1
|
Marchante M, Barrachina F, Piechota S, Fernandez-González M, Giovannini A, Smith T, Kats S, Paulsen B, González E, Calvente V, Silvan A, Abittan B, Klein J, Klatsky P, Ordonez D, Kramme CC. Donor side effects experienced under minimal controlled ovarian stimulation with in vitro maturation vs. conventional controlled ovarian stimulation for in vitro fertilization treatment. F&S SCIENCE 2024:S2666-335X(24)00029-6. [PMID: 38838957 DOI: 10.1016/j.xfss.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To evaluate oocyte retrieval experiences and side effects under minimally controlled ovarian stimulation (COS) treatment for in vitro maturation (IVM) of oocytes compared with conventional COS treatment. DESIGN A retrospective survey study. SETTING Clinical in vitro fertilization treatment center. PATIENT(S) Data were collected from subjects undergoing minimal COS treatment (n = 110; 600-800 IU follicle-stimulating hormone) for IVM of oocytes and conventional COS treatment for egg donation (n = 48; 1,800-2,600 IU follicle-stimulating hormone) from April 2022 to November 2023. INTERVENTION(S) Minimal and conventional COS treatments. MAIN OUTCOME MEASURE(S) The most common side effects experienced during ovarian stimulation and after oocyte pick-up, satisfaction level, and the likelihood of recommending or repeating minimal or conventional COS. Statistical analysis included Mann-Whitney U test and χ2 tests, with a significance level. RESULT(S) During minimal COS treatment, most subjects did not experience breast swelling (86%), pelvic or abdominal pain (76%), nausea or vomiting (96%), and bleeding (96%). After oocyte pick-up, the majority (75%) reported no pelvic or abdominal pain. The most common side effect was abdominal swelling (52%). Compared with conventional COS cycles, minimal COS subjects reported significantly less postretrieval pain, with 33% experiencing no pain (vs. 6%) and with a reduced severe level of pain (5% vs. 19%), leading to fewer subjects requiring pain medication (25% vs. 54%). Additionally, 85% of women were very satisfied with minimal stimulation treatment and would recommend or repeat the treatment. CONCLUSION(S) Reducing the hormonal dose for ovarian stimulation has a beneficial effect on subjects, suggesting the combination of minimal COS treatment with IVM techniques is a well-tolerated alternative for women who cannot or do not wish to undergo conventionally controlled ovarian hyperstimulation treatment.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Eva González
- Ruber Juan Bravo University Hospital, Eugin Group, Madrid, Spain
| | | | - Ana Silvan
- Ruber Juan Bravo University Hospital, Eugin Group, Madrid, Spain
| | | | | | | | - Daniel Ordonez
- Ruber Juan Bravo University Hospital, Eugin Group, Madrid, Spain
| | | |
Collapse
|
2
|
Dorfman CS, Stalls JM, Shelby RA, Arthur SS, Acharya K, Davidson B, Corbett C, Greenup RA. Impact of Financial Costs on Patients' Fertility Preservation Decisions: An Examination of Qualitative Data from Female Young Adults with Cancer and Oncology Providers. J Adolesc Young Adult Oncol 2024; 13:502-513. [PMID: 38294823 DOI: 10.1089/jayao.2023.0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Purpose: To examine the impact of financial costs on fertility preservation decisions among female young adults (YAs) with cancer. Methods: Female YAs (N = 18; aged 21-36) with a history of cancer and oncology providers (N = 12) were recruited from an National Cancer Institute-designated comprehensive cancer center in a state without insurance coverage for fertility preservation. YAs and providers completed individual interviews and a brief online assessment. Qualitative description using thematic analysis was used to identify, analyze, and report common themes. Descriptive statistics was used to characterize the sample. Results: Female YAs and oncology providers highlighted the critical role that high out-of-pocket costs play in YAs' fertility preservation decisions along with the value that enhanced insurance coverage for fertility preservation would have for increasing female YAs' access to and utilization of fertility preservation. Although providers were concerned about preservation costs for their patients, they reported that their concerns did not impact whether they referred interested female YAs to reproductive specialists. Oncology providers expressed concern about inequities in utilization of fertility preservation for female and racially/ethnically minoritized YAs that were exacerbated by the high out-of-pocket fertility preservation costs. Conclusion: Cost is a significant barrier to fertility preservation for female YA cancer patients. Female YAs of reproductive age may benefit from decision support tools to assist with balancing the cost of fertility preservation with their values and family building goals. Policy-relevant interventions may mitigate cost barriers and improve access to care.
Collapse
Affiliation(s)
- Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, North Carolina, USA
| | - Juliann M Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, North Carolina, USA
| | - Rebecca A Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, North Carolina, USA
| | - Sarah S Arthur
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Kelly Acharya
- Division of Reproductive Endocrinology and Infertility; Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, USA
| | - Brittany Davidson
- Division of Gynecologic Oncology; Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, USA
| | - Cheyenne Corbett
- Supportive Care and Survivorship Center, Duke Cancer Institute, Durham, North Carolina, USA
| | - Rachel A Greenup
- Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
3
|
Ribeiro R, Baiocchi G, Obermair A, Costa CN, Leitao M. Uterine transposition for fertility preservation in pelvic cancers. Int J Gynecol Cancer 2024; 34:403-408. [PMID: 38438174 DOI: 10.1136/ijgc-2023-004992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE To review rates of uterine preservation and gonadal function, surgical outcomes, and pregnancy outcomes in patients undergoing surgical uterine transposition. METHODS A structured search and analysis of the published literature on uterine transposition was conducted. Information on study type, sample size, patient characteristics, clinical indications, details of the surgical technique, trans-operative and post-operative results, success rates in preserving reproductive organ function and fertility were extracted. RESULTS A total of 18 cases were reported to date. Patients' median age was 29 (range 3-38) years. Rectal cancers accounted for 9 (50%) cases of published cases of uterine transposition, followed by 6 (33%) cervical squamous cell carcinomas, 1 (6%) vaginal squamous cell carcinoma, 1 (6%) sacral yolk sac tumor, and 1 (6%) pelvic liposarcoma. The median time for uterine transposition to the upper abdomen was 150 (range 80-360) min, and 90 (range 80-310) min for organ reimplantation in the pelvis. Cervical ischemia occurred in 5 (27.8%) cases, being the most commonly reported complication. The median follow-up time was 25 months, and three patients achieved spontaneous pregnancies resulting in successful gestations, out of five patients who were reported as having tried. One patient experienced recurrence and succumbed to the tumor during treatment. CONCLUSIONS Uterine transposition is a feasible and safe surgical approach that offers patients undergoing pelvic radiotherapy an option to preserve gonadal and uterine function, with the potential for spontaneous pregnancy.
Collapse
Affiliation(s)
- Reitan Ribeiro
- Department of Gynecologic Oncology, Hospital Erasto Gaertner, Curitiba, Parana, Brazil
| | - Glauco Baiocchi
- Department of Gynecologic Oncology, ACCamargo Cancer Center, Sao Paulo, São Paulo, Brazil
| | - Andreas Obermair
- Queensland Centre for Gynaecological Cancer, Herston/Brisbane, Queensland, Australia
| | | | - Mario Leitao
- Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
4
|
Dantkale KS, Agrawal M. A Comprehensive Review of Current Trends in the Diagnosis and Treatment of Ovarian Germ Cell Tumors. Cureus 2024; 16:e52650. [PMID: 38380211 PMCID: PMC10877227 DOI: 10.7759/cureus.52650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/20/2024] [Indexed: 02/22/2024] Open
Abstract
Ovarian germ cell tumors constitute a rare and intricate spectrum of neoplasms characterized by diverse histological subtypes. This comprehensive review elucidates the classification, diagnosis, treatment, prognosis, and unique challenges associated with these tumors. The classification is rooted in histological attributes, with principal subtypes encompassing dysgerminoma, immature teratoma, yolk sac tumor (endodermal sinus tumor), choriocarcinoma, and mixed germ cell tumors. Each subtype bears distinct characteristics and clinical implications, necessitating precise diagnosis and tailored therapeutic strategies. Diagnosis hinges upon recognizing the broad clinical presentation, employing imaging techniques (such as ultrasound and MRI), evaluating tumor markers (alpha-fetoprotein and beta-human chorionic gonadotropin), and conducting histopathological examinations where necessary. Staging, primarily utilizing the International Federation of Gynecology and Obstetrics (FIGO) system, is pivotal in determining the extent of disease, guiding treatment choices, and facilitating prognostic assessment. Treatment modalities encompass surgery, chemotherapy (including standard regimens and emerging therapies), radiation therapy, targeted therapies, and immunotherapy. Prognosis is influenced by histological subtype, tumor stage, patient age, surgical success, response to chemotherapy, and tumor markers, while predictive biomarkers are continually emerging. Despite advances in treatment, ovarian germ cell tumors pose distinct challenges, including late diagnosis, treatment-related side effects, and the enigma of chemoresistance. An integral aspect of comprehensive care is supportive strategies to manage symptoms and offer psychological and emotional support. This review accentuates the vital role of early diagnosis and multidisciplinary care in optimizing outcomes. Future research directions and evolving clinical practices are explored in these intricate and distinctive malignancies, highlighting the dynamic landscape of ovarian germ cell tumors.
Collapse
Affiliation(s)
- Ketki S Dantkale
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research (DMIHER), Wardha, IND
| | - Manjusha Agrawal
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research (DMIHER), Wardha, IND
| |
Collapse
|
5
|
Dahmardeh T, Ghanian MH, Ebrahimi B. A self-gelling hydrogel based on thiolated hyaluronic acid for three-dimensional culture of ovine preantral follicles. Int J Biol Macromol 2023; 253:127147. [PMID: 37778594 DOI: 10.1016/j.ijbiomac.2023.127147] [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: 06/02/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/03/2023]
Abstract
Three-dimensional (3D) ovarian follicle culture offers a promising option for fertility preservation in patients who cannot receive ovarian tissue transplantation. Our research evaluated the potential of a hydrogel composed of thiolated hyaluronic acid (HA-SH) for ovine preantral follicle development compared to routinely used alginate hydrogel (ALG). Synthesized via a carbodiimide reaction, HA-SH facilitated a self-crosslinking hydrogel through disulfide bond formation. Ovine preantral follicles (200-300 μm) retrieved through mechanical and enzymatic methods were encapsulated individually in either ALG or HA-SH hydrogels. Although both hydrogels adequately supported follicle survival, 3D integrity, and antrum formation over a 17-day in vitro culture, follicle growth was significantly higher within the HA-SH hydrogel. Gene expression analysis underscored that some folliculogenesis-related genes (ZP3, BMP7, and GJA1) and a steroidogenic gene (CYP19A1) demonstrated higher expression levels in HA-SH encapsulated follicles versus ALG. Collectively, our findings advocate for HA-SH hydrogel as a potent biomaterial for in vitro follicle cultures, attributing its efficacy to facile gelation, bio-responsiveness, and superior support for follicle growth.
Collapse
Affiliation(s)
- Tayebeh Dahmardeh
- Department of Reproductive Biology, Faculty of Basic Science and Advanced Medical Technologies, Royan Institute, ACECR, Tehran, Iran; Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Hossein Ghanian
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
| | - Bita Ebrahimi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| |
Collapse
|
6
|
Dong Y, Yue Z, Zhuang H, Zhang C, Fang Y, Jiang G. The experiences of reproductive concerns in cancer survivors: A systematic review and meta-synthesis of qualitative studies. Cancer Med 2023; 12:22224-22251. [PMID: 38069669 PMCID: PMC10757101 DOI: 10.1002/cam4.6531] [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: 06/13/2023] [Revised: 08/30/2023] [Accepted: 09/02/2023] [Indexed: 12/31/2023] Open
Abstract
AIM The aim of this study was to synthesize qualitative research evidence on cancer survivors' experiences with reproductive concerns (RC). METHODS We conducted a systematic search of qualitative studies and utilized the meta-aggregation approach. The database searches were extended up to May 14, 2023, encompassing 12 databases, specifically MEDLINE, CINAHL, PubMed, EMBASE, Scopus, Web of Science (Core Collection), AMED, PsycINFO, The Cochrane Library, CNKI, Wan Fang Data, and VIP. RESULTS Three overarching themes were synthesized from the analysis of 21 studies that explored cancer patients' awareness of reproductive concerns, their perceptions, needs, and coping styles. These themes encapsulate the multifaceted aspects of cancer patients' reproductive concerns: "Gender differences in fertility concerns among cancer patients: Perspectives from men and women"; "The influence of age: Experiences with fertility issues among cancer patients at different life stages"; "The impact of treatment stages on fertility concerns: The evolution of perception and coping strategies in the course of cancer treatment". CONCLUSION Our study presents an in-depth exploration of the reproductive concerns experienced by cancer patients from various perspectives. We found that the internal experiences of reproductive concerns, their perceptions, needs, and coping mechanisms differ based on their roles. This comprehensive understanding of the complex emotions and needs of cancer patients when confronted with fertility issues can guide clinicians in providing more effective medical assistance, psychological counseling, and fertility-related information services.
Collapse
Affiliation(s)
- Ying Dong
- LiaoNing Cancer Hospital & Institute, DaLian Medical University School of NursingShenyangChina
| | - Zhenyu Yue
- LiaoNing Cancer Hospital & InstituteShenyangChina
| | - Huan Zhuang
- Third Department of GynecologyLiaoNing Cancer Hospital & InstituteShenyangChina
| | - Chen Zhang
- DaLian Medical University School of NursingDalianChina
| | - Yu Fang
- DaLian Medical University School of NursingDalianChina
| | - Guichun Jiang
- Clinical Skills Training CenterLiaoNing Cancer Hospital & InstituteShenyangChina
| |
Collapse
|
7
|
Bewtra C, Acharya N. Preservation of Fertility in Cancer Patients: A Narrative Review. Cureus 2023; 15:e47910. [PMID: 38034134 PMCID: PMC10684029 DOI: 10.7759/cureus.47910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/29/2023] [Indexed: 12/02/2023] Open
Abstract
The survival rates for cancer patients have been steadily improving in recent years due to the improved efficacy of contemporary oncological care, including radiotherapy and chemotherapy. Modern technology makes it feasible to maintain fertility in cancer patients, and this practice needs to be included in oncological care. In many instances, it is impossible to avoid the harm that cancer treatments can cause to a patient's fertility; hence, research in fertility preservation techniques is being conducted to allow cancer patients to have future children biologically related to them. The development of fertility preservation approaches has grown in importance in the field of research over the past few years to increase patient's quality of life and survival. Oncologists must be aware of circumstances in which cancer patients' fertility will be impacted by their therapy and the avenues open for procedures like cryopreservation of the gametes or embryos. When cancer therapy is scheduled, all patients should receive prompt and thorough information on the fertility-related side effects of treatment and the prospects for fertility preservation. The article analyzes the literature, enlisting the factors that contribute to cancer and their effects on fertility, followed by a list of available and newly developed strategies for maintaining fertility in patients. The efficiency of the various fertility preservation techniques following cancer therapy is also discussed.
Collapse
Affiliation(s)
- Chehak Bewtra
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| | - Neema Acharya
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
| |
Collapse
|
8
|
Zheng J, Tang X, Han TL, Zhang C, Zhang S. Metabolomics analysis of serum metabolites during endometrial transformation: association with recurrent implantation failure in hormonal replacement therapy-frozen embryo transfers cycles. J Assist Reprod Genet 2023; 40:2473-2483. [PMID: 37568040 PMCID: PMC10504182 DOI: 10.1007/s10815-023-02904-x] [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: 03/21/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate alterations in serum metabolites during endometrial transformation and possible associations with recurrent implantation failure (RIF) in hormonal replacement therapy (HRT)-frozen embryo transfer (FET) cycles. METHODS We performed a prospective study involving 100 patients scheduled for HRT-FET cycles during January 2022 to April 2022. Blood serum samples were collected on the day of progesterone administration (dPA) and on the third day of progesterone administration (d3PA). Gas chromatography-mass spectrometry (GC-MS) analysis was performed to identify and quantify serum metabolites. A nested case-control study including 19 RIF patients and 19 matching controls was conducted to explore the predictive value of serum metabolites for RIF. Partial least squares discriminant analysis (PLS-DA) and receiver operating characteristic (ROC) curve analysis were performed to establish prediction models. MAIN RESULTS We identified 105 serum metabolites, with 76 of them exhibiting significant alterations during the initial 3 days of endometrial transformation. Metabolites involved in amino acid metabolism and tricarboxylic acid (TCA) cycle showed lower levels during endometrial transformation. In the nested case-control study, the prediction model based on the ratio of serum metabolites between d3PA and dPA showed the highest area under the ROC curve (AUC), accuracy, and R2 and Q2 values. Eight metabolites, including indol-3-propionic acid, beta-alanine, myristoleic acid, malic acid, indole, DL-isocitric acid, proline, and itaconic acid, exhibited high predictive values for RIF. CONCLUSION This study demonstrates alterations in serum metabolites during endometrial transformation, particularly in amino acid metabolism and TCA cycle. The identified metabolites, especially indol-3-propionic acid and malic acid, show potential as predictive markers for RIF. These findings contribute to a better understanding of the metabolic changes associated with endometrial receptivity and provide insights for the development of personalized approaches to improve implantation outcomes in FET cycles.
Collapse
Affiliation(s)
- Jie Zheng
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, No. 288 Tianwen Avenue, Nanan District, Chongqing, 400010, People's Republic of China
| | - Xianglan Tang
- Prenatal Diagnosis Center, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Ting-Li Han
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, No. 288 Tianwen Avenue, Nanan District, Chongqing, 400010, People's Republic of China
- Joint International Research Lab for Reproduction and Development of Ministry of Education of China, Chongqing Medical University, Chongqing, 400010, China
- Mass Spectrometry Centre of Maternal-Fetal Medicine, Chongqing Medical University, Chongqing, 400010, China
| | - Chanyu Zhang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, No. 288 Tianwen Avenue, Nanan District, Chongqing, 400010, People's Republic of China
- Joint International Research Lab for Reproduction and Development of Ministry of Education of China, Chongqing Medical University, Chongqing, 400010, China
| | - Shen Zhang
- The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, No. 288 Tianwen Avenue, Nanan District, Chongqing, 400010, People's Republic of China.
- Joint International Research Lab for Reproduction and Development of Ministry of Education of China, Chongqing Medical University, Chongqing, 400010, China.
| |
Collapse
|
9
|
Albamonte MI, Calabró LY, Albamonte MS, Vitullo AD. FOXO3 and PTEN expression in the ovary of girls with extra-gonadal cancer with or without chemotherapy treatment prior to cryopreservation. BMC Womens Health 2023; 23:509. [PMID: 37737182 PMCID: PMC10515424 DOI: 10.1186/s12905-023-02648-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND FOXO3/pFOXO3 and PTEN expression is known to regulate the dormancy/activation of ovarian primordial follicles. How chemotherapy could influence the expression of FOXO3 and PTEN in pre- and post-menarcheal girls with extra-gonadal cancer remains unexplored. METHODS Ovarian samples were collected from 27 girls suffering from extra-gonadal cancer. Of these, 8 patients had received chemotherapy before the time of sample collection. Ovarian tissue collected at the time of surgery was fixed in 10% formaldehyde for FOXO3/pFOXO3 and PTEN immunohistochemistry or immunofluorescence, or stored at -80 °C for Western blot, or preserved in RNA later for RT-PCR. RESULTS PTEN was detected in a limited number of primordial follicle-enclosed oocytes in approximately fifty percent of the patients, regardless of whether they had received anti-cancer treatment or not. However, there was a significant decrease in PTEN detection in patients who underwent chemotherapy treatment prior to the retrieval of the sample. Both primordial follicle-enclosed oocytes that expressed FOXO3 and those that did not were identified in patients who were treated with chemotherapy and those who were not. FOXO3-positive primordial follicles exhibited either nuclear FOXO3 localization or cytoplasmic pFOXO3 localization. Furthermore, transitional primordial follicles that expressed nuclear FOXO3 and cytoplasmic pFOXO3 were also observed. Primary follicle-enclosed oocytes displayed cytoplasmic pFOXO3 localization, whereas in more advanced stages of folliculogenesis, the expression moved to the somatic stratum. No significant statistical differences were identified in the detection of FOXO3 and pFOXO3 in patients who had or had not received chemotherapy prior to sample collection. CONCLUSION Primordial follicles expressing and not expressing FOXO3 were equally present in both the ovaries of patients who underwent chemotherapy and those who did not. The expression of FOXO3 remained unaltered in response to chemotherapy treatment. Notably, the detection of PTEN was significantly reduced in the treated patients, thereby warranting in-depth investigation, given the limited sample size examined in the present study.
Collapse
Affiliation(s)
- María Itatí Albamonte
- Centro de Estudios Biomédicos Básicos, Aplicados y Desarrollo -CEBBAD, Universidad Maimónides, Hidalgo 775, C1405BCK, Buenos Aires, Argentina
| | - Lara Y Calabró
- Centro de Estudios Biomédicos Básicos, Aplicados y Desarrollo -CEBBAD, Universidad Maimónides, Hidalgo 775, C1405BCK, Buenos Aires, Argentina
| | - Mirta S Albamonte
- Centro de Estudios Biomédicos Básicos, Aplicados y Desarrollo -CEBBAD, Universidad Maimónides, Hidalgo 775, C1405BCK, Buenos Aires, Argentina
| | - Alfredo D Vitullo
- Centro de Estudios Biomédicos Básicos, Aplicados y Desarrollo -CEBBAD, Universidad Maimónides, Hidalgo 775, C1405BCK, Buenos Aires, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, Buenos Aires, Argentina.
| |
Collapse
|
10
|
Najafi A, Asadi E, Benson JD. Ovarian tissue cryopreservation and transplantation: a review on reactive oxygen species generation and antioxidant therapy. Cell Tissue Res 2023; 393:401-423. [PMID: 37328708 DOI: 10.1007/s00441-023-03794-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023]
Abstract
Cancer is the leading cause of death worldwide. Fortunately, the survival rate of cancer continues to rise, owing to advances in cancer treatments. However, these treatments are gonadotoxic and cause infertility. Ovarian tissue cryopreservation and transplantation (OTCT) is the most flexible option to preserve fertility in women and children with cancer. However, OTCT is associated with significant follicle loss and an accompanying short lifespan of the grafts. There has been a decade of research in cryopreservation-induced oxidative stress in single cells with significant successes in mitigating this major source of loss of viability. However, despite its success elsewhere and beyond a few promising experiments, little attention has been paid to this key aspect of OTCT-induced damage. As more and more clinical practices adopt OTCT for fertility preservation, it is a critical time to review oxidative stress as a cause of damage and to outline potential ameliorative interventions. Here we give an overview of the application of OTCT for female fertility preservation and existing challenges; clarify the potential contribution of oxidative stress in ovarian follicle loss; and highlight potential ability of antioxidant treatments to mitigate the OTCT-induced injuries that might be of interest to cryobiologists and reproductive clinicians.
Collapse
Affiliation(s)
- Atefeh Najafi
- Department of Biology, University of Saskatchewan, S7N 5E2, Saskatoon, SK, Canada
| | - Ebrahim Asadi
- Department of Biology, University of Saskatchewan, S7N 5E2, Saskatoon, SK, Canada
| | - James D Benson
- Department of Biology, University of Saskatchewan, S7N 5E2, Saskatoon, SK, Canada.
| |
Collapse
|
11
|
Close A, Burns K, Bjornard K, Webb M, Chavez J, Chow EJ, Meacham L. Fertility preservation in pediatric leukemia and lymphoma: A report from the Children's Oncology Group. Pediatr Blood Cancer 2023; 70:e30407. [PMID: 37194406 PMCID: PMC10525075 DOI: 10.1002/pbc.30407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/18/2023]
Abstract
Certain chemotherapy agents, radiation, and surgery can all negatively impact future fertility. Consults regarding treatment-related risk for infertility and gonadal late effects of these agents should occur at the time of diagnosis as well as during survivorship. Counseling on fertility risk has traditionally varied significantly across providers and institutions. We aim to provide a guide to standardize the assignment of gonadotoxic risk, which can be used in counseling patients both at the time of diagnosis and in survivorship. Gonadotoxic therapies were abstracted from 26 frontline Children's Oncology Group (COG) phase III protocols for leukemia/lymphoma, in use from 2000-2022. A stratification system based on gonadotoxic therapies, sex, and pubertal status was used to assign treatments into minimal, significant, and high level of increased risk for gonadal dysfunction/infertility. Risk levels were assigned to protocols and different treatment arms to aid oncologists and survivor care providers in counseling patients regarding treatment-related gonadotoxicity. Males were most commonly at high risk, with at least one high-risk arm in 14/26 protocols (54%), followed by pubertal females (23% of protocols) and prepubertal females (15% of protocols). All patients who received direct gonadal radiation or hematopoietic stem cell transplant (HSCT) were considered at high risk. Partnering with patients and their oncology/survivorship team is imperative for effective fertility counseling both prior to and post treatment, and this comprehensive guide can be used as a tool to standardize and improve reproductive health counseling in patients undergoing COG-based leukemia/lymphoma care.
Collapse
Affiliation(s)
- Allison Close
- Helen DeVos Children’s Hospital, Division of Hematology/Oncology, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Karen Burns
- Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Kari Bjornard
- Department of Pediatrics, Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, IN, USA; Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | - Martine Webb
- University of California, Los Angeles, Division of Internal Medicine, Los Angeles, CA, USA
| | - Josuah Chavez
- Helen DeVos Children’s Hospital, Division of Hematology/Oncology, Grand Rapids, MI, USA
| | - Eric J. Chow
- Fred Hutchinson Cancer Center, Seattle Children’s Hospital, Seattle, WA, USA
| | - Lillian Meacham
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Pediatric Hematology/Oncology/BMT, Emory University Atlanta, GA USA
| |
Collapse
|
12
|
Parihar A, Kumar A, Panda U, Khan R, Parihar DS, Khan R. Cryopreservation: A Comprehensive Overview, Challenges, and Future Perspectives. Adv Biol (Weinh) 2023; 7:e2200285. [PMID: 36755194 DOI: 10.1002/adbi.202200285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/05/2023] [Indexed: 02/10/2023]
Abstract
Cryopreservation is the most prevalent method of long-term cell preservation. Effective cell cryopreservation depends on freezing, adequate storage, and correct thawing techniques. Recent advances in cryopreservation techniques minimize the cellular damage which occurs while processing samples. This article focuses on the fundamentals of cryopreservation techniques and how they can be implemented in a variety of clinical settings. The article presents a brief description of each of the standard cryopreservation procedures, such as slow freezing and vitrification. Alongside that, the membrane permeating and nonpermeating cryoprotectants are briefly discussed, along with current advancements in the field of cryopreservation and variables influencing the cryopreservation process. The diminution of cryoinjury incurred by the cell via the resuscitation process will also be highlighted. In the end application of cryopreservation techniques in many fields, with a special emphasis on stem cell preservation techniques and current advancements presented. Furthermore, the challenges while implementing cryopreservation and the futuristic scope of the fields are illustrated herein. The content of this review sheds light on various ways to enhance the output of the cell preservation process and minimize cryoinjury while improving cell revival.
Collapse
Affiliation(s)
- Arpana Parihar
- Industrial Waste Utilization, Nano and Biomaterials, CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal, Madhya Pradesh, 462026, India
| | - Avinash Kumar
- Department of Mechanical Engineering, Indian Institute of Information Technology, Design & Manufacturing (IIITD&M), Kancheepuram, 600127, India
| | - Udwesh Panda
- Department of Mechanical Engineering, Indian Institute of Information Technology, Design & Manufacturing (IIITD&M), Kancheepuram, 600127, India
| | - Rukhsar Khan
- Department of Biosciences, Barkatullah University, Bhopal, Madhya Pradesh, 462026, India
| | | | - Raju Khan
- Industrial Waste Utilization, Nano and Biomaterials, CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal, Madhya Pradesh, 462026, India
| |
Collapse
|
13
|
Han E, Seifer DB. Oocyte Cryopreservation for Medical and Planned Indications: A Practical Guide and Overview. J Clin Med 2023; 12:jcm12103542. [PMID: 37240648 DOI: 10.3390/jcm12103542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Oocyte cryopreservation (OC) is the process in which ovarian follicles are stimulated, the follicular fluid is retrieved, and mature oocytes are isolated and vitrified. Since the first successful pregnancy utilizing previously cryopreserved oocytes in 1986, OC has become increasingly utilized as an option for future biologic children in patients facing gonadotoxic therapies, such as for the treatment of cancer. Planned OC, also termed elective OC, is growing in popularity as a means to circumvent age-related fertility decline. In this narrative review, we describe both medically indicated and planned OC, focusing on the physiology of ovarian follicular loss, OC technique and risks, timing of when OC should be performed, associated financial considerations, and outcomes.
Collapse
Affiliation(s)
- Eric Han
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| | - David B Seifer
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| |
Collapse
|
14
|
Castiglione Morelli MA, Iuliano A, Matera I, Viggiani L, Schettini SCA, Colucci P, Ostuni A. A Pilot Study on Biochemical Profile of Follicular Fluid in Breast Cancer Patients. Metabolites 2023; 13:metabo13030441. [PMID: 36984881 PMCID: PMC10054828 DOI: 10.3390/metabo13030441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
Breast cancer (BC) is the most common type of cancer among women in almost all countries worldwide and is one of the oncological pathologies for which is indicated fertility preservation, a type of procedure used to help keep a person's ability to have children. Follicular fluid (FF) is a major component of oocyte microenvironment, which is involved in oocyte growth, follicular maturation, and in communication between germ and somatic cells; furthermore, it accumulates all metabolites during oocytes growth. To obtain information about changes on fertility due to cancer, we aimed at investigating potential biomarkers to discriminate between FF samples obtained from 16 BC patients and 10 healthy women undergoing in vitro fertilization treatments. An NMR-based metabolomics approach was performed to investigate the FF metabolic profiles; ELISA and western blotting assays were used to investigate protein markers of oxidative and inflammatory stress, which are processes closely related to cancer. Our results seem to suggest that FFs of BC women display some significant metabolic alterations in comparison to healthy controls, and these variations are also related with tumor staging.
Collapse
Affiliation(s)
| | - Assunta Iuliano
- Center for Reproductive Medicine of "San Carlo" Hospital, 85100 Potenza, Italy
| | - Ilenia Matera
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| | - Licia Viggiani
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| | | | - Paola Colucci
- Center for Reproductive Medicine of "San Carlo" Hospital, 85100 Potenza, Italy
| | - Angela Ostuni
- Department of Sciences, University of Basilicata, 85100 Potenza, Italy
| |
Collapse
|
15
|
Ahmed Y, Khan AMH, Rao UJ, Shaukat F, Jamil A, Hasan SM, Abrar S, Qureshi BM, Abbasi AN. Fertility preservation is an imperative goal in the clinical practice of radiation oncology: a narrative review. Ecancermedicalscience 2022; 16:1461. [PMID: 36819826 PMCID: PMC9934885 DOI: 10.3332/ecancer.2022.1461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Indexed: 02/24/2023] Open
Abstract
With reduced cancer mortality in recent years, increased efforts must be put into safeguarding cancer survivors' long-term quality of life (QOL). Fertility preservation is recognised as a key component of QOL in survivorship. Concerns about fertility have been seen to significantly impact cancer patients' emotional and mental health as, generally, both malignancy and its treatment may cause a temporary or permanent reduction in infertility. This article reviews the primary effects of radiation therapy on male and female gonads and has further highlighted procedures through which the functioning of these organs can be protected before or during radiation treatment. We have also emphasised the importance of the establishment of multidisciplinary tumour boards and patient education regarding future reproductive function which is an important component of the care of individuals with cancer. This article highlights that infertility is a persistent and major concern that can add to long-term stress in cancer survivors, and education about fertility preservation before the initiation of any treatment is especially important.
Collapse
Affiliation(s)
- Yumna Ahmed
- Department of Radiation Oncology, Aga Khan University Hospital, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan
| | | | | | - Fatima Shaukat
- Department of Radiation Oncology, Cyberknife and Tomotherapy Centre, JPMC, Karachi 75510, Pakistan
| | - Arhum Jamil
- Jinnah Sindh Medical University, Karachi 75510, Pakistan
| | | | - Sehrish Abrar
- Department of Radiation Oncology, Aga Khan University Hospital, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan
| | - Bilal Mazhar Qureshi
- Department of Radiation Oncology, Aga Khan University Hospital, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan
| | - Ahmed Nadeem Abbasi
- Department of Radiation Oncology, Aga Khan University Hospital, Stadium Road, P. O. Box 3500, Karachi 74800, Pakistan
| |
Collapse
|
16
|
Abegglen LM, Harrison TM, Moresco A, Fowles JS, Troan BV, Kiso WK, Schmitt D, Boddy AM, Schiffman JD. Of Elephants and Other Mammals: A Comparative Review of Reproductive Tumors and Potential Impact on Conservation. Animals (Basel) 2022; 12:2005. [PMID: 35953994 PMCID: PMC9367617 DOI: 10.3390/ani12152005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/13/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
Reproductive tumors can impact conception, pregnancy, and birth in mammals. These impacts are well documented in humans, while data in other mammals are limited. An urgent need exists to understand the reproductive impact of these lesions in endangered species, because some endangered species have a documented high prevalence of reproductive tumors. This article documents that the prevalence of both benign and malignant neoplasia differs between African and Asian elephants, with Asian elephants more frequently diagnosed and negatively affected by both. The prevalence of these tumors across mammalian species is compared, and impact plus treatment options in human medicine are reviewed to inform decision making in elephants. Evidence suggests that reproductive tumors can negatively impact elephant conservation. Future studies that document reproductive outcomes, including the success of various treatment approaches in elephants with tumors will benefit conservation efforts.
Collapse
Affiliation(s)
- Lisa M. Abegglen
- Department of Pediatrics & Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Arizona Cancer Evolution Center, Arizona State University, Tempe, AZ 85281, USA
- Exotic Species Cancer Research Alliance, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
| | - Tara M. Harrison
- Arizona Cancer Evolution Center, Arizona State University, Tempe, AZ 85281, USA
- Exotic Species Cancer Research Alliance, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
| | - Anneke Moresco
- Exotic Species Cancer Research Alliance, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
- Reproductive Health Surveillance Program, Morrison, CO 80465, USA
| | - Jared S. Fowles
- Department of Pediatrics & Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Brigid V. Troan
- Exotic Species Cancer Research Alliance, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
| | - Wendy K. Kiso
- White Oak Conservation Foundation, Yulee, FL 32097, USA
| | - Dennis Schmitt
- Department of Animal Science, William H. Darr College of Agriculture, Missouri State University, Springfield, MO 65809, USA
| | - Amy M. Boddy
- Arizona Cancer Evolution Center, Arizona State University, Tempe, AZ 85281, USA
- Exotic Species Cancer Research Alliance, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Joshua D. Schiffman
- Department of Pediatrics & Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Arizona Cancer Evolution Center, Arizona State University, Tempe, AZ 85281, USA
- Exotic Species Cancer Research Alliance, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA
- Peel Therapeutics, Inc., Salt Lake City, UT 84108, USA
| |
Collapse
|
17
|
McCarter K, Stewart J, Gordhandas S, Aluko A, Shah N, Schattman G, Rosenwaks Z. The use of fertility preservation services for cancer patients: a single institution experience. F S Rep 2022; 3:349-354. [PMID: 36568923 PMCID: PMC9783135 DOI: 10.1016/j.xfre.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 12/27/2022] Open
Abstract
Objective To analyze the use of services regarding fertility preservation (FP) in cancer patients at a single institution. Design A retrospective cohort study. Setting Academic medical center. Patients A total of 208 FP referrals. Interventions None. Main Outcome Measures Method of FP; time from referral to FP intervention. Results A total of 553 patients were referred to a reproductive specialist for FP in the setting of a medical diagnosis from 2011 to 2016. Of these, 208 patients satisfied the inclusion criteria and met with a reproductive specialist. Ninety patients underwent FP services. The average age at referral was 30.9 ± 7.9 years. Breast cancer (n=94, 45%) and leukemia/lymphoma (n=62, 30%) were the most prevalent cancer diagnoses. A 68.9% of patients underwent oocyte cryopreservation (n=62), 26.7% underwent embryo cryopreservation (n=24) and 4.4% underwent ovarian tissue preservation (n=4). The time interval from the referral to the FP intervention ranged from 1 to 810 days, with a median of 17 days. Conclusions In the setting of a cancer diagnosis, most patients undergoing FP intervention underwent oocyte cryopreservation, were <35 years old, and underwent FP intervention in <30 days from referral. Whereas FP should ideally be initiated at the time of cancer diagnosis, all patients with a cancer diagnosis should be referred to a reproductive specialist and counseled on options for FP to preserve the optionality for the reproductive future they desire.
Collapse
Affiliation(s)
- Kelly McCarter
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York,Reprint requests: Kelly McCarter, M.D., The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue 6 Floor New York, New York, United States, 10021).
| | - Joshua Stewart
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York
| | - Sushmita Gordhandas
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ashley Aluko
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York
| | - Nirali Shah
- New York University Fertility Center, New York, New York
| | - Glenn Schattman
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York
| |
Collapse
|
18
|
Evaluation of Knowledge, Attitude, and Practice of Health Practitioners towards Fertility Preservation in Cancer Patients in an Environmental Region of Saudi Arabia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:6404837. [PMID: 35707706 PMCID: PMC9192281 DOI: 10.1155/2022/6404837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/05/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
Background Cancer patients face multiple challenges, such as infertility caused by exposure to gonadotoxic agents and gonadal irradiation during cancer treatment. Little is known about the health practitioners' knowledge and practice regarding fertility preservation and its available options in Saudi Arabia. Thus, this study is designed to evaluate the level of knowledge, attitude, and practice (KAP) towards fertility preservation in cancer patients among health practitioners in an environmental region in Saudi Arabia. Methods The cross-sectional study was carried out between September 2020 and January 2021. A self-administered questionnaire was distributed among health practitioners from a variety of specialties who work closely with cancer patients. Results Out of 100 participants, 90% need more knowledge about fertility preservation. The lack of fertility preservation clinics in the patient's area and its unaffordable expenses significantly influenced the health practitioners' attitude towards fertility preservation discussion with cancer patients. The results revealed that 92% of the participants agreed that the Saudi Ministry of Health should establish practice guidelines and provide fertility preservation services for cancer patients. Conclusions The present study showed that clinical practitioners' knowledge remains insufficient. Education of health practitioners and the establishment of practice guidelines and fertility preservation clinics for cancer patients are required.
Collapse
|
19
|
Di Tucci C, Galati G, Mattei G, Chinè A, Fracassi A, Muzii L. Fertility after Cancer: Risks and Successes. Cancers (Basel) 2022; 14:cancers14102500. [PMID: 35626104 PMCID: PMC9139810 DOI: 10.3390/cancers14102500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/08/2022] [Accepted: 05/16/2022] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Approximately one million new cases of cancer are diagnosed in women of reproductive age every year. In the last few decades, advances in early diagnosis and treatment have improved the survival rate. However, the adverse effects of anticancer therapy on the ovaries and uterus have a significant impact on future fertility and may affect the quality of life of cancer survivors. Unfortunately, evidence about the trend of ovarian reserve loss over time is insufficient for predicting the duration of the fertile period. Currently, impaired fertility in cancer survivors is a growing issue that is complicated by an increasing number of women delaying childbearing. This review focuses on the detrimental effects of chemotherapy, radiotherapy, and surgery on reproductive functions and describes the mechanisms causing reduced fertility in cancer survivors. Moreover, in this review, the available fertility preservation strategies to guarantee the chance of motherhood in cancer survivors are illustrated. Abstract The incidence of cancer in reproductive-aged women is 7%, but, despite the increased number of cancer cases, advances in early diagnosis and treatment have raised the survival rate. Furthermore, in the last four decades, there has been a rising trend of delaying childbearing. There has been an increasing number of couples referred to Reproductive Medicine Centers for infertility problems after one partner has been treated for cancer. In these cases, the main cause of reduced fertility derives from treatments. In this review, we describe the effects and the risks of chemotherapy, radiotherapy, and surgery in women with cancer, and we will focus on available fertility preservation techniques and their efficacy in terms of success in pregnancy and live birth rates.
Collapse
|
20
|
Ní Dhonnabháin B, Elfaki N, Fraser K, Petrie A, Jones BP, Saso S, Hardiman PJ, Getreu N. A comparison of fertility preservation outcomes in patients who froze oocytes, embryos, or ovarian tissue for medically indicated circumstances: a systematic review and meta-analysis. Fertil Steril 2022; 117:1266-1276. [PMID: 35459522 DOI: 10.1016/j.fertnstert.2022.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To compare obstetric outcomes in patients cryopreserving reproductive cells or tissues before gonadotoxic therapy. DESIGN A literature search was conducted following PRISMA guidelines on Embase, Medline, and Web of Science. Studies reporting obstetric outcomes in cancer patients who completed cryopreservation of oocyte, embryo, or ovarian tissue were included. SETTING Not applicable. PATIENT(S) Cancer patients attempting pregnancy using cryopreserved cells or tissues frozen before cancer therapy. INTERVENTION(S) Oocyte, embryo, or ovarian tissue cryopreservation for fertility preservation in cancer. MAIN OUTCOME MEASURE(S) The total numbers of clinical pregnancies, live births, and miscarriages in women attempting pregnancy using cryopreserved reproductive cells or tissues were calculated. A meta-analysis determined the effect size of each intervention. RESULT(S) The search returned 4,038 unique entries. Thirty-eight eligible studies were analyzed. The clinical pregnancy rates were 34.9%, 49.0%, and 43.8% for oocyte, embryo, and ovarian tissue cryopreservation, respectively. No significant differences were found among groups. The live birth rates were 25.8%, 35.3%, and 32.3% for oocyte, embryo, and ovarian tissue cryopreservation, respectively, with no significant differences among groups. The miscarriage rates were 9.2%, 16.9%, and 7.5% for oocyte, embryo, and ovarian tissue cryopreservation, respectively. Significantly fewer miscarriages occurred with ovarian tissue cryopreservation than with embryo cryopreservation. CONCLUSION(S) This enquiry is required to counsel cancer patients wishing to preserve fertility. Although the limitations of this study include heterogeneity, lack of quality studies, and low utilization rates, it serves as a starting point for comparison of reproductive and obstetric outcomes in patients returning for family-planning after gonadotoxic therapy.
Collapse
Affiliation(s)
- Bríd Ní Dhonnabháin
- Institute for Women's Health, University College London, London, United Kingdom
| | - Nagla Elfaki
- Department of Obstetrics and Gynaecology, University College London Hospital, London, United Kingdom
| | - Kyra Fraser
- Department of Surgery, The Royal Free Hospital, London, United Kingdom
| | - Aviva Petrie
- Biostatistics Unit, Eastman Dental Institute, University College London, London, United Kingdom
| | - Benjamin P Jones
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Srdjan Saso
- Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom
| | - Paul J Hardiman
- Department of Gynaecology, The Royal Free Hospital, London, United Kingdom
| | - Natalie Getreu
- Institute for Women's Health, University College London, London, United Kingdom.
| |
Collapse
|
21
|
Hao X, Phoon J, Barbunopulos L, Sheikhi M, Palomares AR, Rodriguez-Wallberg KA. Exploring the Developmental Potential of Human Germinal Vesicle Oocytes Aiming at Fertility Preservation: Can We Increase the Yields of Competent Oocytes through IVM Combined with Vitrification? J Clin Med 2022; 11:jcm11061703. [PMID: 35330028 PMCID: PMC8949370 DOI: 10.3390/jcm11061703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 02/04/2023] Open
Abstract
The rescue in vitro maturation (rIVM) of germinal vesicle oocytes (GVs) has been proposed to improve the total number of mature oocytes in women undergoing fertility preservation. Currently, there is no consensus about the clinical utility of this practice, and heterogeneity in the protocols used may influence the final outcomes. This study investigated the developmental potential of mature metaphase II (MII) human oocytes obtained from GVs after rIVM and the impact of applying vitrification at different timepoints either before or after rIVM. After randomization, oocytes were assigned to undergo rIVM and thereafter vitrification or intracytoplasmic sperm injection (ICSI), or to undergo direct vitrification-warming and thereafter rIVM and ICSI. The likelihood of obtaining MII oocytes was just slightly higher in the fresh rIVM group compared to the vitrification-warming-rIVM group. When comparing fresh rIVM that underwent subsequently ICSI, the fertilization and developmental rates up to the blastocyst stage were seen to be reduced in both groups that underwent vitrification either before or after rIVM. Although some blastocysts were obtained in the fresh rIVM-ICSI group, the efficacy of these methods was low overall, suggesting that the further development of protocols for IVM conducted early after denudation is needed to improve the final results of rIVM aiming at fertility preservation.
Collapse
Affiliation(s)
- Xia Hao
- Department of Oncology and Pathology, Karolinska Institutet, Solna, SE-171 76 Stockholm, Sweden;
- Laboratory of Translational Fertility Preservation, BioClinicum, SE-171 64 Stockholm, Sweden
| | - Jessie Phoon
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Novumhuset Plan 4, SE-141 86 Stockholm, Sweden; (J.P.); (L.B.); (M.S.)
| | - Lina Barbunopulos
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Novumhuset Plan 4, SE-141 86 Stockholm, Sweden; (J.P.); (L.B.); (M.S.)
| | - Mona Sheikhi
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Novumhuset Plan 4, SE-141 86 Stockholm, Sweden; (J.P.); (L.B.); (M.S.)
| | - Arturo Reyes Palomares
- Department of Oncology and Pathology, Karolinska Institutet, Solna, SE-171 76 Stockholm, Sweden;
- Laboratory of Translational Fertility Preservation, BioClinicum, SE-171 64 Stockholm, Sweden
- Correspondence: (A.R.P.); (K.A.R.-W.)
| | - Kenny A. Rodriguez-Wallberg
- Department of Oncology and Pathology, Karolinska Institutet, Solna, SE-171 76 Stockholm, Sweden;
- Laboratory of Translational Fertility Preservation, BioClinicum, SE-171 64 Stockholm, Sweden
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Novumhuset Plan 4, SE-141 86 Stockholm, Sweden; (J.P.); (L.B.); (M.S.)
- Correspondence: (A.R.P.); (K.A.R.-W.)
| |
Collapse
|
22
|
McClam M, Xiao S. Preserving Oocytes in Oncofertility†. Biol Reprod 2022; 106:328-337. [PMID: 35040934 PMCID: PMC8862718 DOI: 10.1093/biolre/ioac008] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/09/2021] [Accepted: 01/13/2022] [Indexed: 01/19/2023] Open
Abstract
The prodigious rise of cancer survival rates enables many cancer survivors to live long lives. Therefore, the side effects of cancer treatments as well as the long-term quality of life after cancer have become more relevant. Ovarian toxicity is a major off-target effect of anticancer agents for childhood and young adult female cancer patients. Both chemotherapy and irradiation have been demonstrated to damage the ovary and increase the risks of premature ovarian failure (POF), early menopause, ovarian endocrine disorders, and sub- or infertility. Oncofertility is an emerging and multidisciplinary research and medical field that focuses on providing cancer patients with fertility preservation options. Oocyte quality and quantity are one of the most important factors to determine women's fertility success; therefore, preserving oocytes is paramount for maintaining the ability of young female cancer patients' reproduction after their recovery. This review summarizes peer-reviewed literature on current oocyte preservation options in oncofertility. We describe in-depth oocyte and embryo cryopreservation, ovarian suppression, ovarian tissue cryopreservation, in vitro maturation, ovarian transposition, and adjuvant therapy. Further, we discuss current guidelines and practices of female fertility preservation that cover preserving oocytes.
Collapse
Affiliation(s)
- Maria McClam
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shuo Xiao
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, Piscataway, NJ, USA,Correspondence: 170 Frelinghuysen Rd, Piscataway, NJ 08854, USA. Tel: + 1-848-445-3729; E-mail:
| |
Collapse
|
23
|
Mehedintu C, Frincu F, Carp-Veliscu A, Barac R, Badiu DC, Zgura A, Cirstoiu M, Bratila E, Plotogea M. A Warning Call for Fertility Preservation Methods for Women Undergoing Gonadotoxic Cancer Treatment. Medicina (B Aires) 2021; 57:medicina57121340. [PMID: 34946285 PMCID: PMC8709408 DOI: 10.3390/medicina57121340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022] Open
Abstract
Malignant hematological conditions have recognized an increased incidence and require aggressive treatments. Targeted chemotherapy, accompanied or not by radiotherapy, raises the chance of defeating the disease, yet cancer protocols often associate long-term gonadal consequences, for instance, diminished or damaged ovarian reserve. The negative effect is directly proportional to the types, doses, time of administration of chemotherapy, and irradiation. Additionally, follicle damage depends on characteristics of the disease and patient, such as age, concomitant diseases, previous gynecological conditions, and ovarian reserve. Patients should be adequately informed when proceeding to gonadotoxic therapies; hence, fertility preservation should be eventually regarded as a first-intention procedure. This procedure is most beneficial when performed before the onset of cancer treatment, with the recommendation for embryos or oocytes’ cryopreservation. If not feasible or acceptable, several options can be available during or after the cancer treatment. Although not approved by medical practice, promising results after in vitro studies increase the chances of future patients to protect their fertility. This review aims to emphasize the mechanism of action and impact of chemotherapy, especially the one proven to be gonadotoxic, upon ovarian reserve and future fertility. Reduced fertility or infertility, as long-term consequences of chemotherapy and, particularly, following bone marrow transplantation, is often associated with a negative impact of recovery, social and personal life, as well as highly decreased quality of life.
Collapse
Affiliation(s)
- Claudia Mehedintu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
- Department of Obstetrics and Gynecology, “Nicolae Malaxa” Clinical Hospital, 022441 Bucharest, Romania;
| | - Francesca Frincu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
- Department of Obstetrics and Gynecology, “Nicolae Malaxa” Clinical Hospital, 022441 Bucharest, Romania;
| | - Andreea Carp-Veliscu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
| | - Ramona Barac
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
| | - Dumitru-Cristinel Badiu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
- Correspondence: ; Tel.: +40-723226346
| | - Anca Zgura
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
| | - Monica Cirstoiu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
| | - Elvira Bratila
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.M.); (F.F.); (A.C.-V.), (R.B.); (A.Z.); (M.C.); (E.B.)
| | - Mihaela Plotogea
- Department of Obstetrics and Gynecology, “Nicolae Malaxa” Clinical Hospital, 022441 Bucharest, Romania;
| |
Collapse
|
24
|
Shandley LM, Kipling LM, Spencer JB, Morof D, Mertens AC, Howards PP. Factors Associated with Unplanned Pregnancy Among Cancer Survivors. J Womens Health (Larchmt) 2021; 31:665-674. [PMID: 34860591 PMCID: PMC9133970 DOI: 10.1089/jwh.2021.0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Approximately half of all pregnancies in the United States are unintended. However, women who are diagnosed with cancer in their reproductive years may be a unique population. This study examines the prevalence of and identifies factors associated with unplanned pregnancy among cancer survivors. Methods: Female cancer survivors aged 22-45 years, diagnosed between ages 20-35 years and at least 2 years postdiagnosis, and women with no history of cancer were interviewed about their reproductive histories, including pregnancy intention. Using a random matching process, comparison women were assigned an artificial age at cancer diagnosis equal to that of her cancer survivor match. An adjusted Cox model was fit examining time to unintended pregnancy after cancer for each of 1,000 matches. Cox proportional hazards models were also fit to assess associations between participant characteristics and unplanned pregnancy after cancer among survivors. Results: Cancer survivors (n = 1,282) and comparison women (n = 1,073) reported a similar likelihood of having an unplanned pregnancy in models adjusted for race, income, history of sexually-transmitted infection, and history of unplanned pregnancy before diagnosis (adjusted hazard ratio [aHR] 1.06, 95% simulation interval 0.85-1.36). After adjusting for confounders, unplanned pregnancy among survivors was associated with age <30 years at diagnosis (hazard ratio [HR]: 1.79, 95% confidence interval [CI]: 1.32-2.44), black race (HR: 1.55, 95% CI: 1.13-2.12; referent: white), receiving fertility counseling (aHR: 1.41, 95% CI: 1.04-1.92), and having at least one child before diagnosis (aHR: 1.44, 95% CI: 1.05-1.97). Conclusion: Cancer survivors and comparison women had similar likelihood of unplanned pregnancy. Rates of unplanned pregnancy after cancer were not higher for cancer survivors compared with comparison women, but 46.4% of survivors with a postcancer pregnancy reported an unplanned pregnancy. Cancer patients may benefit from patient-centered guidelines and counseling before cancer treatment that covers both risks of infertility and risks of unplanned pregnancy.
Collapse
Affiliation(s)
- Lisa M Shandley
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lauren M Kipling
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jessica B Spencer
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Diane Morof
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,U.S. Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Ann C Mertens
- Department of Pediatrics, Aflac Cancer Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
25
|
Wang J, Zhang Y, Wu C, Li P, Zhang Z, Xu X, Zhou P, Cao Y. Effects of AavLEA1 Protein on Mouse Ovarian Tissue Cryopreservation by Vitrification. Biopreserv Biobank 2021; 20:168-175. [PMID: 34788107 DOI: 10.1089/bio.2021.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Conventional ovarian tissue cryopreservation often destroys the structural, functional, and DNA integrity of the ovarian tissue. How to effectively retain the ultrastructure and subsequent function of ovarian tissue during cryopreservation has long been an issue of concern. Late embryogenesis abundant (LEA) proteins are a class of highly hydrophilic proteins and have been reported to protect various cells from water stress. However, whether LEA proteins exert protective effects on ovarian tissue cryopreservation remains unknown. To investigate the benefit of LEA proteins in ovarian tissue cryopreservation, we purified the recombinant AavLEA1 protein, a member of Group 3 LEA proteins, then cryopreserved the mouse ovaries with this protein by vitrification, and obtained the ovarian follicle structure, cellular proliferation, apoptosis, and GAPDH gene expression of postcryopreservation ovaries. We found that recombinant AavLEA1 protein protected the ovarian follicles from cryoinjury, improved the proliferative ability of follicles, decreased the apoptosis, and promoted the GAPDH gene expression. These results indicated that the LEA protein enhanced the antiapoptosis ability of ovarian cells and retained DNA/RNA integrity against cryoinjury during ovarian tissue vitrification. LEA proteins exert beneficial effects on ovarian tissue cryopreservation, and maybe provide a novel cryoprotective agent for ovarian tissue cryopreservation.
Collapse
Affiliation(s)
- Jianye Wang
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| | - Yameng Zhang
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| | - Caiyun Wu
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| | - Peng Li
- Medical Affair Department, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhiguo Zhang
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| | - Xiaofeng Xu
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| | - Ping Zhou
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| | - Yunxia Cao
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, China.,Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs, Hefei, China
| |
Collapse
|
26
|
Raza SHA, Abd El-Aziz AH, Abdelnour SA, Easa AA, Alagawany M, Farag MR, Al-Mutary MG, Elfadadny A, Khan R, Quan G, Cheng G, Zan L. The role of forskolin as a lipolytic stimulator during in vitro oocyte maturation and the in vitro embryo production of livestock. Reprod Domest Anim 2021; 56:1486-1496. [PMID: 34592022 DOI: 10.1111/rda.14021] [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: 08/24/2021] [Accepted: 09/28/2021] [Indexed: 11/28/2022]
Abstract
Cryopreservation is a modern technique which assists in the preservation of genetic material from oocytes and embryos for a long time. However, elevated vulnerability to cryopreservation due to the large accumulation of intracellular lipids within oocytes or embryos avoids success of this method. These lipids remain the main crucial factor limiting survival rates of oocytes and embryos after thawing. Lipid ingathering in the oocyte cytoplasm augments lipid peroxidation (LPO) and oxidative stress increases the apoptosis process, declines the viability after thawing, declines cytoskeleton actin filament injuries, lowers the blastocyst rates and reduces cryotolerance in the early stages of embryo development. There have been several attempts to reduce the ingathering of intracellular lipids in oocytes or embryos during the cryopreservation process, in that way enhancing the competence of cryopreserved oocytes or embryos and increasing their viability. One of the most applied agents for chemical delipidation is forskolin. Forskolin exhibited a possible part in improving the oocytes cryopreservation through stimulating cyclic adenosine monophosphate (cAMP) production. The main purpose of cAMP modulation is to provide energy to sustain the mammalian oocytes´ meiotic arrest. The purpose of the existing article is to assess and offer more evidence concerning the forskolin utilization as a modulator of cAMP during the cryopreservation of oocytes and its influence on meiosis completion and the reorganization of cytoplasm, which are prerequisites for the development of oocytes in addition to the contribution to fertilization and subsequently, the development of embryos.
Collapse
Affiliation(s)
- Sayed Haidar Abbas Raza
- College of Animal Science and Technology, Northwest A&F University, Yangling, China.,National Beef Cattle Improvement Center, Northwest A&F University, Yangling, China
| | - Ayman H Abd El-Aziz
- Animal Husbandry and Animal Wealth Development Department, Faculty of Veterinary Medicine, Daman Hour University, Damanhour, Egypt
| | - Sameh A Abdelnour
- Animal Production Department, Faculty of Agriculture, Zagazig University, Zagazig, Egypt
| | - Ahmed A Easa
- Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Damanhour, Egypt
| | - Mahmoud Alagawany
- Department of Poultry, Faculty of Agriculture, Zagazig University, Zagazig, Egypt
| | - Mayada R Farag
- Forensic Medicine and Toxicology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Mohsen G Al-Mutary
- Department of Basic Sciences, College of Education, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Elfadadny
- Department of Animal Medicine, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Rajwali Khan
- Department of Livestock Management, Breeding and Genetics, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Guobo Quan
- Yunnan Animal Science and Veterinary Institute, Kunming, China
| | - Gong Cheng
- College of Animal Science and Technology, Northwest A&F University, Yangling, China
| | - Linsen Zan
- College of Animal Science and Technology, Northwest A&F University, Yangling, China.,National Beef Cattle Improvement Center, Northwest A&F University, Yangling, China
| |
Collapse
|
27
|
Karimi-Zarchi M, Khalili MA, Binesh F, Vatanparast M. Ovarian Tissue Reservation and Risk of Reimplantation in a Young Girl with Acute Lymphocytic Leukemia after 6-Month Chemotherapy: A Case Report. South Asian J Cancer 2021; 10:112-114. [PMID: 34568225 PMCID: PMC8460347 DOI: 10.1055/s-0041-1729495] [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] [Indexed: 10/25/2022] Open
Abstract
In the fertility preservation programs, ovarian cryopreservation is usually offered when the risk of premature ovarian failure is high (>30-50%) while the risk of ovarian metastasis is low. According to the guidelines, it must be done before the patient receives chemotherapy. A 22-year-old girl with acute lymphocytic leukemia was a candidate for ovarian cryopreservation after 6 months of chemotherapy. Despite chemotherapy, the anti-Mullerian hormone survey was within normal range. Ovarian tissue cryopreservation was done. In the histology survey, follicular density was 7.48. This case shows that only having a history of chemotherapy does not exclude the patient from the fertility preservation program. Regarding referring the patients for fertility preservation, cumulative factors such as a history of gonadotoxic treatment, age, and treatment protocol should be considered. In addition, the case was negative for assessing of CD45 marker. New data may challenge previous strict criteria, and extend the indications of this effective method in preserving fertility among cancer patients.
Collapse
Affiliation(s)
- Mojgan Karimi-Zarchi
- Department of Gynecology Oncology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Khalili
- Research and Clinical Center for Infertility, Yazd University of Medical Sciences, Yazd, Iran
| | - Fariba Binesh
- Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboubeh Vatanparast
- Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| |
Collapse
|
28
|
Eshghifar N, Dehghan BK, Do AA, Koukhaloo SZ, Habibi M, Pouresmaeili F. Infertility cell therapy and epigenetic insights. Hum Antibodies 2021; 29:17-26. [PMID: 33554898 DOI: 10.3233/hab-200438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Recent advances in assisted reproductive technology (ART) have allowed couples with severe infertility to conceive, but the methods are not effective for all cases. Stem cells as undifferentiated cells which are found in different stages of embryonic, fetal and adult life are known to be capable of forming different cell types, tissues, and organs. Due to their unlimited resources and the incredible power of differentiation are considered as potential new therapeutic biological tools for treatment of infertility. For reproductive medicine, stem cells are stimulated in vitro to develop various specialized functional cells including male and female gametes. The epigenetic patterns can be modified in the genome under certain drugs exposure or lifestyle alterations. Therefore, epigenetics-related disorders may be treated if the nature of the modifications is completely admissible. It is proved that our understanding of epigenetic processes and its association with infertility would help us not only to understand the etiological factors but also to treat some type of male infertilities. Exploration of both genetic and epigenetic variations in the disease development could help in the identification of the interaction patterns between these two phenomena and possible improvement of therapeutic methods.
Collapse
Affiliation(s)
- Nahal Eshghifar
- Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Behnam Kamali Dehghan
- Department of Medical Genetics, National Institute of Medical Engineering and Biotechnology (NIGEB), Tehran, Iran.,Medical Genetics, Jiroft University of Medical Sciences and Health Services, Jiroft, Kerman, Iran.,Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Atieh Abedin Do
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Quebec, Canada
| | | | - Mohsen Habibi
- Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farkhondeh Pouresmaeili
- Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
29
|
Cioffi R, Mangili G, Sarais V, Cervini L, Longo V, Bergamini A, Stella Vanni V, Pagliardini L, Candiani M, Papaleo E. Do stage and grade of malignancy impact fertility preservation in breast cancer patients? J Gynecol Obstet Hum Reprod 2021; 50:102215. [PMID: 34482003 DOI: 10.1016/j.jogoh.2021.102215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The impact of cancer on basal fertility and ovarian response to stimulation has not yet been clarified. Evidence on this topic is scarce and conflicting. Aim of this study was to assess the impact of breast cancer stage and grade on the number of retrieved mature oocytes during controlled ovarian stimulation for fertility preservation. METHODS Retrospective cohort study evaluating data on 101 stimulation cycles of women with breast cancer undergoing oocyte cryopreservation categorized according to breast cancer stage (low-stage: I; high-stage:II-III) and grade (low-grade: G1-2; high-grade: G3) using the American Joint Committee on Cancer staging system (VIII edition). RESULTS High-stage disease was not associated with worse oocyte retrieval outcomes (median 7 vs 7, p = 0.75). High-grade disease patients showed a significantly lower antral follicle count (AFC) compared to low-grade disease patients (10 vs 13, p = 0.03), and required higher doses of FSH (2612 IU vs 2250 IU; p = 0.03) during stimulation. Median number of vitrified oocytes was 6 in low-grade disease patients and 7 in high-grade disease patients (p = 0.35). CONCLUSIONS Stage and grade of breast cancer do not impact the number of retrieved mature oocytes. However, higher grade of breast cancer is associated with lower AFC at baseline and need for higher doses of gonadotropin during ovarian stimulation.
Collapse
Affiliation(s)
- Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Sarais
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Cervini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vito Longo
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Stella Vanni
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Pagliardini
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
30
|
Abstract
Importance Many adolescents and young adults diagnosed with Hodgkin lymphoma (HL) experience disease progression requiring high-dose alkylating salvage therapy, which often results in permanent infertility. Objective The aim of this report is to discuss fertility preservation options in female patients with consideration of chemotherapeutic agents in HL. Evidence Acquisition An electronic literature review was performed utilizing a combination of the terms "Hodgkin lymphoma," "fertility preservation," "ovarian tissue cryopreservation," "oocyte cryopreservation," "embryo cryopreservation," and "gonadotropin-releasing hormone agonist." References and data from identified sources were searched and compiled to complete this review. Results Initial treatment of HL is often nonsterilizing; however, salvage therapy and conditioning for stem cell transplantation confer significant gonadotoxicity. Established fertility preservation options for pubertal females include embryo cryopreservation and oocyte cryopreservation. These options are contraindicated within 6 months of receipt of chemotherapy. Ovarian tissue cryopreservation is an option for patients who require salvage therapy within 6 months of first-line therapy. Conclusions Timing and choice of fertility preservation techniques depends on planned first-line chemotherapy and response to treatment. In patients initially treated with low-risk chemotherapy, it is reasonable to defer invasive fertility techniques until treatment failure; however, upfront fertility preservation should be considered in patients planning to undergo primary treatment with high-risk therapy.
Collapse
|
31
|
Sarabadani M, Tavana S, Mirzaeian L, Fathi R. Co-culture with peritoneum mesothelial stem cells supports the in vitro growth of mouse ovarian follicles. J Biomed Mater Res A 2021; 109:2685-2694. [PMID: 34228401 DOI: 10.1002/jbm.a.37260] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/23/2022]
Abstract
The important roles played by the ovarian microenvironment and cell interactions in folliculogenesis suggest promising approaches for in vivo growth of ovarian follicles using appropriate scaffolds containing suitable cell sources. In this study, we have investigated the growth of early preantral follicles in the presence of decellularized mesenteric peritoneal membrane (MPM), peritoneum mesothelial stem cells (PMSCs), and conditioned medium (CM) of PMSCs. MPM of mouse was first decellularized; PMSCs were isolated from MPM and cultured and their conditioned medium (CM) was collected. Mouse follicles were separated into four groups: (1) culture in base medium (control), (2) culture in decellularized MPM (DMPM), (3) co-culture with PMSCs (Co-PMSCs), and (4) culture in CM of PMSCs (CM-PMSCs). Qualitative and quantitative assessments were performed to evaluate intact mesenteric peritoneal membrane (IMPM) as well as decellularized ones. After culturing the ovarian follicles, follicular and oocyte diameter, viability, eccentric oocyte percentage, and estradiol hormone amounts were evaluated. Quantitative and qualitative evaluations confirmed removal of cells and retention of the essential fibers in MPM after the decellularization process. Follicular parameters showed that Co-PMSCs better support in vitro growth and development of ovarian follicles than the other groups. The eccentric rate and estradiol production were statistically higher for the Co-PMSCs group than for the CM-PMSCs and control groups. Although the culture of early preantral follicles on DMPM and CM-PMSCs could improve in vitro follicular growth, co-culture of follicles with PMSCs showed even greater improvements in terms of follicular growth and diameter.
Collapse
Affiliation(s)
- Mahdieh Sarabadani
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Developmental Biology, University of Science and Culture, Tehran, Iran
| | - Somayeh Tavana
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Leila Mirzaeian
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Rouhollah Fathi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| |
Collapse
|
32
|
Sehring J, Hussain A, Grimm L, Rosen E, Esguerra J, Matevossian K, Louden E, Beltsos A, Jeelani R. A call to action: unified clinical practice guidelines for oncofertility care. J Assist Reprod Genet 2021; 38:1745-1754. [PMID: 33709343 PMCID: PMC8324617 DOI: 10.1007/s10815-021-02142-z] [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: 10/28/2020] [Accepted: 03/03/2021] [Indexed: 12/01/2022] Open
Abstract
By 2030, WHO estimates that 1.4 million reproductive-aged women will be diagnosed with cancer annually. Fortunately, cancer is no longer considered an incurable disease in many cases. From 2008-2014, 85% of women under the age of 45 years diagnosed with cancer survived. This increase in survival rate has shifted attention from focusing exclusively on preserving life to focusing on preserving quality of life after treatment. One aspect of this is preserving the ability to have a biological family. Oncofertility, the field that bridges oncology and reproductive endocrinology with the goal of preserving fertility, offers these patients hope. Though it is clear that ASCO and ASRM recognize the importance of fertility preservation as an aspect of comprehensive oncology care, there are not yet unified guidelines for oncologists and fertility specialists for treating oncofertility patients. First, we identify the need for reproductive counseling prior to cancer treatment, as many patients report that their fertility preservation concerns are not addressed adequately. We then delineate multi-modal fertility preservation options that are available and appropriate for different patients with corresponding outcomes using different treatments. We discuss the unique challenges and considerations, including ethical dilemmas, for delivering timely and comprehensive care specifically for oncofertility patients. Finally, we address the multidisciplinary team that includes oncologists, reproductive endocrinologists, surgeons as well as their staff, nurses, genetic counselors, mental health professionals, and more. Since oncofertility patient care requires the coordination of both physician teams, one set of unified guidelines will greatly improve quality of care.
Collapse
Affiliation(s)
- Jacqueline Sehring
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA.
| | - Anisa Hussain
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| | - Lauren Grimm
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| | - Elisabeth Rosen
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| | - Jody Esguerra
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| | | | - Erica Louden
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| | - Angeline Beltsos
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| | - Roohi Jeelani
- Vios Fertility Institute, 1455 N Milwaukee Ave, Chicago, IL, 60622, USA
| |
Collapse
|
33
|
Qu J, Li Y, Liao S, Yan J. The Effects of Negative Elements in Environment and Cancer on Female Reproductive System. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1300:283-313. [PMID: 33523439 DOI: 10.1007/978-981-33-4187-6_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
With the development of human society, factors that contribute to the impairment of female fertility is accumulating. Lifestyle-related risk factors, occupational risk factors, and iatrogenic factors, including cancer and anti-cancer treatments, have been recognized with their negative effects on the function of female reproductive system. However, the exact influences and their possible mechanism have not been elucidated yet. It is impossible to accurately estimate the indexes of female fertility, but many researchers have put forward that the general fertility has inclined through the past decades. Thus the demand for fertility preservation has increased more and more dramatically. Here we described some of the factors which may influence female reproductive system and methods for fertility preservation in response to female infertility.
Collapse
Affiliation(s)
- Jiangxue Qu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yuehan Li
- Department of Gynaecology and Obstetrics, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shujie Liao
- Department of Gynaecology and Obstetrics, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Jie Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
| |
Collapse
|
34
|
Decellularization Methods of Ovary in Tissue Engineering. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1345:129-139. [PMID: 34582019 DOI: 10.1007/978-3-030-82735-9_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The ovaries or female gonads are situated in the ovarian fossa of the abdominal cavity. These are paired, almond-shaped organs measuring about 3.5 cm long and 1.5 cm thick and exist out of a central medullary zone and a peripheral cortex that are enclosed in a fibrous capsule called the tunica albuginea. The ovaries serve 2 main functions, the first one being the production of female gametes called oocytes (oogenesis). Interestingly, the number of primary oocytes that reside in the ovary is determined at birth. About 400 oocyte-containing follicles successfully go through all the developmental stages from this limited pool during folliculogenesis throughout the female reproductive life. In this process, primordial follicles grow and advance until forming a mature or Graafian follicle; during ovulation, secondary oocytes are released and the remaining follicular wall collapses and forms the highly vascularized corpus luteum or luteal gland. This ovarian cycle is regulated by several hormones secreted from the adenohypophysis and lasts about 28 days. During this cycle, the ovaries also serve as endocrine glands and produce female sex hormones such as estrogens and progesterone (steroidogenesis), influencing the growth and development of tissues sensitive to these hormones such as the endometrium. Hence, the endometrial cycle goes synchronized with the ovarian cycle.
Collapse
|
35
|
Kim J, You S. After cyclophosphamide exposure, granulosa cells recover their anti-müllerian hormone-producing ability but not their numbers. Cytometry A 2020; 99:807-813. [PMID: 33342073 PMCID: PMC8451832 DOI: 10.1002/cyto.a.24297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
Anti‐müllerian hormone (AMH) produced by granulosa cells (GCs), reserves the ovarian follicle pool for future recruitment and ovulation. However, women who have undergone cyclophosphamide (Cy) treatment have decreased AMH levels due to damaged GCs. This study establishes flow cytometry protocols for identification of GCs and investigates the cause of the Cy‐induced AMH decrease by analyzing the number of GCs and their AMH production at the single cell level. Over 2 weeks, C57BL/6 mice were intraperitoneally injected 6 times with 100 mg/kg Cy and sacrificed either immediately or 4 weeks after Cy treatment. Twenty‐four hours post‐Cy exposure, a decrease in serum AMH levels was seen due to a reduction in the number of follicle‐stimulating hormone receptor (FSHR)+AMH+ GCs and their ability to produce AMH. However, 4 weeks after Cy treatment, serum AMH levels were still decreased due to the decreased number of FSHR+AMH+ GCs, however, their AMH‐producing ability was unaltered. Consistently, in vitro, Cy‐induced low AMH production in FSHR+AMH+ hGL5 cells (immortalized human GCs) was restored 24 h after Cy treatment, although their numbers remained decreased. Thus, the surviving GCs after Cy exposure had intact AMH‐producing ability. In future, an effort to minimize GC death by Cy treatment is required, while maintaining its therapeutic effects.
Collapse
Affiliation(s)
- Jihyun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Sooseong You
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| |
Collapse
|
36
|
Samul-tang ameliorates oocyte damage due to cyclophosphamide-induced chronic ovarian dysfunction in mice. Sci Rep 2020; 10:21925. [PMID: 33318603 PMCID: PMC7736329 DOI: 10.1038/s41598-020-79013-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/03/2020] [Indexed: 01/27/2023] Open
Abstract
Samul-tang (SM), a traditional herbal medicine, has been used to treat menstrual irregularities and infertility in women. However, the cellular and molecular mechanisms underlying the effects of SM remain elusive. We investigated the potential protective effect of SM against chronic ovarian dysfunction and used bioinformatics analysis to identify its underlying mechanism in a mouse model of cyclophosphamide (CP)-induced diminished ovarian reserve. Female C57BL/6 mice were intraperitoneally injected with CP three times a week, followed by oral administration of distilled water (CP group) or SM (CP + SM group) for 4 weeks. Four weeks later, the effect of SM was assessed by ovarian tissue histological analysis, steroid hormone measurement, oocyte quality, and mRNA and microRNA microarray analysis in the ovaries. Although SM administration did not prevent CP-induced follicle loss in mice, the quality of oocytes was better in CP + SM mice than in CP mice. Gene expression analysis revealed that the expression of fertilisation- and ovarian follicle development-related genes was altered by CP treatment but normalized after SM administration. Further bioinformatics analysis showed possible interactions between differentially expressed mRNAs and microRNAs. Therefore, we demonstrated the protective effects of SM on ovarian function and oocyte maturation against CP-induced damage via multiple epigenetic mechanisms.
Collapse
|
37
|
Lohynska R, Jirkovska M, Novakova-Jiresova A, Mazana E, Vambersky K, Veselsky T, Kindlova A, Stankusova H, Malinova B. Radiotherapy dose limit for uterus fertility sparing in curative chemoradiotherapy for rectal cancer. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:99-101. [PMID: 32975243 DOI: 10.5507/bp.2020.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022] Open
Abstract
AIMS Curative sphincter sparing radiotherapy is a treatment option for early rectal cancer. There are many methods developed for fertility preservation in young patients treated with pelvic radiotherapy. Pregnancy rates after radiotherapy are dependent on the radiation dose to ovaries and uterus. Data on outcomes of total body irradiation suggest a pregnancy is possible following 12-14 Gy TBI, despite elevated rates of preterm deliveries and other complications. METHODS We report a case of full-term delivery of twins after curative chemoradiotherapy for anorectal adenocarcinoma T2 N0 M0 with the total dose 58.6 Gy. The patient underwent laparoscopic laterocranial ovarian transposition before radiotherapy. RESULTS Long term complete remission was achieved after treatment. Although a spontaneous conception was not successful, the patient underwent an in vitro fertilisation procedure with donor eggs and conceived twins 10 years after the radiotherapy treatment. The mean dose to the uterus was 16 Gy and to the uterine cervix 35 Gy. She reached a full-term pregnancy and delivered two healthy babies by caesarean section at a gestational age of 38 weeks, weighing 2420 g and 2220 g. CONCLUSION This is the first case report of the successful pregnancy following sphincter sparing curative pelvic radiotherapy for rectal cancer. Furthermore it allows us to propose an increased limit dose to the uterus enabling fertility sparing beyond the limits achieved from total body irradiation series with 12-14 Gy and accept 16 Gy as uterine body (35 Gy for uterine cervix) limit for IMRT treatment planning in young patients asking for maintaining fertility potential.
Collapse
Affiliation(s)
- Radka Lohynska
- Department of Oncology, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital Prague, Czech Republic
| | - Michaela Jirkovska
- Department of Oncology, Second Faculty of Medicine, Charles University in Prague and University Hospital Motol Hospital, Prague, Czech Republic
| | - Alena Novakova-Jiresova
- Department of Oncology, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital Prague, Czech Republic
| | - Eva Mazana
- Department of Oncology, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital Prague, Czech Republic
| | - Kamil Vambersky
- Department of Medical Physics, University Hospital Motol, Prague, Czech Republic
| | - Tomas Veselsky
- Department of Medical Physics, University Hospital Motol, Prague, Czech Republic
| | - Anna Kindlova
- Department of Medical Physics, University Hospital Motol, Prague, Czech Republic
| | - Hana Stankusova
- Department of Oncology, Second Faculty of Medicine, Charles University in Prague and University Hospital Motol Hospital, Prague, Czech Republic
| | - Bela Malinova
- Department of Oncology, Second Faculty of Medicine, Charles University in Prague and University Hospital Motol Hospital, Prague, Czech Republic
| |
Collapse
|
38
|
Joachim C, Véronique-Baudin J, Desroziers L, Chatignoux É, Belliardo S, Plenet J, Macni J, Ulric-Gervaise S, Peruvien J, Bhakkan-Mambir B, Deloumeaux J. Gynaecological cancer in Caribbean women: data from the French population-based cancer registries of Martinique, Guadeloupe and French Guiana (2007-2014). BMC Cancer 2020; 20:643. [PMID: 32650744 PMCID: PMC7350571 DOI: 10.1186/s12885-020-07128-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 07/02/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND For the first time, we present regional-level cancer incidence and world-standardized mortality rates for cancers for Martinique, Guadeloupe and French Guiana. METHODS For Martinique, Guadeloupe and French Guiana, incidence data come from population-based cancer registries, and cover the periods 2007-2014, 2008-2014 and 2010-2014 respectively. Standardized incidence and mortality rates were calculated using the world population. RESULTS In the 3 regions, all cancers combined represent 3567 new cases per year, of which 39.8% occur in women, and 1517 deaths per year (43.4% in women). Guadeloupe and Martinique present similar world-standardized incidence rates. Among gynaecological cancers, breast cancer, the second most common cancer type in the 3 regions, has an incidence rate 35 to 46% lower than in mainland France. On the other hand, cervical cancer has a higher incidence rate, particularly in French Guiana. For both endometrial cancer and ovarian cancer, no significant differences in incidence rates are found compared to mainland France. Regarding mortality, world-standardized mortality rates are similar between Guadeloupe and Martinique, and higher than in French Guiana. This situation compares favourably with mainland France (all cancers). Among gynaecological cancers, the mortality rate is lower for breast cancer in all regions compared to mainland France, and also lower for ovarian cancer in Martinique and Guadeloupe, but higher (albeit non-significantly) in French Guiana. CONCLUSION The ethno-geographic and socio-demographic characteristics in this population of mainly Afro-Caribbean origin could partially explain these disparities. Major disparities exist for certain cancer sites: excess incidence and excess mortality for cervical cancer; lower, but increasing incidence of breast cancer.
Collapse
Affiliation(s)
- Clarisse Joachim
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
- French Network of Cancer Registries, F-31000 Toulouse, France
| | - Jacqueline Véronique-Baudin
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
| | - Laure Desroziers
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre général des cancers de la Guyane, Guyane, France
| | - Édouard Chatignoux
- French National Public Health Agency, 12 rue du Val d’Osne, 94410 Saint Maurice, France
| | - Sophie Belliardo
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre général des cancers de la Guyane, Guyane, France
| | - Juliette Plenet
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre général des cancers de la Guyane, Guyane, France
| | - Jonathan Macni
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
- French Network of Cancer Registries, F-31000 Toulouse, France
| | - Stephen Ulric-Gervaise
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, UF 1441 Registre Général des cancers de la Martinique, F-97200 Martinique, France
- French Network of Cancer Registries, F-31000 Toulouse, France
| | - Jessica Peruvien
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I. Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | - Bernard Bhakkan-Mambir
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I. Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| | - Jacqueline Deloumeaux
- French Network of Cancer Registries, F-31000 Toulouse, France
- Registre Général des Cancers de Guadeloupe, Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe F.W. I. Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France
| |
Collapse
|
39
|
Volodarsky-Perel A, Cohen Y, Arab S, Son WY, Suarthana E, Dahan MH, Tulandi T, Buckett W. Effects of cancer stage and grade on fertility preservation outcome and ovarian stimulation response. Hum Reprod 2020; 34:530-538. [PMID: 30689898 DOI: 10.1093/humrep/dey382] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/08/2018] [Accepted: 12/04/2018] [Indexed: 01/09/2023] Open
Abstract
STUDY QUESTION Do the stage and grade of malignancy affect the fertility preservation outcome in females? SUMMARY ANSWER Patients with high-grade cancer have a decreased number of retrieved mature oocytes and cryopreserved embryos. WHAT IS KNOWN ALREADY Cancer has local and systemic effects on the host. The effects of cancer spread and aggressiveness on the ovarian function and stimulation response remain unclear. STUDY DESIGN, SIZE, DURATION Retrospective cohort study evaluating data of all fertility preservation treatment cycles among women with cancer at the reproductive unit of the McGill University Health Centre in the period from 2008 to 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Study inclusion criteria were age 18-38 years, first stimulation cycle, GnRH-antagonist protocol and early follicular phase stimulation start. Only one stimulation cycle per patient was included. Patients with ovarian pathology, previous ovarian surgery and previous chemo- or radiotherapy were excluded. The outcomes of women with low-stage cancer (local tumor Stage I-II, no lymph node involvement, no metastases) were compared with those with high-stage disease (local tumor Stage III-IV, lymph node involvement or metastases). Similarly we compared those with low-grade (G1-2) and high-grade (G3-4) malignancies. The primary outcome measure was the number of mature oocytes retrieved. The secondary outcomes included the total number of retrieved oocytes, the number of vitrified oocytes, and the number of frozen embryos. We used Student's t-test for normally distributed data and Wilcoxon test for skewed data. To determine factors associated with good fertility preservation outcome defined as over 10 retrieved mature oocytes, we used multivariate logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE A total of 147 patients were included in the final analysis. Age, body mass index, ovarian reserve parameters of the study groups in stage- and grade-based analyses were similar. Compared to women with low-stage cancer (n = 83), those with high-stage cancer (n = 64) required a higher dose of gonadotropin (P = 0.02). The number of retrieved mature oocytes (9 (7-13) versus 8 (5-12); P = 0.37) and vitrified oocytes (10 (7-15) versus 10 (7-13); P = 0.53) were similar between the two groups. However, in cycles where fertilization of all retrieved oocytes was performed, the fertilization rate (82.7% versus 71.5%; P = 0.03) and the number of vitrified embryos (6.2 ± 3.2 versus 4.3 ± 2.1; P = 0.01) were higher in the low-stage group. Compared to patients with low-grade cancer (n = 62), those with high-grade disease (n = 85) had significantly lower number of retrieved mature oocytes (11 (7-15) versus 8 (5-11); P = 0.002) and vitrified oocytes (12 (8-15) versus 10 (7-11); P = 0.005). The number of vitrified embryos was lower in high-grade group (6.5 ± 3.5 versus 4.6 ± 2.3; P = 0.03) in cycles where the fertilization was performed. In multivariate logistical analysis, the low-grade cancer was significantly associated with retrieval of over 10 mature oocytes (OR = 4.26; 95% CI 1.82-9.98; P = 0.0009). LIMITATIONS, REASONS FOR CAUTION The main limitations of the study include its retrospective design and the relatively small sample size in the embryological outcome analysis. The results of our study should be viewed with caution as different malignancy types were included in the study groups, although their distribution between the study groups was similar. WIDER IMPLICATIONS OF THE FINDINGS Cancer grade seems to have a negative impact on the fertility preservation outcome and the ovarian stimulation response. STUDY FUNDING/COMPETING INTEREST(S) Authors have not received any funding to support this study. There are no conflicts of interest to declare.
Collapse
Affiliation(s)
| | - Yoni Cohen
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Suha Arab
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Weon-Young Son
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Eva Suarthana
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Michael Haim Dahan
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Togas Tulandi
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - William Buckett
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| |
Collapse
|
40
|
Floyd JL, Campbell S, Rauh-Hain JA, Woodard T. Fertility preservation in women with early-stage gynecologic cancer: optimizing oncologic and reproductive outcomes. Int J Gynecol Cancer 2020; 31:345-351. [PMID: 32565487 DOI: 10.1136/ijgc-2020-001328] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/22/2022] Open
Abstract
Almost all standard therapies for gynecologic cancer, including surgical intervention, gonadotoxic chemotherapy, and radiation therapy, threaten a woman's childbearing potential. Preservation of fertility should be discussed with premenopausal women with early-stage gynecologic cancer shortly after diagnosis and, for women who desire to preserve fertility, during treatment planning. Many authors have investigated both oncologic and reproductive outcomes following fertility-sparing therapy, and there is ongoing development of assisted reproduction techniques available to cancer patients and survivors. Women with early-stage (IA1-IB1) cervical cancer may be candidates for fertility-sparing cervical conization, simple trachelectomy, or radical trachelectomy. In women with stage I epithelial ovarian cancer, fertility-sparing surgery appears safe overall, although controversy remains in patients with high-risk features (eg, high pathologic grade, clear cell histology, or stage IC disease). In women with low-grade, early-stage endometrial cancer, hormonal therapy has emerged as a viable option. Criteria for patient selection for fertility-sparing therapy are not well defined, thus patients and providers must carefully discuss potential risks and benefits. In general, in carefully selected patients, survival outcomes do not appear to differ significantly between radical and fertility-sparing approaches. Women who undergo fertility-sparing therapies may experience a number of fertility and obstetric complications. Preconception counseling with high-risk obstetric specialists is important to optimize health before a woman attempts to conceive. Identifying appropriate candidates for fertility-sparing treatments, assessing fertility potential, and helping women conceive after cancer treatment is best accomplished through multidisciplinary collaboration between gynecologic oncologists and fertility specialists.
Collapse
Affiliation(s)
- Jessica Lauren Floyd
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Sukhkamal Campbell
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA
| | - Jose Alejandro Rauh-Hain
- Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Terri Woodard
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, TX, USA .,Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
41
|
Fertility in Breast Cancer Survivors in the Middle East: A Retrospective Study. Breast 2020; 52:58-63. [PMID: 32388348 PMCID: PMC7377329 DOI: 10.1016/j.breast.2020.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 01/09/2023] Open
Abstract
Introduction By the time they complete breast cancer therapy, many young patients are still of childbearing age. We aim to estimate the incidence of pregnancies in women who completed treatment and examine the percentage of patients who received fertility counseling before initiation of therapy. Material and methods Electronic health records of breast cancer patients between 2008 and 2014 at AUBMC were screened for exclusion criteria of having metastatic disease or known infertility, still receiving therapy, and being above 42 years at diagnosis. Data about therapy and tumor characteristics was obtained for the included survivors who were interviewed as well via telephone for information about fertility preservation counseling, pregnancy occurrence, and delivery. Results 451 breast cancer patients were identified. 39 patients remained after application of exclusion criteria. 30.76% (n = 12) wanted more children at the time of diagnosis. 10.25% (n = 4) of all 39 patients treated for breast cancer achieved one or more pregnancy after a median time of 3.83 years after completion of therapy. 25% (n = 3) of women who wanted more children at diagnosis (n = 12) were able to conceive. 23.07% (n = 9) of patients discussed fertility with their primary oncologist prior to treatment initiation. 35.89% (n = 14) of patients were aware of fertility preservation technique availability, but none of these patients used one. Conclusions The observed rate of pregnancy is comparable to the literature. There is a lack in fertility counseling of breast cancer patients, and the rate of use of fertility preservation techniques is very low despite prior knowledge about their availability. There is a low rate of discussion of therapy effects on fertility prior to treatment. 35.89% of patients were aware of fertility preservation techniques, but none used one. 10.25% of patients achieved one or more pregnancy after a median time of 3.83 years. Women may still desire to have children despite their disease status. We shed light on importance of patient education and shared decision-making process.
Collapse
|
42
|
Ayres LS, Berger M, Durli ICLDO, Kuhl CP, Terraciano PB, Garcez TNA, Dos Santos BG, Guimarães JA, Passos EP, Cirne-Lima EO. Kallikrein-kinin system and oxidative stress in cisplatin-induced ovarian toxicity. Reprod Toxicol 2019; 93:1-9. [PMID: 31874189 DOI: 10.1016/j.reprotox.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/09/2019] [Accepted: 12/06/2019] [Indexed: 01/05/2023]
Abstract
Kallikrein-kinin system (KKS) is involved in vascular reactivity and inflammatory response to cytotoxic drugs. Since cisplatin is a widely used chemotherapy and its cytotoxic mechanism can trigger inflammation and oxidative damage, in this work we evaluated the role of KKS in an animal model of cisplatin-induced ovarian toxicity. Biomarkers of ovarian stem cells, activity of KKS, inflammation and oxidative damage were measured in ovarian tissue of C57BL/6 female mice treated with vehicle or cisplatin (2.5 mg/kg). Cisplatin group presented greater number of atretic follicles, and lower numbers of antral and total viable follicles. Ki67, DDX4 and OCT-4 markers were similar between groups. Cisplatin triggered plasma and ovarian tissue kallikrein generation; and increased expression of bradykinin receptors B1 and B2. Neutrophil and macrophage infiltration markers increased. Superoxide anion generation also increased, while reduced glutathione levels decreased. These results suggest that KKS is activated and contributes to ovarian injury during cisplatin treatment.
Collapse
Affiliation(s)
- Laura Silveira Ayres
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Markus Berger
- Laboratório de Bioquímica Farmacológica, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Isabel Cirne Lima de Oliveira Durli
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Cristiana Palma Kuhl
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Paula Barros Terraciano
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Tuane Nerissa Alves Garcez
- Unidade de Experimentação Animal, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil.
| | - Bruna Gomes Dos Santos
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil.
| | - Jorge Almeida Guimarães
- Laboratório de Bioquímica Farmacológica, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Biologia Celular e Molecular, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves 9500, Campus do Vale - Building 43421, 91501-970, Porto Alegre, RS, Brazil.
| | - Eduardo Pandolfi Passos
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| | - Elizabeth Obino Cirne-Lima
- Laboratório de Embriologia e Diferenciação Celular, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Santa Cecília, 90035-903, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, 90035003, Porto Alegre, RS, Brazil.
| |
Collapse
|
43
|
Pais AS, Guerra N, Couto D, Sousa AP, Almeida-Santos T. Fertility preservation with successful pregnancy outcome in a patient with transplanted heart and non-Hodgkin's lymphoma - a case report. BMC Pregnancy Childbirth 2019; 19:421. [PMID: 31744460 PMCID: PMC6862739 DOI: 10.1186/s12884-019-2587-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 11/08/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Fertility preservation must be discussed with reproductive age women before cancer treatment. Heart transplantation raises complex issues in pregnancy. Pregnancy in a heart transplant woman after pelvic irradiation involves close multidisciplinary follow-up to avoid complications in the mother and the foetus. We report the first live birth in a heart transplant woman after pelvic irradiation, chemotherapy and fertility preservation. CASE PRESENTATION A 36-year-old heart transplant woman with pelvic non-Hodgkin lymphoma spared her fertility, with cryopreservation of oocytes and embryos, before chemotherapy and pelvic irradiation. After multidisciplinary discussion and pre-conception evaluation, pregnancy was achieved. A close follow-up by a multidisciplinary team allowed a normal pregnancy without maternal or foetal complications and the delivery of a healthy infant. CONCLUSIONS Achieving pregnancy in heart transplant women with iatrogenic ovarian failure after oncologic treatment including pelvic irradiation is possible and can be successful. Careful and close surveillance by a multidisciplinary team is mandatory due to increased risk of maternal and foetal complications.
Collapse
Affiliation(s)
- Ana Sofia Pais
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
- Obstetrics A Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Nuno Guerra
- Obstetrics A Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Daniela Couto
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Ana Paula Sousa
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Teresa Almeida-Santos
- Reproductive Medicine Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
44
|
Turkgeldi L, Cutner A, Turkgeldi E, Al Chami A, Cassoni A, Macdonald N, Mould T, Nichol A, Olaitan A, Saridogan E. Laparoscopic Ovarian Transposition and Ovariopexy for Fertility Preservation in Patients Treated with Pelvic Radiotherapy with or without Chemotherapy. Facts Views Vis Obgyn 2019; 11:235-242. [PMID: 32082530 PMCID: PMC7020947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Preservation of fertility in cancer patients of reproductive age is a concern for both the patient and the clinician. In this study, we aimed to study the effectiveness of laparoscopic ovarian transposition or ovariopexy in preserving ovarian function in women undergoing pelvic radiotherapy with or without chemotherapy for pelvic tumours. METHODS The records of patients who underwent laparoscopic ovarian transposition or ovariopexy prior to pelvic radiation therapy between 2002 and 2018 were reviewed retrospectively. RESULTS Thirty-nine women or adolescent girls with a diagnosis of cervical cancer (n=15), Hodgkin's lymphoma (n=6) or other types of pelvic tumours (n=18) were included in the study. The majority of patients had bilateral (n=25) or unilateral (n=8) ovarian transposition prior to radiotherapy. Nine out of 10 (90%) patients with soft tissue tumors, Ewing sarcoma or ependymoma, five out of seven (71.4%) patients with Hodgkin's lymphoma, two patients (100%) with rectal and anal cancer, and six out of 15 (40%) with cervical cancer retained ovarian function. Patients with cervical cancer, those who received concomitant chemotherapy and those older than 30 years were more likely to experience ovarian failure. Five patients conceived spontaneously and two women had four live births. CONCLUSION Laparoscopic repositioning of the ovaries out of the radiation field in order to protect ovarian function in patients receiving radiotherapy appears to be effective in the majority of patients. The procedure seems safe and should be considered either as a sole procedure or in association with other fertility preservation methods prior to pelvic radiotherapy.
Collapse
Affiliation(s)
- L Turkgeldi
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom;,Current address: ‘Fulya Bahceci IVF Centre’, Istanbul, Turkey
| | - A Cutner
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - E Turkgeldi
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom;,Current address: Koc University Hospital, Istanbul, Turkey
| | - A Al Chami
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - A Cassoni
- University College London Hospital, Cancer Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - N Macdonald
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - T Mould
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - A Nichol
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - A Olaitan
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| | - E Saridogan
- University College London Hospital, Women’s Health Division, 250 Euston Road, London NW1 2PG, United Kingdom
| |
Collapse
|
45
|
Alexandroni H, Shoham G, Levy-Toledano R, Nagler A, Mohty M, Duarte R, Leong M, Shoham Z. Fertility preservation from the point of view of hematopoietic cell transplant specialists—a worldwide-web-based survey analysis. Bone Marrow Transplant 2019; 54:1747-1755. [DOI: 10.1038/s41409-019-0519-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/20/2019] [Accepted: 03/17/2019] [Indexed: 01/09/2023]
|
46
|
Marci R, Mallozzi M, Di Benedetto L, Schimberni M, Mossa S, Soave I, Palomba S, Caserta D. Radiations and female fertility. Reprod Biol Endocrinol 2018; 16:112. [PMID: 30553277 PMCID: PMC6295315 DOI: 10.1186/s12958-018-0432-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 10/24/2018] [Indexed: 11/18/2022] Open
Abstract
Hundreds of thousands of young women are diagnosed with cancer each year, and due to recent advances in screening programs, diagnostic methods and treatment options, survival rates have significantly improved. Radiation therapy plays an important role in cancer treatment and in some cases it constitutes the first therapy proposed to the patient. However, ionizing radiations have a gonadotoxic action with long-term effects that include ovarian insufficiency, pubertal arrest and subsequent infertility. Cranial irradiation may lead to disruption of the hypothalamic-pituitary-gonadal axis, with consequent dysregulation of the normal hormonal secretion. The uterus might be damaged by radiotherapy, as well. In fact, exposure to radiation during childhood leads to altered uterine vascularization, decreased uterine volume and elasticity, myometrial fibrosis and necrosis, endometrial atrophy and insufficiency. As radiations have a relevant impact on reproductive potential, fertility preservation procedures should be carried out before and/or during anticancer treatments. Fertility preservation strategies have been employed for some years now and have recently been diversified thanks to advances in reproductive biology. Aim of this paper is to give an overview of the various effects of radiotherapy on female reproductive function and to describe the current fertility preservation options.
Collapse
Affiliation(s)
- Roberto Marci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, via L. Borsari, 46, 44121, Ferrara, Italy.
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Division of Obstetrics and Gynecology, University Hospital of Geneva, Boulevard de la Cluse 30, 1205, Geneva, Switzerland.
| | - Maddalena Mallozzi
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy
| | - Luisa Di Benedetto
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy
| | - Mauro Schimberni
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy
| | - Stefano Mossa
- Radiation Oncology Unit, S Andrea Hospital, University Sapienza, Rome, Italy
| | - Ilaria Soave
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy
| | - Stefano Palomba
- Unit of Obstetrics and Gynecology, Grande Ospedale Metropolitano 'Bianchi - Melacrino - Morelli', Reggio Calabria, Italy
| | - Donatella Caserta
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy
| |
Collapse
|
47
|
Castiglione Morelli MA, Iuliano A, Schettini SCA, Petruzzi D, Ferri A, Colucci P, Viggiani L, Cuviello F, Ostuni A. NMR metabolomics study of follicular fluid in women with cancer resorting to fertility preservation. J Assist Reprod Genet 2018; 35:2063-2070. [PMID: 30069850 PMCID: PMC6240554 DOI: 10.1007/s10815-018-1281-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/24/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the possible application of metabolomics to identify follicular fluid changes in cancer patients undergoing fertility preservation. Although metabolomics have been applied already in cancer studies, this is the first application on follicular fluid of cancer patients. METHODS We selected for the study ten patients with breast cancer and lymphoma who resorted to oocyte cryopreservation to preserve fertility and ten healthy women undergoing in vitro fertilization treatments. Follicular fluid was collected at the time of oocytes retrieval. Metabolomic analysis of follicular fluids was performed by 1H-nuclear magnetic resonance (NMR) spectroscopy in combination with multivariate analysis to interpret the spectral data. Univariate statistical analysis was applied to find correlations between patients' features and metabolites identified by NMR. RESULTS Partial least squares discriminant analysis allowed to discriminate samples from cancer patients and healthy controls. Univariate statistical analysis found significant correlations between patients' features and metabolites identified by NMR. This finding allowed to identify biomarkers to differentiate both healthy controls from cancer patients and the two different classes of oncological patients. CONCLUSION The follicular fluids of cancer patients display significant metabolic alterations in comparison to healthy subjects. NMR-based metabolomics could be a valid prognostic tool for identifying and selecting the best cryopreserved oocytes and improving the outcome prediction in cancer women undergoing in vitro fertilization.
Collapse
Affiliation(s)
| | - Assunta Iuliano
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | | | - Donatina Petruzzi
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Angela Ferri
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Paola Colucci
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Licia Viggiani
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy
| | - Flavia Cuviello
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy
| | - Angela Ostuni
- Department of Sciences, University of Basilicata, viale Ateneo Lucano 10, 85100, Potenza, Italy.
| |
Collapse
|
48
|
Kan SF, Wang J, Sun GX. Sulforaphane regulates apoptosis- and proliferation‑related signaling pathways and synergizes with cisplatin to suppress human ovarian cancer. Int J Mol Med 2018; 42:2447-2458. [PMID: 30226534 PMCID: PMC6192763 DOI: 10.3892/ijmm.2018.3860] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 08/13/2018] [Indexed: 12/21/2022] Open
Abstract
Ovarian cancer is currently the most life‑threatening type of gynecological malignancy with limited treatment options. Therefore, improved targeted therapies are required to combat ovarian cancer across the world. Sulforaphane is found in raw cruciferous vegetables. The chemotherapeutic and anti‑carcinogenic properties of sulforaphane have been demonstrated, however, the underlying mechanisms remain to be fully elucidated, particularly in ovarian cancer. In the present study, the possibility of repurposing sulforaphane as an anti‑ovarian cancer agent was examined. Cell viability and colony formation assay were used to test the anticancer efficiency of sulforaphane. Then wound healing assay, migration assay, cell cycle and apoptosis assays were used to detect how the drug worked on the cells. The mechanism of sulforaphane was investigated by western blot analysis. It was found that sulforaphane effectively suppressed the progression of human ovarian cancer cell proliferation, migration and cell cycle, and promoted apoptosis. Sulforaphane inhibited multiple cancer‑associated signaling pathways, including B‑cell lymphoma 2 (Bcl‑2), Bcl‑2‑associated X protein, cytochrome c, Caspase‑3, phosphorylated AKT, phosphorylated nuclear factor‑κB, P53, P27, Cyclin‑D1 and cMyc, and reduced the expression levels of human epidermal growth factor receptor 2 in human ovarian cancer cells. Sulforaphane synergized with cisplatin to suppress the cancer cell proliferation and enhance ovarian cancer cell apoptosis. Xenograft experiments in vivo confirmed that sulforaphane effectively suppressed tumor growth by inhibiting ovarian cancer cell proliferation through targeting tumor‑related signals. The results indicated that sulforaphane may be repurposed as an effective anti‑ovarian cancer agent, with further preclinical or clinical investigations required.
Collapse
Affiliation(s)
| | - Jian Wang
- Department of Gynecology, Zaozhuang City Hospital, Zaozhuang, Shandong 277102, P.R. China
| | | |
Collapse
|
49
|
VEGFR2 Expression Is Differently Modulated by Parity and Nulliparity in Mouse Ovary. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6319414. [PMID: 30310818 PMCID: PMC6166384 DOI: 10.1155/2018/6319414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/01/2018] [Accepted: 09/01/2018] [Indexed: 11/18/2022]
Abstract
Parity and nulliparity exert opposite effects on women's health, as parity is considered a protective factor for several reproductive diseases. This study is aimed at determining if ovarian VEGF and VEGFR2 expression are differently modulated in the ovaries of parous and nulliparous mice. To this end primiparous and nulliparous fertile mice were sacrificed at postovulatory stage. Whole ovaries, corpus luteum, and residual stromal tissues were analyzed to assess VEGF/VEGFR2 expression levels. Ovarian mRNA amounts of Vegfa (120 and 164) and Vegfr2 were comparable between primiparous and nulliparous mice; both isoforms and receptor were accumulated mainly in corpus luteum tissues. VEGF 120 and 164 protein accumulation and distribution mirrored that of mRNA. Conversely, VEGFR2 protein content was significantly higher in ovaries of nulliparous mice and was more efficiently phosphorylated in ovaries of primiparous mice. In both groups, VEGFR2 was preferentially expressed in corpus luteum, while its phosphorylated form was equally distributed in two somatic compartments. We suggest that parity influences VEGFR2/phospho-VEGFR2 expression and tissue distribution. This difference could be part of a more complex mechanism that at least in mice is activated after the first pregnancy and likely aims to preserve female health.
Collapse
|
50
|
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]
|