J, Edashige K, Suzuki N. Quantification of residual cryoprotectants and cytotoxicity in thawed bovine ovarian tissues after slow freezing or vitrification. Hum Reprod 2022; 37:522-533. [PMID: 34928342 DOI: 10.1093/humrep/deab274] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 11/17/2021] [Indexed: 09/27/2023] Open
Abstract
STUDY QUESTION How much residual cryoprotectant remains in thawed/warmed ovarian tissues after slow freezing or vitrification? SUMMARY ANSWER After thawing/warming, at least 60 min of diffusion washing in media was necessary to significantly reduce the residual cryoprotectants in ovarian tissues frozen by slow freezing or vitrification. WHAT IS KNOWN ALREADY Ovarian tissue cryopreservation (OTC) by slow freezing has been the conventional method; while the vitrification method has gained popularity for its practicality. The main concern about vitrification is how much potentially toxic residual cryoprotectant remains in the warmed tissues at the time of transplantation. STUDY DESIGN, SIZE, DURATION This was an animal study using the ovarian tissues from 20 bovine ovaries. The duration of this study was from 2018 to 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Ovarian cortex tissues were prepared from 20 bovine ovaries and assigned randomly to groups of fresh (non-frozen) control, slow freezing with 1.5 M dimethyl sulfoxide (DMSO), 1.5 M 1,2-propanediol (PROH) and vitrification with 35% ethylene glycol (EG). The residual cryoprotectant concentrations in thawed/warmed tissues were measured by gas chromatography at the following time points: frozen (before thawing/warming), 0 min (immediately after thawing/warming), 30, 60 and 120 min after diffusion washing in media. Next, the ultrastructural changes of primordial follicles, granulosa cells, organelles and stromal cells in the ovarian tissues (1 mm × 1 mm × 1 mm) were examined in fresh (non-frozen) control, slow freezing with DMSO or PROH and vitrification with EG groups. Real-time quantitative PCR was carried out to examine the expressions of poly (ADP-ribose) polymerase-1 (PARP1), a DNA damage sensor and caspase-3 (CASP3), an apoptosis precursor, in thawed/warmed ovarian tissues that were washed for either 0 or 120 min and subsequently in tissues that were ex vivo cultured for 24 or 48 h. The same set of tissues were also used to analyze the protein expressions of gamma H2A histone family member X (γH2AX) for DNA double-strand breaks and activated caspase-3 (AC3) for apoptosis by immunohistochemistry. MAIN RESULTS AND THE ROLE OF CHANCE The residual cryoprotectant concentrations decreased with the extension of diffusion washing time. After 60 min washing, the differences of residual cryoprotectant between DMSO, PROH and EG were negligible (P > 0.05). This washing did not affect the tissue integrity or significantly elevate the percentage of AC3 and γH2AX positive cells, indicating that tissues are safe and of good quality for transplantation. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Since the study was performed with ovarian tissues from bovines, generalizability to humans may be limited. Potential changes in ovarian tissue beyond 120 min were not investigated. WIDER IMPLICATIONS OF THE FINDINGS This study addresses concerns about the cytotoxicity of EG in warmed ovarian tissues and could provide insights when devising a standard vitrification protocol for OTC. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by a Grant-in-Aid for Scientific Research (B) from the Japan Society for the Promotion of Science to N.S.
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Affiliation(s)
- Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Lingbo Meng
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Sandy Nishimura
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Sayako Furuyama
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Atsushi Uekawa
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Akiko Tozawa-Ono
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Junko Migitaka-Igarashi
- Department of Anatomy, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
- Center for Reproductive Medicine, Dokkyo Medical University, Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Hibiki Seino
- Department of Pathology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yasunori Natsuki
- Graduate School Facility of Electron Microscope Research, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Manabu Kubota
- Department of Pathology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Junki Koike
- Department of Anatomy, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Keisuke Edashige
- Faculty of Agriculture and Marine Science, Department of Agricultural Chemistry, Kochi University, Nankoku, Kochi, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
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High cryo-resistance of SARS-CoV-2 virus: Increased risk of re-contamination at transplantation of cryopreserved ovarian tissue after COVID-19 pandemic. Cryobiology 2021; 103:1-6. [PMID: 34571024 PMCID: PMC8463116 DOI: 10.1016/j.cryobiol.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/16/2022]
Abstract
Cryopreservation and re-transplantation of ovarian tissue after anticancer treatment is important medical technology. Today, during a pandemic, the risk of contamination of transplanted cells with SARS-CoV-2 virus is extremely high. Data about cryo-resistance (virulence and/or infectivity) of SARS-CoV-2 are limited. Analysis and systematization of literature data allow us to draw the following conclusions: 1) The cytoplasmic membrane of somatic cell, like envelope of corona viruses, consists of lipid bilayer and this membrane, like envelope of corona virus, contains membrane proteins. Thus, we can consider the cytoplasmic membrane of an ordinary somatic cell as a model of the envelope membrane of SARS-CoV-2. It is expected that the response of the virus to cryopreservation is similar to that of a somatic cell. SARS-CoV-2 is more poor-water and more protein-rich than somatic cell, and this virus is much more cryo-resistant. 2) The exposure of somatic cells at low positive temperatures increases a viability of these cells. The safety of the virus is also in direct proportion to the decrease in temperature: the positive effect of low temperatures on SARS-CoV-2 virus has been experimentally proven. 3) Resistance of SARS-CoV-2 to cryoprotectant-free cryopreservation is extremely high. The high viability rate of SARS-CoV-2 after freezing-drying confirms its high cryo-resistance. 4) The risk of SARS-CoV-2 infection after transplantation of cryopreserved ovarian tissues that have been contaminated with this virus, increases significantly. Our own experimental data on the increase in the viability of cancer cells after cryopreservation allow us to formulate a hypothesis about increasing of viability (virulence and/or infectivity) of SARS-CoV-2 virus after cryopreservation.
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Cheng J, Ruan X, Zhou Q, Li Y, Du J, Jin F, Gu M, Mueck AO. Long-time low-temperature transportation of human ovarian tissue before cryopreservation. Reprod Biomed Online 2021; 43:172-183. [PMID: 34183267 DOI: 10.1016/j.rbmo.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/21/2021] [Accepted: 05/01/2021] [Indexed: 02/08/2023]
Abstract
RESEARCH QUESTION Can the low-temperature transport time of removed human ovarian tissue be prolonged until cryopreservation? DESIGN Fresh ovarian cortex from nine premenopausal patients was either slow-frozen immediately or stored at 4°C for 24 or 48 h before slow-freezing. The fresh and frozen-thawed biopsies were evaluated by follicle counting via calcein staining, histologic analyses via haematoxylin and eosin staining, and apoptosis via terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling (TUNEL). The fresh cortex was assessed by reactive oxygen species (ROS) and total antioxidant capacity (TAC) assay to detect oxidative stress. The frozen-thawed cortex biopsies were also evaluated by quantitative PCR for messenger RNA (mRNA) expression of BCL-2, BAX, TNFa, HIF-1a, BMP15 and GDF9, and Western blot for detection of BCL-2, BMP15, GDF9 and CASPASE-3. The frozen-thawed cortex was cultured in vitro for 4 days, anti-Müllerian hormone and glucose were assessed in the supernatant, and ROS and TAC assay detected any oxidative stress in the cortex. RESULTS In the fresh cortex, there were no significant differences between the three groups. In the frozen-thawed cortex, there were no significant differences between the three groups regarding follicle viability, TUNEL, mRNA expression of TNFa, HIF-1a or BMP15. GDF9 mRNA and BAX/BCL-2 were lower and higher at 48 h than at 0 h, respectively. However, the protein expression of BCL-2, CASPASE-3, GDF9 and BMP15 were no different. In the cultured cortex, ROS, TAC and glucose uptake were no different across the three groups. CONCLUSION Ovarian tissue transportation was validated for 24 h in the procedure used in clinical practice. This study showed that 4-8°C transportation for 24 or 48 h does not seem to damage the ovarian tissue. However, ovarian tissue transportation beyond 48 h needs to be further studied for conclusions to be made.
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Affiliation(s)
- Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China; Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tubingen, Tubingen D-72076, Germany.
| | - Qi Zhou
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Yanglu Li
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Fengyu Jin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Muqing Gu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Alfred Otto Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China; Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tubingen, Tubingen D-72076, Germany
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Chen J, Todorov P, Isachenko E, Rahimi G, Mallmann P, Isachenko V. Construction and cryopreservation of an artificial ovary in cancer patients as an element of cancer therapy and a promising approach to fertility restoration. HUM FERTIL 2021; 25:651-661. [PMID: 33648431 DOI: 10.1080/14647273.2021.1885756] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The proportion of cancer patients that survive is increasing because of improvements in cancer therapy. However, some cancer treatments, such as chemo- and radio-therapies, can cause considerable damage to reproductive function. The issue of fertility is paramount for women of childbearing age once they are cured from cancer. For those patients with prepubertal or haematogenous cancer, the possibilities of conventional fertility treatments, such as oocyte or embryo cryopreservation and transplantation, are limited. Moreover, ovarian tissue cryopreservation as an alternative to fertility preservation has limitations, with a risk of re-implanting malignant cells in patients who have recovered from potentially fatal malignant disease. One possible way to restore fertility in these patients is to mimic artificially the function of the natural organ, the ovary, by grafting isolated follicles embedded in a biological scaffold to their native environment. Construction and cryopreservation of an artificial ovary might offer a safer alternative option to restore fertility for those who cannot benefit from traditional fertility preservation techniques. This review considers the protocols for constructing an artificial ovary, summarises advances in the field with potential clinical application, and discusses future trends for cryopreservation of these artificial constructions.
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Affiliation(s)
- Jing Chen
- University Maternal Hospital, Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, Cologne University, Cologne, Germany
| | - Plamen Todorov
- Institute of Biology and Immunology of Reproduction, Sofia, Bulgaria
| | - Evgenia Isachenko
- University Maternal Hospital, Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, Cologne University, Cologne, Germany
| | - Gohar Rahimi
- University Maternal Hospital, Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, Cologne University, Cologne, Germany
| | - Peter Mallmann
- University Maternal Hospital, Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, Cologne University, Cologne, Germany
| | - Vladimir Isachenko
- University Maternal Hospital, Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, Cologne University, Cologne, Germany
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New method of FACS analyzing and sorting of intact whole ovarian fragments (COPAS) after long time (24 h) cooling to 5 °C before cryopreservation. Cell Tissue Bank 2021; 22:487-498. [PMID: 33486657 PMCID: PMC8426248 DOI: 10.1007/s10561-020-09898-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/27/2020] [Indexed: 01/01/2023]
Abstract
As recently announced by the American Society for Reproductive Medicine (ASRM), human ovarian tissue cryopreservation is an established option for fertility preservation in prepubertal girls and young women undergoing gonadotoxic treatments for cancer as well as some autoimmune diseases. Proper ovarian tissue assessment before and after cryopreservation is essential to increase success rates. Ovarian fragments from 16 patients were divided into small pieces in form of cortex with medulla, and randomly divided into the following two groups. Pieces of Group 1 (n = 16) were frozen immediately after operation, thawed and just after thawing their quality was analyzed. Group 2 pieces (n = 16) after operation were cooled to 5 °C for 24 h, then frozen after 24 h pre-cooling to 5 °C, thawed and just after thawing their quality was analyzed. The effectiveness of the pre-freezing cooling of tissue was evaluated by the development and viability of follicles (Calcein-AM and Propidium Iodide) using complex object parametric analyzer and sorter machine (COPAS). Positive effect of cooling of cells to low supra-zero temperatures on their future development after re-warming has been observed. New flow cytometry- technique is suitable for the evaluation and sorting of cryopreserved whole human whole intact ovarian fragments. Long time (24 h) cooling of ovarian tissue to 5 °C before cryopreservation has a trend of a cell viability increasing.
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Abstract
Cryopreserved ovarian cortex tissue can be used to improve or restore female fertility. It can be used for cancer patients to restore fertility after chemotherapy treatment or for social reasons for women who want to postpone their pregnancy wish. In order to preserve ovarian tissue viability in these cases, the tissue needs to be stored by cryopreservation. In this chapter we describe the entire process chain needed to prepare, transport, and cryopreserve human ovarian cortex tissues as well as to subsequently thaw and implant it.
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Vilela JDMV, Dolmans MM, Amorim CA. Ovarian tissue transportation: a systematic review. Reprod Biomed Online 2020; 42:351-365. [PMID: 33288476 DOI: 10.1016/j.rbmo.2020.11.001] [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: 08/04/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/20/2022]
Abstract
In recent years, some countries and fertility preservation networks have started adopting 24 h transportation for ovarian tissue, a practice that has the potential to spread very quickly due to the high costs and bureaucracy involved in the establishment of ovarian tissue cryobanks. While pregnancies and live births have been reported after such long periods of transportation, this, however, remains an empirical procedure. This review aims to prompt reflection on ovarian tissue transport, highlighting the lack of knowledge in humans by providing a counterpoint looking into more than 40 studies published in different animal models. By discussing these studies in animals, the findings of various models can be deciphered, and light shed on the patterns identified. Like the development of different assisted reproductive technology procedures, this is an important step in creating guidelines for future studies on human ovarian tissue transportation.
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Affiliation(s)
| | - Marie-Madeleine Dolmans
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium; Gynecology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christiani Andrade Amorim
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
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Vilela JDMV, Dolmans MM, Maruhashi E, Blackman MCNM, Sonveaux P, Miranda-Vilela AL, Amorim CA. Evidence of metabolic activity during low-temperature ovarian tissue preservation in different media. J Assist Reprod Genet 2020; 37:2477-2486. [PMID: 32885380 PMCID: PMC7550475 DOI: 10.1007/s10815-020-01935-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/25/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Although ovarian tissue transportation has been validated for up to 24 h, there is no standard protocol to date. We aimed to elucidate how existing media currently used for ovarian tissue transportation affect ovarian tissue metabolism and cell viability. METHODS Cow ovarian fragments were immersed in 0.9% NaCl solution, IVF medium, Leibovitz 15 medium (L-15), or PBS for 1, 4, or 24 h at 4 °C. Media were analyzed for pH, lactate dehydrogenase (LDH) activity, and glucose, pyruvate, and lactate concentrations, while apoptosis was assessed by TUNEL assays in fixed fragments. Viability rates were assessed by flow cytometry (FACS). RESULTS There were lower pH levels in NaCl at all time points compared with other media. LDH activity increased with time and was lowest in NaCl at 1 and 4 h. There was no significant difference in glucose levels, but a significant pyruvate decrease in L-15 and a significant lactate increase in all media. TUNEL showed apoptosis rates ranging from 0 to 5%. FACS showed a mean of 4% necrotic cells and 15-19% apoptotic cells after 1 h of incubation, but less than 1% necrotic cells and 2-6% apoptotic cells after 24 h in all media. CONCLUSION Our results indicate marked metabolic activity in ovarian tissue at 4 °C and suggest that cells use internal sources of energy, which may influence transplantation outcomes. This highlights the importance of better understanding whole tissue dynamics to develop a standard protocol for ovarian tissue transportation. Graphical abstract.
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Affiliation(s)
- Janice de M V Vilela
- 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
| | - 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, 1200, Brussels, Belgium
| | - Emi Maruhashi
- 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
| | - Marine C N M Blackman
- Pôle de Pharmacologie et Thérapeutique, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200, Brussels, Belgium
| | - Pierre Sonveaux
- Pôle de Pharmacologie et Thérapeutique, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200, Brussels, 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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Salama M, Anazodo A, Woodruff TK. Preserving fertility in female patients with hematological malignancies: a multidisciplinary oncofertility approach. Ann Oncol 2019; 30:1760-1775. [PMID: 31418765 DOI: 10.1093/annonc/mdz284] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies that occur in girls and young women and therefore necessitate oncofertility care are acute lymphocytic leukemia, acute myeloid leukemia, non-Hodgkin's lymphoma, and Hodgkin's lymphoma. Aggressive gonadotoxic anticancer regimens including alkylating chemotherapy and total body irradiation are used often in treating girls and young women with hematological malignancies. The risks of gonadotoxicity and subsequent iatrogenic premature ovarian insufficiency and fertility loss depend mainly on the type and stage of the disease, dose of anticancer therapy as well as the age of the patient at the beginning of treatment. To avoid or at least mitigate the devastating complications of anticancer therapy-induced gonadotoxicity, effective and comprehensive strategies that integrate different options for preserving and restoring fertility ranging from established to experimental strategies should be offered before, during, and after chemotherapy or radiotherapy. A multidisciplinary approach that involves strong coordination and collaboration between hemato-oncologists, gynecologists, reproductive biologists, research scientists, and patient navigators is essential to guarantee high standard of care.
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Affiliation(s)
- M Salama
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA
| | - A Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - T K Woodruff
- Department of Obstetrics and Gynecology, Feinberg School of Medicine-Northwestern University, Chicago, USA.
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Liebenthron J, Montag M, Reinsberg J, Köster M, Isachenko V, van der Ven K, van der Ven H, Krüssel JS, von Wolff M. Overnight ovarian tissue transportation for centralized cryobanking: a feasible option. Reprod Biomed Online 2019; 38:740-749. [PMID: 30733076 DOI: 10.1016/j.rbmo.2019.01.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/21/2018] [Accepted: 01/03/2019] [Indexed: 12/11/2022]
Abstract
RESEARCH QUESTION Is overnight transportation of ovarian tissue before cryopreservation in a centralized cryobank from the FertiPROTEKT network feasible? DESIGN Data from 1810 women with cryopreserved ovarian tissue after overnight transportation from December 2000 to December 2017 were analysed with a focus on transportation, tissue activity parameters and pregnancy, and delivery rates after transplantation. RESULTS A total of 92.4% of tissue samples arrived at ideal temperatures of 2-8°C, 0.4% were transported at temperatures lower than ideal and 6.4% were transported at temperatures that were too high, generally due to mishandling of the inlayed cool packs of the transportation boxes. In 62 women, 78 tissue transplantations were carried out. A subgroup of 30 women who underwent a single orthotopic transplantation with fulfilled criteria of a complete follow-up after transplantation until the end of study, a premature ovarian insufficiency after gonadotoxic therapy as well as the absence of pelvic radiation, was further analysed. In this group, transplantations into a peritoneal pocket accounted for 90%. Transplants were still active at 1 year and above after transplantation in 93.3%. Pregnancy and delivery rates were 46.7% and 43.3%, respectively, with one ongoing pregnancy at the end of the study. CONCLUSIONS Overnight transportation for central cryobanking is a feasible concept that results in high reproducible success rates through standardized professional tissue freezing and storage.
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Affiliation(s)
- Jana Liebenthron
- UniCareD, University Cryobank for Assisted Reproductive Medicine and Fertility Protection at UniKiD, University Women's Hospital Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany.
| | - Markus Montag
- Ilabcomm GmbH, Eisenachstr. 34, Augustin 53757 St., Germany
| | - Jochen Reinsberg
- Department of Gynecological Endocrinology and Reproductive Medicine, University Clinic Bonn, Sigmund-Freud-Str. 25, Bonn 53125, Germany
| | - Maria Köster
- KWZ Germany GmbH, Joseph-Schumpeter-Allee 1, Bonn 53227, Germany
| | - Vladimir Isachenko
- Department of Gynecological Endocrinology and Reproductive Medicine, University Clinic Cologne, Kerpener Straße 34, Cologne 50931, Germany
| | - Katrin van der Ven
- MVZ für Frauenheilkunde und IvF-Medizin Bonn GbR, Godesberger Allee 64, Bonn 53175, Germany
| | - Hans van der Ven
- MVZ für Frauenheilkunde und IvF-Medizin Bonn GbR, Godesberger Allee 64, Bonn 53175, Germany
| | - Jan-Steffen Krüssel
- UniCareD, University Cryobank for Assisted Reproductive Medicine and Fertility Protection at UniKiD, University Women's Hospital Düsseldorf, Moorenstr. 5, Düsseldorf 40225, Germany
| | - Michael von Wolff
- University Women's Hospital Bern, Division of Gynecological Endocrinology and Reproductive Medicine, Effingerstrasse 102, Bern 3010, Switzerland
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12
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Schmidt VM, Isachenko E, Rappl G, Rahimi G, Hanstein B, Morgenstern B, Mallmann P, Isachenko V. Construction of human artificial ovary from cryopreserved ovarian tissue: Appearance of apoptosis and necrosis after enzymatic isolation of follicles. Cryobiology 2018; 84:10-14. [DOI: 10.1016/j.cryobiol.2018.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
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13
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Pascolo L, Venturin I, Gianoncelli A, Bortul R, Zito G, Giolo E, Salomé M, Bedolla DE, Altissimo M, Zweyer M, Ricci G. Light element distribution in fresh and frozen–thawed human ovarian tissues: a preliminary study. Reprod Biomed Online 2018; 37:153-162. [DOI: 10.1016/j.rbmo.2018.04.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 12/20/2022]
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14
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Schmidt VM, Isachenko V, Rappl G, Rahimi G, Hanstein B, Morgenstern B, Mallmann P, Isachenko E. Comparison of the enzymatic efficiency of Liberase TM and tumor dissociation enzyme: effect on the viability of cells digested from fresh and cryopreserved human ovarian cortex. Reprod Biol Endocrinol 2018; 16:57. [PMID: 29859539 PMCID: PMC5985056 DOI: 10.1186/s12958-018-0374-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 05/23/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the effectiveness of Tumor Dissociation Enzyme (TDE) on the viability of follicles after digestion of fresh and cryopreserved ovarian cortex fragments (OCFs). METHODS Fresh and thawed OCF from 14 patients (29 ± 6 years), sized 20 to 210 mm3 were randomly distributed into four treatment groups and digested with 16% TDE or 0.05 mg/ml Liberase TM: Group 1, frozen OCF digested with TDE; Group 2, frozen OCF digested with LiberaseTM; Group 3, fresh OCF digested with TDE; and Group 4, fresh OCF digested with Liberase TM. Evaluation of follicle viability was performed under light microscope after staining with Neutral red. For visualization of viable and dead cells under a confocal laser scanning microscope, the follicles were stained with Calcein AM and ethidium homodimer-1. RESULTS The results showed that the number of retrieved follicles was significantly higher (990 vs 487; P < 0.01) in the TDE-treatment group compared to the Liberase TM-group. The presence of intense neutral red stained follicles was significantly higher in Group 1 and Group 3 compared to Group 2 and Group 4 (70.3% ± +/- 6.22 vs 53,1% ± 2.03 and 94.2% ± 6.6 vs 79.1% ± 2.1; P < 0.01). The percentage of Calcein AM stained follicles of class V1 was significantly higher in Group 1 and Group 3 compared to Group 2 and Group 4 (95.97% ± 7.8 vs 87.87% ± 2.4; 97.1% ± 6.8 vs 91.3% ± 2.3; P < 0.01). CONCLUSION The enzymatic digestion of ovarian cortex with TDE provides recovery of a higher number of healthy preantral follicles in contrast to earlier described Liberase TM procedure.
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Affiliation(s)
- Viola Maria Schmidt
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany
| | - Vladimir Isachenko
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany
| | - Gunter Rappl
- Cell Sort Service Department, Center for Molecular Medicine Cologne University (CMMC), Robert Koch Str. 21, 50931, Cologne, Germany
| | - Gohar Rahimi
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany
| | - Bettina Hanstein
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany
| | - Bernd Morgenstern
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany
| | - Peter Mallmann
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany
| | - Evgenia Isachenko
- Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931, Cologne, Germany.
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15
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Kyono K, Hashimoto T, Toya M, Koizumi M, Sasaki C, Shibasaki S, Aono N, Nakamura Y, Obata R, Okuyama N, Ogura Y, Igarashi H. A transportation network for human ovarian tissue is indispensable to success for fertility preservation. J Assist Reprod Genet 2017; 34:1469-1474. [PMID: 28866830 PMCID: PMC5699996 DOI: 10.1007/s10815-017-1022-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/11/2017] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the efficacy of an ovarian tissue transportation network for fertility preservation (FP) for cancer patients in Japan. METHODS PubMed was searched for papers on transportation of human ovarian tissue for FP. We analyzed population, area, number of cancer patients for ovarian tissue cryopreservation (OTC), quality control/assessment and safety, cost of a cryopreservation center for the building for 30 years, and medical fees of cancer patients (operation, cryopreservation, and storage of ovarian tissue). RESULTS More than twenty babies have been born in Denmark and Germany through a transportation system. Up to 400 new patients a year need OTC. The fees for removal, cryopreservation, and storage for 5 years, and transplantation of ovarian tissue are around €5,000, €4,000, and €5,000, respectively. It costs more than €5 million to establish and maintain one cryopreservation center for 30 years. If we have a few cryopreservation centers in Japan, we can cryopreserve 400 patients' ovarian tissue per year by safer slow freezing and maintain quality control/assessment. We need to lighten the patients' burden for easy to use FP by a government subsidy and medical insurance coverage. CONCLUSIONS This model has been termed the Danish model ("the woman stays - the tissue moves"). This is truly patient-centered medicine. We can have maximum effects with the minimum burden. A transportation network like those of Denmark and Germany is the best strategy for FP in Japan. It may be the best system for cancer patients, medical staff, and the Ministry of Health, Labor, and Welfare.
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Affiliation(s)
- K Kyono
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan.
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan.
| | - T Hashimoto
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - M Toya
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - M Koizumi
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - C Sasaki
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - S Shibasaki
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - N Aono
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - Y Nakamura
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - R Obata
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - N Okuyama
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - Y Ogura
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - H Igarashi
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
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16
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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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17
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Nakamura Y, Obata R, Okuyama N, Aono N, Hashimoto T, Kyono K. Residual ethylene glycol and dimethyl sulphoxide concentration in human ovarian tissue during warming/thawing steps following cryopreservation. Reprod Biomed Online 2017. [PMID: 28645837 DOI: 10.1016/j.rbmo.2017.05.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There have been 60 births after transplantation of cryopreserved ovarian tissue: 58 using the slow freezing method, and two using the vitrification method. DMSO and EG are widely used as cryoprotectants. However DMSO is a known epimutagen, and EG has been reported to be toxic in high concentrations. In this study, we measured residual DMSO and EG in ovarian tissue after vitrification and slow freezing. Cryoprotectants remained at a high concentration in the vitrified/warmed ovarian tissue just before transplantation (DMSO: 9.8 mg/g, EG: 9.8 mg/g). We must consider the impact of the cryoprotectants on the mother and the baby.
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Affiliation(s)
- Yusuke Nakamura
- Kyono ART Clinic, 1-1 3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - Ryuichiro Obata
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa, Minatoku, Tokyo, 108-0074, Japan
| | - Noriyuki Okuyama
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa, Minatoku, Tokyo, 108-0074, Japan
| | - Nobuya Aono
- Kyono ART Clinic, 1-1 3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan; Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa, Minatoku, Tokyo, 108-0074, Japan
| | - Tomoko Hashimoto
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa, Minatoku, Tokyo, 108-0074, Japan
| | - Koichi Kyono
- Kyono ART Clinic, 1-1 3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan; Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1, Takanawa, Minatoku, Tokyo, 108-0074, Japan.
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18
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Gastal GDA, Alves BG, Alves KA, Souza MEM, Vieira AD, Varela AS, Figueiredo JR, Feugang JM, Lucia T, Gastal EL. Ovarian fragment sizes affect viability and morphology of preantral follicles during storage at 4°C. Reproduction 2017; 153:577-587. [PMID: 28246309 DOI: 10.1530/rep-16-0621] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/15/2017] [Accepted: 02/28/2017] [Indexed: 01/06/2023]
Abstract
The method of transportation and the conditions imposed on the ovarian tissue are pivotal aspects for the success of ovarian tissue cryopreservation (OTC). The aim of this study was to evaluate the effect of the size of the ovarian tissue (e.g. whole ovary, biopsy size and transplant size) during different times of storage (0, 6, 12 and 24 h) on the structural integrity of equine ovarian tissue transported at 4°C. Eighteen pairs of ovaries from young mares (<10 years old) were harvested in a slaughterhouse and processed to simulate the fragment sizes (biopsy and transplant size groups) or kept intact (whole ovary group) and stored at 4°C for up to 24 h in α-MEM-enriched solution. The effect of the size of the ovarian tissue was observed on the morphology of preantral follicles, stromal cell density, DNA fragmentation and mitochondrial membrane potential. The results showed that (i) biopsy size fragments had more morphologically normal preantral follicles after 24 h of storage at 4°C; (ii) mitochondrial membrane potential was the lowest during each storage time when the whole ovary was used; (iii) DNA fragmentation rate in the ovarian cells of all sizes of fragments increased as storage was prolonged and (iv) transplant size fragments had increased stromal cell density during storage at cool temperature. In conclusion, the biopsy size fragment was the best to preserve follicle morphology for long storage (24 h); however, transportation/storage should be prior determined according to the distance (time of transportation) between patient and reproduction centers/clinics.
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Affiliation(s)
- G D A Gastal
- Department of Animal ScienceFood and Nutrition, Southern Illinois University, Carbondale, Illinois, USA
| | - B G Alves
- Department of Animal ScienceFood and Nutrition, Southern Illinois University, Carbondale, Illinois, USA
| | - K A Alves
- Department of Animal ScienceFood and Nutrition, Southern Illinois University, Carbondale, Illinois, USA
| | - M E M Souza
- Department of Animal ScienceFood and Nutrition, Southern Illinois University, Carbondale, Illinois, USA
| | - A D Vieira
- Laboratory of Animal ReproductionFaculty of Veterinary Medicine
| | - A S Varela
- Institute of Biological SciencesFederal University of Pelotas, Capão do Leão, Rio Grande do Sul, Brazil
| | - J R Figueiredo
- Laboratory of Manipulation of Oocytes and Preantral FolliclesFaculty of Veterinary Medicine, State University of Ceara, Fortaleza, Ceará, Brazil
| | - J M Feugang
- Department of Animal and Dairy SciencesMississippi State University, Mississippi State, Mississippi, USA
| | - T Lucia
- Laboratory of Animal ReproductionFaculty of Veterinary Medicine
| | - E L Gastal
- Department of Animal ScienceFood and Nutrition, Southern Illinois University, Carbondale, Illinois, USA
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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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Isachenko V, Orth I, Isachenko E, Mallmann P, Peters D, Schmidt T, Morgenstern B, Foth D, Hanstein B, Rahimi G. Viability of human ovarian tissue confirmed 5 years after freezing with spontaneous ice-formation by autografting and chorio-allantoic membrane culture. Cryobiology 2013; 66:233-8. [PMID: 23454031 DOI: 10.1016/j.cryobiol.2013.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 02/08/2013] [Accepted: 02/11/2013] [Indexed: 12/20/2022]
Abstract
To achieve optimal and uniform outcomes, slow cooling protocols for human ovarian tissues generally initiate ice formation at high sub-zero temperatures (-6 to -9 °C). The aim of the study was to investigate the function of ovarian tissue that had unintentionally self seeded at -20 °C during the freezing step, by examining its development following chicken embryonic chorioallantoic membrane (CAM) grafting and after transplantation back to the patient. Ovarian tissue was frozen in 6% (v/v) dimethyl sulfoxide, 6% (v/v) ethylene glycol and 0.15M sucrose which had self-seeded at -20 °C. Five years after cryopreservation, 8 pieces were thawed and transplanted back to the patient. Two small (1 × 2 × 1 mm) pieces of this thawed tissue were cultured in a CAM-system for 5 days to assess the tissue viability. The autografted ovarian tissue re-established spontaneous menstrual bleeding within five months and raised serum 17-β Estradiol from 19 to 330 pg/ml. Ultrasound revealed a dominant follicle at the site of the transplanted tissue in the follicular phase after the menstrual bleed. Analysis of the CAM cultured tissue established that 88% of the primordial follicles are degenerated and there was limited in growth of blood vessels. In conclusion, in spite of the damage caused by the cryopreservation with spontaneous ice-formation the viability could be confirmed by CAM culture and the restoration of ovarian function after auto-transplantation.
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Affiliation(s)
- Vladimir Isachenko
- Department of Obstetrics and Gynaecology, University Maternal Hospital, Cologne University, Kerpener Str. 34, 50931 Cologne, Germany.
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