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Koizumi T, Sugishita Y, Suzuki-Takahashi Y, Nara K, Miyagawa T, Nakajima M, Sugimoto K, Futamura M, Furui T, Takai Y, Matsumoto H, Yamauchi H, Ohno S, Kataoka A, Kawai K, Fukuma E, Nogi H, Tsugawa K, Suzuki N. Oncofertility-related psycho-educational therapy for young adult patients with breast cancer and their partners: Randomized controlled trial. Cancer 2023; 129:2568-2580. [PMID: 37082910 DOI: 10.1002/cncr.34796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND A couples' psycho-educational program called Oncofertility! Psycho-Education and Couple Enrichment (O!PEACE) therapy was created and its effect when provided before cancer treatment was examined. METHODS This multicenter randomized controlled trial with nonmasking, parallel two-group comparison enrolled women aged 20 to 39 years with early-stage breast cancer and their partners. They were randomly assigned to receive O!PEACE (37 couples) or usual care (37 couples). Primary end points were cancer-related posttraumatic stress symptoms, symptoms of depression, and anxiety. Secondary end points were stress-coping strategies, resilience, and marital relationship. RESULTS Women receiving psycho-educational therapy had significantly reduced Impact of Event Scale-revised version for Japanese scores (p = .011, ηp 2 = = .089). For patients with Impact of Event Scale-revised version for Japanese scores at baseline ≥18.27, O!PEACE therapy improved these scores when compared with usual care (U = 172.80, p = .027, r = 0.258). A >5-point reduction was present in 59.3% and 30% of women in the O!PEACE therapy and usual-care groups, respectively. For partners, O!PEACE therapy significantly improved stress-coping strategies (95% CI, -0.60 to -0.05; p = .018, ηp 2 = = .074) and escape-avoidance marital communication (95% CI, -0.33 to -0.08; p = .001, ηp 2 = .136). O!PEACE therapy significantly improved the partners' support (95% CI, 0.10-0.50; p = .001, ηp 2 = .127), the rate of receiving fertility preservation consultations, and knowledge levels. CONCLUSIONS O!PEACE therapy before cancer treatment can improve posttraumatic stress symptoms, stress-coping behavior, and marital relationships. Larger sample sizes and longer term follow-up are required. PLAIN LANGUAGE SUMMARY A psycho-educational program, the Oncofertility! Psycho-Education and Couple Enrichment (O!PEACE) therapy program was developed and evaluated for women diagnosed with breast cancer and their partners. A multicenter randomized controlled trial showed that the O!PEACE psycho-educational therapy, with only two precancer treatment sessions, can reduce cancer-related posttraumatic stress symptoms and improve oncofertility knowledge and marital relationships in young adult patients with breast cancer. The therapy could also improve stress-coping strategies in marital communications with their partners. Couples may use O!PEACE psycho-educational therapy to consider fertility preservation and improve their psychosocial aspects.
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Affiliation(s)
- Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Yodo Sugishita
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kazuko Nara
- Department of Clinical Psychology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomoko Miyagawa
- Department of Clinical Psychology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | | | - Kouhei Sugimoto
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Manabu Futamura
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical University Saitama Medical Center, Kawagoe, Saitama, Japan
| | - Hiroshi Matsumoto
- Lacteal Gland Surgery Department, Saitama Cancer Center, Kitaadachi, Saitama, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Chuo, Tokyo, Japan
| | - Shinji Ohno
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo, Japan
| | - Akemi Kataoka
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo, Japan
| | - Kiyotaka Kawai
- Kameda IVF Clinic, Chiba, Chiba, Japan
- Assisted Reproductive Technology Center, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Eisuke Fukuma
- Breast Center, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Hiroko Nogi
- Department of Surgery, Jikei University School of Medicine, Minato, Tokyo, Japan
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Yudoh K, Sugishita Y, Suzuki-Takahashi Y. Bone Development and Regeneration 2.0. Int J Mol Sci 2023; 24:ijms24108761. [PMID: 37240107 DOI: 10.3390/ijms24108761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/29/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
Bone is an important tissue which is a structural body component, carrying out the roles of mechanical stress response and organ/tissue protection [...].
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Affiliation(s)
- Kazuo Yudoh
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Yodo Sugishita
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Yuki Suzuki-Takahashi
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
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Suzuki R, Horage-Okutsu Y, Kawahara T, Nakamura K, Shiraishi E, Iwahata H, Suzuki-Takahashi Y, Sugishita Y, Takae S, Suzuki N. The effect of aromatase inhibitor on controlled ovarian stimulation for oocyte cryopreservation in adolescent and young cancer patients. J Obstet Gynaecol Res 2023; 49:973-979. [PMID: 36606606 DOI: 10.1111/jog.15535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023]
Abstract
AIM To determine the impact of aromatase inhibitor (AI) use in oocyte cryopreservation among Japanese adolescent and young adult (AYA) cancer patients for fertility preservation, we evaluated the oocyte cryopreservation outcomes following AI therapy in combination with the follicular phase start (FPS) and random start (RS) protocols. METHODS This retrospective study included 81 cycles of controlled ovarian stimulation (COS) among 73 AYA patients with cancer who underwent oocyte cryopreservation to maintain fertility. The outcome measures were the total number of matured oocytes that were retrieved and cryopreserved, as well as their maturation rates. The AI (+) and AI (-) groups were compared using the RS and FPS protocols. RESULTS Our results showed that the combined use of AI and COS decreases serum E2 levels and maintains the number of retrieved and cryopreserved mature oocytes. We also confirmed the efficacy of the RS protocol, which was found to have comparable outcomes to that of the FPS protocol in both AI (+) and AI (-) groups. CONCLUSION The combined use of AI and COS is beneficial for oocyte cryopreservation in patients with estrogen-sensitive cancer, regardless of the menstrual cycle phase of COS initiation.
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Affiliation(s)
- Reiko Suzuki
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Horage-Okutsu
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Tai Kawahara
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Kentaro Nakamura
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Eriko Shiraishi
- Department of Obstetrics and Gynecology, The Jikei University school of medicine, Tokyo, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Yodo Sugishita
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
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4
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Okutsu-Horage Y, Iwahata H, Suzuki-Takahashi Y, Sugishita Y, Takae S, Suzuki N. Correction to: Clinical outcome of embryo cryopreservation in Japanese breast cancer patients: pregnancy rates after transfer of thawed embryos. J Assist Reprod Genet 2022; 39:2201. [PMID: 36044165 DOI: 10.1007/s10815-022-02604-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 07/11/2022] [Indexed: 10/14/2022] Open
Affiliation(s)
- Yuki Okutsu-Horage
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2‑16‑11 Sugao, Miyamae, Kawasaki City, Kanagawa Prefecture, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2‑16‑11 Sugao, Miyamae, Kawasaki City, Kanagawa Prefecture, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2‑16‑11 Sugao, Miyamae, Kawasaki City, Kanagawa Prefecture, Japan
| | - Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2‑16‑11 Sugao, Miyamae, Kawasaki City, Kanagawa Prefecture, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2‑16‑11 Sugao, Miyamae, Kawasaki City, Kanagawa Prefecture, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2‑16‑11 Sugao, Miyamae, Kawasaki City, Kanagawa Prefecture, Japan.
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Meng L, Sugishita Y, Nishimura S, Uekawa A, Suzuki-Takahashi Y, Suzuki N. Investigation of the optimal culture time for warmed bovine ovarian tissues before transplantation. Biol Reprod 2022; 107:1319-1330. [PMID: 35980811 DOI: 10.1093/biolre/ioac161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/25/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Ovarian tissue cryopreservation by vitrification is an effective technique, but there are still many unresolved issues related to the procedure. The aim of this study was to investigate the optimal culture time of post-warmed ovarian tissues and their viability before ovarian tissue transplantation. The bovine ovarian tissues were used to evaluate the effect of post-warming culture periods (0, 0.25, 0.5, 1, 2, 5 and 24 hours) in the levels of residual cryoprotectant, LDH release, ROS generation, gene and protein abundance, and follicle viability and its mitochondrial membrane potential. Residual cryoprotectant (CPA) concentration decreased significantly after 1 hour of culture. The warmed ovarian tissues that underwent between 0 to 2 hours of culture time showed similar LDH and ROS levels compared to fresh non-frozen tissues. The AMH transcript abundance did not differ in any of the groups. No increase in the relative transcript abundance and protein level of Caspase 3 and Cleaved-Caspase 3, respectively, in the first 2 hours of culture after warming. On the other hand, an increased protein level of double stranded DNA breaks (gamma-H2AX) was observed in post-warmed tissues disregarding the length of culture time, and a temporary reduction in pan-AKT was detected in post-warming tissues between 0 to 0.25 hours of culture time. Prolonged culture time lowered the percentage of viable follicles in warmed tissues, but it did not seem to affect the follicular mitochondrial membrane potential. In conclusion, 1 to 2 hours of culture time would be optimal for vitrified-warmed tissues before transplantation.
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Affiliation(s)
- Lingbo Meng
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Frontier Medicine, Institute of Medical Science, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Sandy Nishimura
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Atsushi Uekawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Frontier Medicine, Institute of Medical Science, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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Sugishita Y, Meng L, Suzuki-Takahashi Y, Nishimura S, Furuyama S, Uekawa A, Tozawa-Ono A, Migitaka-Igarashi J, Koizumi T, Seino H, Natsuki Y, Kubota M, Koike J, Edashige K, Suzuki N. Quantification of residual cryoprotectants and cytotoxicity in thawed bovine ovarian tissues after slow freezing or vitrification. Hum Reprod 2022; 37:522-533. [PMID: 34928342 DOI: 10.1093/humrep/deab274] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 11/17/2021] [Indexed: 09/27/2023] Open
Abstract
STUDY QUESTION How much residual cryoprotectant remains in thawed/warmed ovarian tissues after slow freezing or vitrification? SUMMARY ANSWER After thawing/warming, at least 60 min of diffusion washing in media was necessary to significantly reduce the residual cryoprotectants in ovarian tissues frozen by slow freezing or vitrification. WHAT IS KNOWN ALREADY Ovarian tissue cryopreservation (OTC) by slow freezing has been the conventional method; while the vitrification method has gained popularity for its practicality. The main concern about vitrification is how much potentially toxic residual cryoprotectant remains in the warmed tissues at the time of transplantation. STUDY DESIGN, SIZE, DURATION This was an animal study using the ovarian tissues from 20 bovine ovaries. The duration of this study was from 2018 to 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Ovarian cortex tissues were prepared from 20 bovine ovaries and assigned randomly to groups of fresh (non-frozen) control, slow freezing with 1.5 M dimethyl sulfoxide (DMSO), 1.5 M 1,2-propanediol (PROH) and vitrification with 35% ethylene glycol (EG). The residual cryoprotectant concentrations in thawed/warmed tissues were measured by gas chromatography at the following time points: frozen (before thawing/warming), 0 min (immediately after thawing/warming), 30, 60 and 120 min after diffusion washing in media. Next, the ultrastructural changes of primordial follicles, granulosa cells, organelles and stromal cells in the ovarian tissues (1 mm × 1 mm × 1 mm) were examined in fresh (non-frozen) control, slow freezing with DMSO or PROH and vitrification with EG groups. Real-time quantitative PCR was carried out to examine the expressions of poly (ADP-ribose) polymerase-1 (PARP1), a DNA damage sensor and caspase-3 (CASP3), an apoptosis precursor, in thawed/warmed ovarian tissues that were washed for either 0 or 120 min and subsequently in tissues that were ex vivo cultured for 24 or 48 h. The same set of tissues were also used to analyze the protein expressions of gamma H2A histone family member X (γH2AX) for DNA double-strand breaks and activated caspase-3 (AC3) for apoptosis by immunohistochemistry. MAIN RESULTS AND THE ROLE OF CHANCE The residual cryoprotectant concentrations decreased with the extension of diffusion washing time. After 60 min washing, the differences of residual cryoprotectant between DMSO, PROH and EG were negligible (P > 0.05). This washing did not affect the tissue integrity or significantly elevate the percentage of AC3 and γH2AX positive cells, indicating that tissues are safe and of good quality for transplantation. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Since the study was performed with ovarian tissues from bovines, generalizability to humans may be limited. Potential changes in ovarian tissue beyond 120 min were not investigated. WIDER IMPLICATIONS OF THE FINDINGS This study addresses concerns about the cytotoxicity of EG in warmed ovarian tissues and could provide insights when devising a standard vitrification protocol for OTC. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by a Grant-in-Aid for Scientific Research (B) from the Japan Society for the Promotion of Science to N.S.
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Affiliation(s)
- Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Lingbo Meng
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Sandy Nishimura
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Sayako Furuyama
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Atsushi Uekawa
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Akiko Tozawa-Ono
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Junko Migitaka-Igarashi
- Department of Anatomy, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
- Center for Reproductive Medicine, Dokkyo Medical University, Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Hibiki Seino
- Department of Pathology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yasunori Natsuki
- Graduate School Facility of Electron Microscope Research, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Manabu Kubota
- Department of Pathology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Junki Koike
- Department of Anatomy, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
| | - Keisuke Edashige
- Faculty of Agriculture and Marine Science, Department of Agricultural Chemistry, Kochi University, Nankoku, Kochi, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan
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Mohd Faizal A, Sugishita Y, Suzuki-Takahashi Y, Iwahata H, Takae S, Horage-Okutsu Y, Suzuki N. Twenty-first century oocyte cryopreservation—in vitro maturation of immature oocytes from ovarian tissue cryopreservation in cancer patients: A systematic review. Womens Health (Lond Engl) 2022; 18:17455057221114269. [PMID: 35983837 PMCID: PMC9393350 DOI: 10.1177/17455057221114269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Our review aimed to consolidate the latest update on the application of in
vitro maturation among immature oocyte harvest in combination with ovarian
tissue cryopreservation known as ovarian tissue oocyte–in vitro
maturation. Methods: A thorough search for relevant studies was conducted via PubMed, Google
Scholar, EMBASE, and clinical.gov databases up to December 2020. The primary
outcome was the oocyte maturation rate, which measured the number of
immature oocytes (geminal vesicle stage) that progressed to mature oocytes
(meiosis II stage) following in vitro maturation. The secondary outcomes
were the fertilization rate following intracytoplasmic sperm injection/in
vitro fertilization of these oocytes for the embryo cryopreservation cohort.
Our review included pre-pubertal girls and women with cancer who underwent
ovarian tissue oocyte–in vitro maturation as fertility preservation. Results: The primary search identified 207 studies. Twelve manuscripts were selected
for inclusion in our review following duplication assessment, title and
abstract screening, and full-text evaluation tailored to our inclusion
criteria. All the population belonged to a cancer group and underwent
concurrent ovarian tissue oocyte–in vitro maturation. A total of 5724
immature oocytes were obtained following ovarian tissue cryopreservation.
Approximately 33.84% of the immature oocytes successfully matured via in
vitro maturation, which were cryopreserved as oocytes or fertilized as
embryos and subsequently stored for future use. Conclusion: Our review proposed the potential application of ovarian tissue oocyte–in
vitro maturation in increasing the number of mature oocytes. The acceptable
improvement in oocyte maturation rate following in vitro maturation
indicates that improving oocyte outcomes is an excellent cost-effective
strategy for fertility preservation among women with cancer.
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Affiliation(s)
- Ahmad Mohd Faizal
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
- Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia, Cheras, Malaysia
| | - Yodo Sugishita
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Seido Takae
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Horage-Okutsu
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics & Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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Ahmad MF, Sugishita Y, Suzuki-Takahashi Y, Sawada S, Iwahata H, Shiraishi E, Takae S, Horage-Okutsu Y, Suzuki N. Case Report: Young Adults With Breast Cancer: A Case Series of Fertility Preservation Management and Literature Review. Front Med (Lausanne) 2021; 8:670872. [PMID: 34422852 PMCID: PMC8378131 DOI: 10.3389/fmed.2021.670872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/13/2021] [Indexed: 01/20/2023] Open
Abstract
Breast cancer comprised at least 21.8% of the overall cancer among young adult (YA) women and became the leading cancer in this group in Japan, with 50% adolescent and YAs being diagnosed and 15–44-year-old women showing excellent 5-year survival. Surgical-chemoradiation therapy often results in excellent survivorship with an increased incidence of treatment-induced subfertility. Therefore, adding fertility preservation (FP) to the primary cancer treatment is necessary. Herein, we reported a series of cases of YA women with breast cancer who opted for FP, where their option was tailored accordingly. To date, the selection of oocytes, embryos and ovarian tissue is widely available as an FP treatment. PGT could reduce the risk of BRCA mutation transmission amongst BRCA carriers before pregnancy planning. Otherwise, gonadotropin-releasing hormone analog has no gonadoprotective effect and thus should not be considered as an FP option.
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Affiliation(s)
- Mohd Faizal Ahmad
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Laboratory of Cancer and Reproductive Science, Department of Frontier Medicine, St. Marianna University, School of Medicine, Kawasaki, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shino Sawada
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Eriko Shiraishi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Horage-Okutsu
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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Ahmad MF, Sugishita Y, Suzuki-Takahashi Y, Sawada S, Iwahata H, Shiraishi E, Takae S, Horage-Okutsu Y, Suzuki N. Oncofertility Treatment Among Breast Cancer Women: A Paradigm Shift of Practice After a Decade of Service. J Adolesc Young Adult Oncol 2020; 9:496-501. [PMID: 32283045 DOI: 10.1089/jayao.2019.0177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Our center is known as a pioneer center initiating oncofertility service since 2010 in Japan. We demonstrate our transition of this service in regional university hospitals ingenuously. Methods: We compared two phases of service: initial phase (2011 and 2012) and current phase (2019). The comparison included the number of women attending the oncofertility unit, diversity of breast cancer cases, the acceptability of preservation service, and the type of fertility preservation (FP) option offered in between these phases. Results: A total of 58 women were seen during the initial phase as compared with 41 women in the later phase. The mean age at diagnosis was not significantly different between the two periods. The majority of them were married and diagnosed with stage II luminar type. The current phase had a tendency to have a higher anti-Müllerian hormone level although not reaching significance. At least 50% of them declined FP and 84.5% never received ovarian control stimulation in the initial phase. Otherwise, 61% used aromatase inhibitor in the current phase. Only 15.5% in the initial phase received control ovarian stimulation whereas 63.4% in the current phase received it. The ovarian tissue cryopreservation was highly chosen during the initial phase (25.9%), whereas embryo cryopreservation (39%) was highly opted for during the current phase. All of our parameters are comparable between these two phases (p > 0.05). Conclusion: The significant changes of oncofertility practice were observed mainly due to the understanding of the oncofertility concept among reproductive physicians and the acceptance environment, including standard guidelines, supportive society, as well as advancements in cryobiology technique.
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Affiliation(s)
- Mohd Faizal Ahmad
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yodo Sugishita
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shino Sawada
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Eriko Shiraishi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuki Horage-Okutsu
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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