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Lotz L, Bender-Liebenthron J, Dittrich R, Häberle L, Beckmann MW, Germeyer A, Korell M, Sänger N, Kruessel JS, von Wolff M. Determinants of transplantation success with cryopreserved ovarian tissue: data from 196 women of the FertiPROTEKT network. Hum Reprod 2022; 37:2787-2796. [PMID: 36272106 DOI: 10.1093/humrep/deac225] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 02/19/2022] [Revised: 09/19/2022] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION What are the pregnancy and live birth rates for ovarian tissue transplantation and which factors are associated with the success rate? SUMMARY ANSWER Pregnancy and live birth rates per transplanted woman are 32.7% and 26.5% and success rate is associated with female age and first versus repeated transplantation. WHAT IS KNOWN ALREADY Live birth rates after ovarian tissue transplantations have been reported to be between around 24% and 41% per patient. Success rates seem to be negatively associated with increasing female age at the time of tissue cryopreservation and with pelvic radiation. Success rates are apparently not reduced after overnight transportation of ovarian tissue before freezing. STUDY DESIGN, SIZE, DURATION Registry analysis of 244 transplantations in 196 women, performed by 26 FertiPROTEKT network centres from 2007 to 2019 with follow-up till December 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Orthotopic ovarian tissue transplantations were performed in 196 women, 191 with previous malignant and 5 with previous non-malignant diseases. Size of transplanting centres varied between 1 and 100 transplantations per centre (median: 2). Factors possibly associated with success rate such as female age, first and repeated transplantation, experience of the transplanting centre and overnight transportation of the ovarian tissue before freezing were analysed. MAIN RESULTS AND THE ROLE OF CHANCE Average age of all 196 transplanted women was 31.3 years (SD 5.2; range 17-44) at the time of cryopreservation of tissue and 35.9 years (SD 4.8; range 23-47) at the time of transplantation. Pregnancy rate was 30.6% (95% CI, 24.2-37.6%) per first transplantation and 32.7% (95% CI, 26.1-39.7%) per patient. Pregnancy rate was higher after first transplantation (30.6% (95% CI, 24.2-37.6%)) compared to second and subsequent transplantations (11.8% (95% CI, 3.3-27.5%)). Live birth rate per first transplantation was 25.0% (95% CI, 19.1-31.7%) and per patient 26.5% (95% CI, 20.5-33.3%). Success rate decreased with increasing age at the time of ovarian tissue freezing. Live birth rate was 28.2% (95% CI, 20.9-36.3%) in women <35 years and 16.7% (95% CI, 7.9-29.3%) in women >35 years. Pregnancy rates after first transplantation were higher in centres who had performed ≥10 transplantations (35.1%) compared to centres with <10 transplantation (25.4%) (P = 0.12). Corresponding live birth rates were 27.0% and 18.6%. Success rates were not different in women with and without overnight transportation of tissue before cryopreservation. LIMITATIONS, REASONS FOR CAUTION The data were drawn from a registry analysis. Data such as ovarian reserve and premature ovarian insufficiency were not available for all women. Data might be influenced by different follow-up policies of the centres. WIDER IMPLICATIONS OF THE FINDINGS The study reveals the high potential of ovarian tissue freezing and transplantation, but only if freezing is performed in younger women. The study suggests focus should be placed on the first and not on repeated transplantations. It also opens the discussion of whether transplantation should rather be performed by experienced centres. STUDY FUNDING/COMPETING INTEREST(S) No funding. No competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L Lotz
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - J Bender-Liebenthron
- UniCareD, University Cryobank for Assisted Reproductive Medicine and Fertility Protection at UniKiD, University Women's Hospital Duesseldorf, Duesseldorf, Germany
| | - R Dittrich
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - L Häberle
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
- Biostatistics Unit, Department of Gynaecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - M W Beckmann
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - A Germeyer
- Department of Gynaecological Endocrinology and Fertility Disorders, University Women's Hospital Heidelberg, Heidelberg, Germany
| | - M Korell
- Department of Obstetrics and Gynaecology, Johanna-Etienne-Hospital Neuss, Neuss, Germany
| | - N Sänger
- Department of Gynaecological Endocrinology and Reproductive Medicine, University Hospital of Bonn, Bonn, Germany
| | - J S Kruessel
- Department of Obstetrics/Gynecology and Reproductive Endocrinology and Infertility, UniKiD, University Women's Hospital Duesseldorf, Duesseldorf, Germany
| | - M von Wolff
- Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital, Bern, Switzerland
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Lotz L, Bender-Liebenthron J, Dittrich R, Häberle L, Beckmann MW, Germeyer A, Korell M, Sänger N, Von Wolff M. O-033 Ovarian tissue transplantations in 196 women by FertiPROTEKT– live birth rate of 26.5% per woman is associated with female age and first versus repeated transplantation. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.033] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
What is the live birth rate of ovarian tissue transplantation and which factors are associated with the success rate?
Summary answer
Live birth rate per transplanted woman is 26.5% and the success rate is associated with female age and first versus repeated transplantation.
What is known already
Live birth rates after tissue transplantations have been reported to be between around 24% and 41% per patient. Success rates seem to be negatively associated with increasing female age at the time of tissue cryopreservation and with pelvic radiation. Success rates are apparently not reduced after overnight transportation of tissue before freezing.
Study design, size, duration
Registry analysis of 244 transplantations in 196 women, performed by 26 centers of the FertiPROTEKT network from 2007 to 2019 with a follow up till 12/2020.
Participants/materials, setting, methods
Orthotopic transplantation was performed in 196 women, 191 with previous malignant and 5 with previous non-malignant diseases. Size of transplanting centers varied between 1 and 100 transplantations per center (average: 9.5 ± 19.6 transplantations). Factors possibly associated with success rate such as female age, first and repeated transplantation, experience of the transplanting center and overnight transportation of the tissue before freezing were analysed.
Main results and the role of chance
Average age of all transplanted 196 women was 31.3 years (SD, standard deviation, 5.2) at the time of cryopreservation (range 17-44y) and 35.9 years (SD 4.8, range 23-47) at the time of first transplantation. Overall pregnancy rate was 30.6% (95% CI, 24.2-37.6%) per first transplantation and 32.7% (95% CI, 26.1-39.7) per patient. Overall live birth rate per first transplantation was 25.0% (95% CI, 19.1-31.7%) and per patient 26.5% (95% CI, 20.5-33.3%). Pregnancy and live birth rates were calculated and graphically expressed as a continuous function of age to allow estimation of success rates per age group. Success rate decreased with increasing age at the time of tissue freezing. Pregnancy rate after first transplantation was 34.5% (95% CI, 26.7-42.9%) in women <35y and 20.4% (95% CI, 10.6-33.5%) in women ≥35y.
Pregnancy rate was higher after 1st transplantation (30.6% (95% CI, 24.2-37.6%)) compared to 2nd and more transplantations (11.8% (95% CI, 3.3-27.5%)).
Pregnancy rates after 1st transplantation was higher in centers with ≥10 transplantations (35.1%) compared to centers with <10 transplantation (25.4%) (p = 0.12). Corresponding live birth rates were 27.0% and 18.6%.
Success rates was not different in women with and without overnight transportation of tissue before cryopreservation.
Limitations, reasons for caution
The data were drawn from a registry analysis. Data such as ovarian reserve and premature ovarian insufficiency were not available for all women. Data might be influenced by different follow up policies of the centers.
Wider implications of the findings
The study reveals the high potential of ovarian tissue freezing and transplantation but only if freezing is performed in younger women. The study suggests to better focus on the first and not on repeated transplantations. It also opens the discussion if transplantation should rather be performed by experienced centres.
Trial registration number
Non
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Affiliation(s)
- L Lotz
- University-Hospital Erlangen- University Erlangen-Nuremberg, Obstetrics and Gynecology, Erlangen , Germany
| | - J Bender-Liebenthron
- University Women's Hospital Duesseldorf, UniCareD- University Cryobank for Assisted Reproductive Medicine and Fertility Protection at UniKiD, Duesseldorf , Germany
| | - R Dittrich
- University-Hospital Erlangen- University Erlangen-Nuremberg, Obstetrics and Gynecology, Erlangen , Germany
| | - L Häberle
- University-Hospital Erlangen- University Erlangen-Nuremberg, Biostatistics Unit- Department of Gynecology and Obstetrics-, Erlangen , Germany
| | - M W Beckmann
- University-Hospital Erlangen- University Erlangen-Nuremberg, Obstetrics and Gynecology, Erlangen , Germany
| | - A Germeyer
- University Women’s Hospital Heidelberg, Gynecological Endocrinology and Fertility Disorders, Heidelberg , Germany
| | - M Korell
- Johanna-Etienne-Hospital Neuss, Obstetrics and Gynecology, Neuss , Germany
| | - N Sänger
- University Hospital of Bonn, Gynecological Endocrinology and Reproductive Medicine, Bonn , Germany
| | - M Von Wolff
- University Women's Hospital- Inselspital, Gynecological Endocrinology and Reproductive Medicine, Bern , Switzerland
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Bauer FN, Tertel T, Stambouli O, Dittrich R, Staubach S, Börger V, Brandau S, Giebel B. Exosomes/EVs: MSC-EV PREPARATIONS WITH AND WITHOUT IMMUNOMODULATORY CAPABILITIES REVEAL COMPARABLE, DETERGENT RESISTANT ECTO-5’-NUCLEOTIDASE (CD73) ACTIVITIES. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00141-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Stambouli O, Dittrich R, Nardi-Bauer F, Tertel T, Horn P, Giebel B. Impact of mesenchymal stromal/stem cell isolation strategies on the immunomodulatory activity of their extracellular vesicles. Cytotherapy 2021. [DOI: 10.1016/s1465324921004539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pontones CA, Lubrich H, Schwenke E, Cupisti S, Dittrich R, Kehl S, Beckmann MW, Fahlbusch C, Oppelt PG. Präkonzeptionelle Beratung, Schwangerschaftsvorsorge und peripartales Management bei Patientinnen mit Ullrich-Turner-Syndrom und kardiovaskulärem Hochrisikoprofil. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718309] [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] [Indexed: 10/23/2022] Open
Affiliation(s)
- CA Pontones
- Universitätsfrauenklinik Erlangen, Kinder- und Jugendgynäkologie
| | - H Lubrich
- Universitätsfrauenklinik Erlangen, Kinder- und Jugendgynäkologie
| | - E Schwenke
- Universitätsfrauenklinik Erlangen, Geburtshilfe
| | - S Cupisti
- Universitätsfrauenklinik Erlangen, Endokrinologie
| | - R Dittrich
- Universitätsfrauenklinik Erlangen, Endokrinologie
| | - S Kehl
- Universitätsfrauenklinik Erlangen, Geburtshilfe
| | | | - C Fahlbusch
- Universitätsfrauenklinik Erlangen, Kinder- und Jugendgynäkologie
| | - PG Oppelt
- Universitätsfrauenklinik Erlangen, Kinder- und Jugendgynäkologie
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Hildebrandt T, Lotz L, Blum S, Fahlbusch C, Heusinger K, Cupisti S, Dittrich R, Beckmann MW, Antoniadis S. Ergebnisse der Stimulationsbehandlung durch pulsatile GnRH-Substitution unter Verwendung eines innovativen, patientenkontrollierten Systems (LutrePulse®). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718228] [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] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - L Lotz
- Frauenklinik Universität Erlangen
| | - S Blum
- Frauenklinik Universität Erlangen
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Keckstein P, Fattahi A, Liverani L, Dittrich R, Hoffmann I, Boccaccini AR, Beckmann MW, Bleisinger N. Fertilitätserhalt: Optimierung der Follikelextraktion vor Kultivierung im künstlichen Ovar. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717705] [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] [Indexed: 10/23/2022] Open
Affiliation(s)
- P Keckstein
- Frauenklinik des Universitätsklinikums Erlangen der Friedrich-Alexander-Universität Erlangen-Nürnberg, Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - A Fattahi
- Frauenklinik des Universitätsklinikums Erlangen der Friedrich-Alexander-Universität Erlangen-Nürnberg, Gynäkologische Endokrinologie und Reproduktionsmedizin
- Tabriz University of Medical Sciences, Women’s Reproductive Health Research Center, Tabriz
| | - L Liverani
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Department Werkstoffwissenschaften, Lehrstuhl für Biomaterialien
| | - R Dittrich
- Frauenklinik des Universitätsklinikums Erlangen der Friedrich-Alexander-Universität Erlangen-Nürnberg, Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - I Hoffmann
- Frauenklinik des Universitätsklinikums Erlangen der Friedrich-Alexander-Universität Erlangen-Nürnberg, Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - AR Boccaccini
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Department Werkstoffwissenschaften, Lehrstuhl für Biomaterialien
| | - MW Beckmann
- Frauenklinik des Universitätsklinikums Erlangen der Friedrich-Alexander-Universität Erlangen-Nürnberg, Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - N Bleisinger
- Frauenklinik des Universitätsklinikums Erlangen der Friedrich-Alexander-Universität Erlangen-Nürnberg, Gynäkologische Endokrinologie und Reproduktionsmedizin
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Lotz L, Hoffmann I, Beckmann MW, Dittrich R. Kryokonservierung von Ovarialgewebe bei Patientinnen mit Ullrich Turner Syndrom im Rahmen des Fertilitätserhaltes. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714012] [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] [Indexed: 10/23/2022] Open
Affiliation(s)
- L Lotz
- Frauenklinik, Universitätsklinikum Erlangen
| | - I Hoffmann
- Frauenklinik, Universitätsklinikum Erlangen
| | | | - R Dittrich
- Frauenklinik, Universitätsklinikum Erlangen
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Madel R, Börger V, Dittrich R, Bremer M, Baba H, Brandau S, Buer J, Horn P, Kirschning C, Giebel B. Large-scale preparations of small extracellular vesicles from conditioned media of mesenchymal stromal cells modulate therapeutic impacts on a newly established Graft-versus-Host-Disease model in batch dependent manners. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Börger V, Dittrich R, Staubach S, Zumegen S, Horn P, Giebel B. Tangential flow filtration, a potential method for the scaled preparation of extracellular vesicles. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lotz L, Raffel N, Blum S, Hoffmann I, Beckmann MW, Dittrich R. Erfahrungen mit der Kryokonservierung von Ovarialgewebe bei präpubertären und pubertären Mädchen an der Frauenklinik des Universitätsklinikum Erlangen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671649] [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] [Indexed: 10/28/2022] Open
Affiliation(s)
- L Lotz
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - N Raffel
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - S Blum
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - I Hoffmann
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - MW Beckmann
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - R Dittrich
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
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Lotz L, Raffel N, Hoffmann I, Beckmann MW, Dittrich R. Does endometriosis affect oocyte quality in in vitro fertilization and intracytoplasmic sperm injection cycles compared to oocyte were endometrioses has been excluded by laparoscopy? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670981] [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] [Indexed: 10/28/2022] Open
Affiliation(s)
- L Lotz
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - N Raffel
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - I Hoffmann
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - MW Beckmann
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - R Dittrich
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
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Raffel N, Fattahi A, Boccaccini AR, Lotz L, Hoffmann I, Beckmann MW, Dittrich R, Liverani L. Biomimetic approach for the development of artificial ovary: first promising results. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671620] [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] [Indexed: 10/28/2022] Open
Affiliation(s)
- N Raffel
- Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Department of Obstetrics and Gynecology, Erlangen, Deutschland
| | - A Fattahi
- Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Department of Obstetrics and Gynecology, Erlangen, Deutschland
| | - AR Boccaccini
- University Erlangen-Nürnberg, Institute of Biomaterials, Department of Materials Science and Engineering, Erlangen, Deutschland
| | - L Lotz
- Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Department of Obstetrics and Gynecology, Erlangen, Deutschland
| | - I Hoffmann
- Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Department of Obstetrics and Gynecology, Erlangen, Deutschland
| | - MW Beckmann
- Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Department of Obstetrics and Gynecology, Erlangen, Deutschland
| | - R Dittrich
- Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Department of Obstetrics and Gynecology, Erlangen, Deutschland
| | - L Liverani
- University Erlangen-Nürnberg, Institute of Biomaterials, Department of Materials Science and Engineering, Erlangen, Deutschland
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Reinke F, Bettin M, Ross LS, Kochhäuser S, Kleffner I, Ritter M, Minnerup J, Dechering D, Eckardt L, Dittrich R. Refinement of detecting atrial fibrillation in stroke patients: results from the TRACK-AF Study. Eur J Neurol 2018; 25:631-636. [PMID: 29205690 DOI: 10.1111/ene.13538] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 02/23/2017] [Accepted: 10/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Detection of occult atrial fibrillation (AF) is crucial for optimal secondary prevention in stroke patients. The AF detection rate was determined by implantable cardiac monitor (ICM) and compared to the prediction rate of the probability of incident AF by software based analysis of a continuously monitored electrocardiogram at follow-up (stroke risk analysis, SRA); an optimized AF detection algorithm is proposed by combining both tools. METHODS In a monocentric prospective study 105 out of 389 patients with cryptogenic stroke despite extensive diagnostic workup were investigated with two additional cardiac monitoring tools: (a) 20 months' monitoring by ICM and (b) SRA during hospitalization at the stroke unit. RESULTS The detection rate of occult AF was 18% by ICM (n = 19) (range 6-575 days) and 62% (n = 65) had an increased risk for AF predicted by SRA. When comparing the predictive accuracy of SRA to ICM, the sensitivity was 95%, specificity 35%, positive predictive value 27% and negative predictive value 96%. In 18 patients with AF detected by ICM, SRA also showed a medium risk for AF. Only one patient with a very low risk predicted by SRA developed AF revealed by ICM after 417 days. CONCLUSIONS A combination of SRA and ICM is a promising strategy to detect occult AF. SRA is reliable in predicting incident AF with a high negative predictive value. Thus, SRA may serve as a cost-effective pre-selection tool identifying patients at risk for AF who may benefit from further cardiac monitoring by ICM.
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Affiliation(s)
- F Reinke
- Department of Cardiovascular Medicine, Division of Electrophysiology, University Hospital of Muenster, Muenster, Germany
| | - M Bettin
- Department of Cardiovascular Medicine, Division of Electrophysiology, University Hospital of Muenster, Muenster, Germany
| | - L S Ross
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
| | - S Kochhäuser
- Department of Cardiovascular Medicine, Division of Electrophysiology, University Hospital of Muenster, Muenster, Germany
| | - I Kleffner
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
| | - M Ritter
- Physicians Centre at the Principal Market, Muenster, Germany
| | - J Minnerup
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
| | - D Dechering
- Department of Cardiovascular Medicine, Division of Electrophysiology, University Hospital of Muenster, Muenster, Germany
| | - L Eckardt
- Department of Cardiovascular Medicine, Division of Electrophysiology, University Hospital of Muenster, Muenster, Germany
| | - R Dittrich
- Department of Neurology, University Hospital of Muenster, Muenster, Germany.,Department of Neurology, Paracelsus-Klinik Osnabrueck, Osnabrueck, Germany
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Dittrich R, Lotz L, Hoffmann I, Beckmann MW. Ovartransposition vor Radiatio und Ovartransplantation nach Kryokonservierung. Gynäkologische Endokrinologie 2017. [DOI: 10.1007/s10304-017-0140-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dittrich R, Beckmann MW, Würfel W. Reply to "Response to: Dittrich et al.: Non-Embryo-Destructive Extraction of Pluripotent Embryonic Stem Cells - Overlooked Legal Prohibitions, Professional Legal Consequences and Inconsistencies in Patent Law". Geburtshilfe Frauenheilkd 2017; 76:1308-1309. [PMID: 28042168 DOI: 10.1055/s-0042-116545] [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] [Indexed: 10/20/2022] Open
Affiliation(s)
- R Dittrich
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M W Beckmann
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - W Würfel
- Kinderwunsch-Centrum München, München, Germany
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Findeklee S, Lotz L, Heusinger K, Hoffmann I, Dittrich R, Beckmann MW. Twenty-five-year-old Woman with Bilateral Borderline Ovarian Tumour Desiring to Preserve Fertility - Case Report and Literature Review on the Current State of Fertility Preservation in Women with Borderline Ovarian Tumours. Geburtshilfe Frauenheilkd 2016; 76:1189-1193. [PMID: 27904170 PMCID: PMC5123880 DOI: 10.1055/s-0042-109267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/09/2016] [Revised: 05/03/2016] [Accepted: 05/24/2016] [Indexed: 01/05/2023] Open
Abstract
Borderline ovarian tumours are semimalignant tumours occurring unilaterally or bilaterally with a peak incidence among women of reproductive age. Since the affected women often wish to preserve fertility, particular precautions must be taken when counselling the patient and obtaining consent prior to planning an individual treatment. Options for preserving fertility include an organ-sparing surgical procedure and cryopreservation of oocytes and/or ovarian tissue. In this article, we report on a 25-year-old patient with a bilateral seromucinous borderline tumour who desired all fertility-preserving options. In order to perform the procedure without delay, we opted to perform luteal phase stimulation prior to oocyte retrieval. We conclude by discussing the current literature on the state of fertility preservation in the treatment of borderline ovarian tumours.
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Affiliation(s)
- S. Findeklee
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - L. Lotz
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - K. Heusinger
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - I. Hoffmann
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - R. Dittrich
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - M. W. Beckmann
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
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Beckmann MW, Dittrich R, Findeklee S, Lotz L. Surgical Aspects of Ovarian Tissue Removal and Ovarian Tissue Transplantation for Fertility Preservation. Geburtshilfe Frauenheilkd 2016; 76:1057-1064. [PMID: 27761026 DOI: 10.1055/s-0042-115017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 01/16/2023] Open
Abstract
Introduction: The removal of ovarian tissue prior to starting oncologic treatment and the subsequent transplantation of this tissue after completing therapy have become increasingly important surgical fertility-preserving techniques. The aim of this review was to investigate the different surgical techniques used for this method reported in the literature to date and to discuss the advantages and disadvantages of the respective techniques. Review: A search was done in MEDLINE using a defined algorithm to find studies published between January 2004 and December 2015. All study designs were included in our review if they contained statements on the surgical technique used. We found 16 publications (8 retrospective cohort studies, 6 case reports and 2 systematic reviews) with a total of 1898 female patients which reported on the surgical technique used for ovarian biopsy and 15 publications (7 retrospective cohort studies, 6 case reports and 2 systematic reviews) with a total of 455 women which mentioned the surgical technique used for ovarian transplantation. Different surgical techniques can be used both for ovarian biopsy and for the transplantation of ovarian tissue. A number of different surgical routes have been used, and the amount of tissue extracted, the instruments used, the treatment of the ovary, the transplantation site, the blood supply to the transplanted ovarian tissue and the procedure used for simultaneous surgical interventions vary. Conclusion: In future, one of the tasks will be to establish a standard surgical method for ovarian extraction and transplantation which will have a low rate of complications and a high pregnancy and birth rate while ensuring that the transplanted tissue is fully functional.
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Affiliation(s)
- M W Beckmann
- Frauenklinik, Comprehensive Cancer Center ER-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - R Dittrich
- Frauenklinik, Comprehensive Cancer Center ER-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Findeklee
- Frauenklinik, Comprehensive Cancer Center ER-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - L Lotz
- Frauenklinik, Comprehensive Cancer Center ER-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Lotz L, Findeklee S, Hoffmann I, Beckmann MW, Dittrich R. Optimale Bedingungen für den Transport von Ovarialgewebe an spezialisierten reproduktiven Einrichtungen zur Kryokonservierung. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Findeklee S, Lotz L, Hoffmann I, Dittrich R, Beckmann MW. Operative Komplikationen und Ergebnisse bei der laparoskopischen Entnahme und Transplantation von Ovargewebe: Eigene Erfahrungen im Vergleich mit der Literatur. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ringelstein E, Dittrich R, Sitzer M, Arnold M, Haring HP, Frese A. Spontane Dissektionen der extra- und intrakraniellen hirnversorgenden Arterien. Akt Neurol 2016. [DOI: 10.1055/s-0042-114742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- E. Ringelstein
- Ehemal. Direktor der Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster
| | - R. Dittrich
- Allgemeine Klinik für Neurologie, Universitätsklinikum Münster
| | - M. Sitzer
- Klinik für Neurologie des Klinikums Herford
| | - M. Arnold
- Universitätsklinik für Neurologie, Inselspital, Bern, Schweiz
| | - H.-P. Haring
- Abteilung für Neurologie, Kepler Universitätsklinikum – Neuro Med Campus, Linz, Österreich
| | - A. Frese
- Akademie für Manuelle Medizin, Münster
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Van der Ven H, Liebenthron J, Beckmann M, Toth B, Korell M, Krüssel J, Frambach T, Kupka M, Hohl MK, Winkler-Crepaz K, Seitz S, Dogan A, Griesinger G, Häberlin F, Henes M, Schwab R, Sütterlin M, von Wolff M, Dittrich R. Ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment in a fertility preservation network: tissue activity, pregnancy and delivery rates. Hum Reprod 2016; 31:2031-41. [PMID: 27378768 DOI: 10.1093/humrep/dew165] [Citation(s) in RCA: 195] [Impact Index Per Article: 24.4] [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: 10/24/2015] [Accepted: 05/27/2016] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What is the success rate in terms of ovarian activity (menstrual cycles) as well as pregnancy and delivery rates 1 year after orthotopic ovarian transplantations conducted in a three-country network? SUMMARY ANSWER In 49 women with a follow-up >1 year after transplantation, the ovaries were active in 67% of cases and the pregnancy and delivery rates were 33 and 25%, respectively. WHAT IS KNOWN ALREADY Cryopreservation of ovarian tissue in advance of cytotoxic therapies and later transplantation of the tissue is being performed increasingly often, and the total success rates in terms of pregnancy and delivery have been described in case series. However, published case series have not allowed either a more detailed analysis of patients with premature ovarian insufficiency (POI) or calculation of success rates based on the parameter 'tissue activity'. STUDY DESIGN, SIZE, DURATION Retrospective analysis of 95 orthotopic transplantations in 74 patients who had been treated for cancer, performed in the FertiPROTEKT network from 2008 to June 2015. Of those 95 transplantations, a first subgroup (Subgroup 1) was defined for further analysis, including 49 women with a follow-up period >1 year after transplantation. Of those 49 women, a second subgroup (Subgroup 5) was further analysed, including 40 women who were transplanted for the first time and who were diagnosed with POI before transplantation. PARTICIPANTS/MATERIALS, SETTING, METHODS Transplantation was performed in 16 centres and data were transferred to the FertiPROTEKT registry. The transplantations were carried out after oncological treatment had been completed and after a remission period of at least 2 years. Tissue was transplanted orthotopically, either into or onto the residual ovaries or into a pelvic peritoneal pocket. The success rates were defined as tissue activity (menstrual cycles) after 1 year (primary outcome) and as pregnancies and deliveries achieved. MAIN RESULTS AND THE ROLE OF CHANCE The average age of all transplanted 74 women was 31 ± 5.9 years at the time of cryopreservation and 35 ± 5.2 at the time of transplantation. Twenty-one pregnancies and 17 deliveries were recorded. In Subgroup 1, tissue was cryopreserved at the age of 30 ± 5.6 and transplanted at 34 ± 4.9 years. Ovaries remained active 1 year after transplantation in 67% of cases (n = 33/49), the pregnancy rate was 33% (n = 16/49) and the delivery rate was 25% (n = 12/49). In Subgroup 5, tissue was cryopreserved at the age 30 ± 5.9 years and transplanted at 34 ± 5.2 years. Ovaries remained active 1 year after transplantation in 63% of cases (n = 25/40), the pregnancy rate was 28% (n = 11/40) and the delivery rate was 23% (n = 9/40). The success rates were age dependant with higher success in women who cryopreserved at a younger age. In Subgroup 5, tissue was exclusively transplanted into the ovary in 10% (n = 4/40) of women and into a peritoneal pocket in 75% (n = 30/40), resulting in spontaneous conceptions in 91% of patients (n = 10/11). LIMITATIONS, REASONS FOR CAUTION The data were drawn from a retrospective analysis. The cryopreservation and transplantation techniques used have changed during the study period. The tissue was stored in many tissue banks and many surgeons were involved, leading to heterogeneity of the procedures. However, this does reflect the realistic situation in many countries. Although patients with POI were evaluated before transplantation to allow specific analysis of the transplanted tissue itself, the possibility cannot be excluded that residual ovarian tissue was also reactivated. WIDER IMPLICATIONS OF THE FINDINGS This is the largest case series worldwide to date and it confirms that cryopreservation and transplantation of ovarian tissue can be a successful option for preserving fertility. Persistent tissue activity 12 months after transplantation suggests that the pregnancy and delivery rates may increase further in the future. As transplantation into the peritoneum results in a high success rate, this approach may be an alternative to transplantation into the ovary. However, in order to establish the best transplantation site, a randomized study is required. STUDY FUNDING/COMPETING INTEREST This study was in part funded from the Deutsche Forschungsgemeinschaft (# DI 1525) and the Wilhelm Sander Foundation (2012.127.1) and did not receive any funding from a commercial company. No competing interests. TRIAL REGISTRATION NUMBER None.
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Affiliation(s)
- H Van der Ven
- Department of Gynaecological Endocrinology and Reproductive Medicine, Medical University of Bonn, Bonn, Germany
| | - J Liebenthron
- Department of Gynaecological Endocrinology and Reproductive Medicine, Medical University of Bonn, Bonn, Germany
| | - M Beckmann
- Department of Obstetrics and Gynaecology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - B Toth
- Department of Gynaecologic Endocrinology and Fertility Disorders, Medical University of Heidelberg, Heidelberg, Germany
| | - M Korell
- Department of Obstetrics and Gynaecology, Johanna Etienne Hospital of Neuss, Neuss, Germany
| | - J Krüssel
- Department of Obstetrics and Gynaecology, University of Düsseldorf, Düsseldorf, Germany
| | - T Frambach
- Department of Obstetrics and Gynaecology, St. Joseph-Stift Hospital, Bremen, Germany
| | - M Kupka
- IVF Centre, Altonaer Strasse, Hamburg, Germany
| | - M K Hohl
- Baden Infertility Centre, Baden-Dättwil, Switzerland
| | - K Winkler-Crepaz
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - S Seitz
- Department of Obstetrics and Gynaecology, Caritas Hospital St. Josef, Regensburg, Germany
| | - A Dogan
- Department of Obstetrics and Gynaecology, University of Jena, Jena, Germany
| | - G Griesinger
- Division of Reproductive Medicine and Gynaecological Endocrinology, Department of Obstetrics and Gynecology, Schleswig-Holstein University Hospital, Lübeck, Germany
| | - F Häberlin
- Department of Obstetrics and Gynaecology, Kantonspital, St. Gallen, Switzerland
| | - M Henes
- Division of Gynaecologic Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - R Schwab
- Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynaecology, University of Freiburg, Freiburg, Germany
| | - M Sütterlin
- Department of Obstetrics and Gynaecology, Mannheim University Hospital, Mannheim, Germany
| | - M von Wolff
- Division of Reproductive Medicine and Endocrinology, Department of Obstetrics and Gynaecology, Inselspital/Bern University Hospital, Effingerstrasse 102, 3010 Bern, Switzerland
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Findeklee S, Lotz L, Hoffmann I, Dittrich R, Beckmann MW. Operative Komplikationen und Ergebnisse bei der laparoskopischen Entnahme und Transplantation von Ovargewebe: Eigene Erfahrungen im Vergleich mit der Literatur. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1580640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lotz L, Findeklee S, Hoffmann I, Beckmann MW, Dittrich R. Fertilitätserhalt bei Krebserkrankungen: Optimale Transportbedingungen für ovarielles Gewebe vor einer Kryokonservierung in spezialisierten reproduktiven Einrichtungen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1580643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Dittrich R, Findeklee S, Lotz L, Liebenthron J, Hoffmann I, Beckmann MW. Wiederholte Reifung von Eizellen in nicht-stimuliertem xenotransplantiertem Eierstockgewebe eines präpubertären Mädchens. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1580639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lotz L, Findeklee S, Blum S, Hildebrandt T, Hoffmann I, Dittrich R, Beckmann MW. Erfahrungen mit der Kryokonservierung von Ovarialgewebe an der Frauenklinik des Universitätsklinikum Erlangen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1580644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Tempfer C, Horn LC, Ackermann S, Beckmann MW, Dittrich R, Einenkel J, Günthert A, Haase H, Kratzsch J, Kreissl MC, Polterauer S, Ebert AD, Schneider KTM, Strauss HG, Thiel F. Gestational and Non-gestational Trophoblastic Disease. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 032/049, December 2015). Geburtshilfe Frauenheilkd 2016; 76:134-144. [PMID: 26941444 DOI: 10.1055/s-0041-111788] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 12/28/2022] Open
Abstract
Purpose: The aim was to establish an official interdisciplinary guideline, published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). The guideline was developed for use in German-speaking countries. In addition to the Germany Society of Gynecology and Obstetrics, the guideline has also been approved by the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). The aim was to standardize diagnostic procedures and the management of gestational and non-gestational trophoblastic disease in accordance with the principles of evidence-based medicine, drawing on the current literature and the experience of the colleagues involved in compiling the guideline. Methods: This s2k guideline represents the consensus of a representative panel of experts with a range of different professional backgrounds commissioned by the DGGG. Following a review of the international literature and international guidelines on trophoblastic tumors, a structural consensus was achieved in a formalized, multi-step procedure. This was done using uniform definitions, objective assessments, and standardized management protocols. Recommendations: The recommendations of the guideline cover the epidemiology, classification and staging of trophoblastic tumors; the measurement of human chorionic gonadotropin (hCG) levels in serum, and the diagnosis, management, and follow-up of villous trophoblastic tumors (e.g., partial mole, hydatidiform mole, invasive mole) and non-villous trophoblastic tumors (placental site nodule, exaggerated placental site, placental site tumor, epitheloid trophoblastic tumor, and choriocarcinoma).
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Affiliation(s)
- C Tempfer
- Universitätsfrauenklinik der Ruhr-Universität Bochum, Bochum
| | - L-C Horn
- Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig
| | | | - M W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - R Dittrich
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - J Einenkel
- Universitätsfrauenklinik, Universitätsklinikum Leipzig, Leipzig
| | - A Günthert
- Frauenklinik, Luzerner Kantonsspital, Lucerne, Switzerland
| | - H Haase
- Frauenselbsthilfe nach Krebs, e. V
| | - J Kratzsch
- Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik, Universitätsklinikum Leipzig, Leipzig
| | - M C Kreissl
- Klinik für Nuklearmedizin, Klinikum Augsburg, Augsburg
| | - S Polterauer
- Universitätsfrauenklinik, Medizinische Universität Wien, Vienna, Austria
| | - A D Ebert
- Praxis für Gynäkologie und Geburtshilfe, Berlin
| | - K T M Schneider
- Abteilung für Geburtshilfe und Perinatalmedizin, Klinium rechts der Isar, Technische Universität München, Munich
| | - H G Strauss
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale), Halle (Saale)
| | - F Thiel
- Frauenklinik, Alb Fils Kliniken, Göppingen
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Dittrich R, Beckmann MW, Würfel W. Non-embryo-destructive Extraction of Pluripotent Embryonic Stem Cells: Implications for Regenerative Medicine and Reproductive Medicine. Geburtshilfe Frauenheilkd 2015; 75:1239-1242. [PMID: 26726264 DOI: 10.1055/s-0035-1558183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/29/2022] Open
Abstract
On August 1, 2013, the German Patent and Trademark Office issued a patent for the "Non-embryo-destructive extraction of pluripotent embryonic stem cells, stem cells obtained by this process and their uses" (DE 10 2004 062 184 B4). The patent document describes a non-embryo-destructive process to harvest embryonic stem cells from the inner cell mass (ICM) during the blastocyst development stage. The patent application was filed with the German Patent Office in Munich on December 23, 2004 and the patent claim was published in 2006. The patent was granted on August 1, 2013. Processing the patent application was a lengthy affair due to the fact that, for a long time, the prevailing opinion in Germany was that genetic screening of embryos (preimplantation genetic diagnosis) was prohibited under the German Embryo Protection Act (ESchG). A ruling by the German Federal Court in 2010 proved this opinion to be false. Animal studies have provided the evidence that the described procedure is technically feasible; healthy offspring were born after stem cells were harvested from the blastocyst and stored. We report here on a technique for the non-embryo-destructive extraction of pluripotent embryonic stem cells together with potential future applications for stem cells harvested in this manner.
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Affiliation(s)
- R Dittrich
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - M W Beckmann
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - W Würfel
- Kinderwunsch-Centrum München, München
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Findeklee S, Lotz L, Heusinger K, Hoffmann I, Dittrich R, Beckmann MW. Fertility Protection in Female Oncology Patients: How Should Patients Be Counseled? Geburtshilfe Frauenheilkd 2015; 75:1243-1249. [PMID: 26726265 PMCID: PMC4686370 DOI: 10.1055/s-0035-1558184] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 08/22/2015] [Accepted: 08/25/2015] [Indexed: 12/18/2022] Open
Abstract
Protecting the fertility of patients with oncologic disease is becoming more and more important, as fulfilling the wish to have children is increasingly occurring at a later stage in life and long-term survival rates after cancer are continuing to improve. A number of fertility-preserving options exist. In addition to techniques which have been around for some time such as medical ovarian suppression, ovarian transposition, and organ-preserving surgery, there are other, more recent, innovative methods which have developed over the last few years such as cryopreservation of oocytes or ovarian tissue transplantation after completing cancer therapy. As every procedure has its specific advantages and disadvantages, informed patient consent is essential. The physician's aim must be to select the optimal procedure for each patient. The extent of patients' information about the options to preserve fertility in women with oncologic disease remains limited. One of the main reasons for this is that clinicians are not sure how to inform patients about existing procedures and methods. The aim of this review article is to provide help in clinical practice.
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Affiliation(s)
- S. Findeklee
- Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
| | - L. Lotz
- Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
| | - K. Heusinger
- Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
| | - I. Hoffmann
- Gynecologic Endocrinology and Reproductive Medicine, Universitätsklinikum Erlangen, Erlangen
| | - R. Dittrich
- Gynecologic Endocrinology and Reproductive Medicine, Universitätsklinikum Erlangen, Erlangen
| | - M. W. Beckmann
- Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen
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Lotz L, Hauenstein T, Nichols-Burns SM, Strissel P, Hoffmann I, Findeklee S, Dittrich R, Beckmann MW, Oppelt PG. Comparison of Whole Ovary Cryotreatments for Fertility Preservation. Reprod Domest Anim 2015; 50:958-64. [PMID: 26446780 DOI: 10.1111/rda.12615] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 08/26/2015] [Indexed: 11/28/2022]
Abstract
The goal of this study was to compare a traditional slow-freeze method (TF) with an open unidirectional slow freeze cooling system (UF) for whole ovary cryopreservation. Therefore, whole pig ovaries were randomly assigned to (A) fresh control, (B) traditional slow freeze (TF) or (C) unidirectional slow freeze (UF). Ovaries were perfused with 10% DMSO in Krebs-Ringer. For TF, whole ovaries were placed in specimen jars containing 10% DMSO and placed into a specialized container for freezing filled with propan-2-ol. For UF, whole ovaries were placed within a specially designed container containing 10% DMSO and transferred to a specialized freezing machine (CTE 920). Histological evaluation demonstrated intact morphology of follicles in all groups; however, an overall decrease of follicle numbers in TF (46%) and UF (50%) compared to fresh control. Live/dead assay indicated significantly lower populations of live cells in both TF (60%) and UF (58%) compared to fresh tissue (74%). TUNEL assay confirmed a difference in percentage of apoptotic follicles between fresh and TF, but there was no significant difference between fresh and UF. To improve the structural and functional integrity of whole ovaries, further investigation, especially into directional freezing, is needed. Whole ovary cryopreservation could provide opportunities for women facing fertility loss due to chemo- or radiotherapy treatment.
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Affiliation(s)
- L Lotz
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - T Hauenstein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - S M Nichols-Burns
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - P Strissel
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - I Hoffmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - S Findeklee
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - R Dittrich
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - M W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - P G Oppelt
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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Langenbruch L, Runge S, Riemer A, Boentert M, Dziewas R, Dittrich R, Young P, Möddel G. P138. Acute onset and reversibility of triphasic waves in the EEG correlating with hypercapnia. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dittrich R, Lotz L, Findeklee S, Hoffmann I, Beckmann M. Ergebnisse der Retransplantationen von Ovarialgewebe nach Krebserkrankung aus dem Universitätsklinikum Erlangen. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lotz L, Dittrich R, Findeklee S, Maktabi A, Hoffmann I, Beckmann M. Kryokonservierung von ovariellem Gewebe zum Fertilitätserhalt bei gonadotoxischer Therapie: Befragung von 300 Patientinnen an der Universitätsklinikum Erlangen. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Reinhard M, Munz M, von Kannen AL, Griesser-Leute HJ, Dittrich R, Engelter ST. Risk of recurrent cervical artery dissection during pregnancy, childbirth and puerperium. Eur J Neurol 2014; 22:736-9. [DOI: 10.1111/ene.12602] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M. Reinhard
- Department of Neurology; University of Freiburg; Freiburg Germany
| | - M. Munz
- Department of Neurology; University of Freiburg; Freiburg Germany
| | - A.-L. von Kannen
- Department of Neurology; University of Freiburg; Freiburg Germany
| | | | - R. Dittrich
- Department of Neurology; University of Münster; Münster Germany
| | - S. T. Engelter
- Department of Neurology and Stroke Center; University of Basel; Basel Switzerland
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Hackl J, Dittrich R, Lotz L, Hildebrandt T, Hoffmann I, Beckmann MW. Pregnancies and live births after 20 transplantations of cryopreserved ovarian tissue in a single center. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Lotz L, Dittrich R, Maktabi A, Hildebrandt T, Hoffmann I, Hackl J, Schneider H, Beckmann MW. Kinderwunsch und Fertilitätserhalt bei gonadotoxischer Therapie: Befragung von 200 Patientinnen mit kryokonserviertem ovariellem Gewebe an der Frauenklinik Erlangen. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Dittrich R, Lotz L, Nichols-Burns S, Schneider H, Hoffmann I, Beckmann MW. Xenotransplantation of whole pig ovaries into nude rats as an experimental model for fertility preservation. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hildebrandt T, Oversohl N, Wagner S, Dittrich R, Cupisti S, Oppelt PG, Heusinger K, Beckmann MW, Lux MP. Hat eine IVF/ICSI-Behandlung einen gesundheitsökonomischen Wert für die deutsche Gesellschaft? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Dittrich R, Lotz L, Nichols-Burns S, Scheider H, Hoffmann I, Hackl J, Beckmann MW. Xenotransplantation of cryopreserved ovarian tissue: A realistic option for restoring fertility after cancer treatment? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Cupisti S, Müller A, Hildebrandt T, Hackl J, Beckmann MW, Dittrich R. Culture of Individually Required Number of 2-Pronuclei-Stage Oocytes - Patient Participation in Decision-Making is in Accordance with the Aim of Avoiding Surplus Embryo Freezing. Geburtshilfe Frauenheilkd 2014; 74:157-160. [PMID: 24741127 DOI: 10.1055/s-0033-1360344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/22/2013] [Revised: 12/12/2013] [Accepted: 12/31/2013] [Indexed: 10/25/2022] Open
Abstract
Background: The aim of this study was to evaluate how many embryos will develop if more than 3 2-pronuclei-stage oocytes (2-PNOs) are cultured at the patient's request and in accordance with the Germany Embryo Protection Law. Methods: A total of 106 cycles of patients undergoing their 1st, 2nd or 3rd cycle of IVF or ICSI treatment in 2010 were prospectively included in the study. In each individual case, a decision was taken prior to treatment about the number of 2-PNOs to be cultured after each cycle. Results: Ninety female patients were treated for a total of 106 cycles. A mean of two to six 2-PNOs were cultivated for a period of between 3 and 6 days for each patient. After culture, no viable embryo was identified for 5 patients (4.7 %), a single viable embryo was identified for 37 cycles (34.7 %), and 2 viable embryos were identified for 52 cycles (48.8 %). Eleven patients (10.3 %) had 3 viable embryos after a further 11 cycles and 1 patient had 4 viable embryos in a single cycle. Ten of the patients with 3 embryos each opted to have all 3 embryos transferred in the same cycle. This meant that a single embryo from one patient with 3 viable embryos and a single embryo of the patient with 4 viable embryos were cryopreserved after culture. The pregnancy rate was 19 % per embryo transfer and 25 % per blastocyst transfer (20 pregnancies in total). All cryopreserved embryos were transferred in a subsequent cycle. Discussion: Based on this study it is possible to make a statement about the number of viable embryos which should be cultivated to obtain, at best, two embryos for transfer without running an unacceptably high risk of producing too many embryos which would then need to be cryopreserved. Only 12 patients (13.3 %) had more than 2 viable embryos. The number of supernumerary pre-implantation-stage embryos was acceptably low (only 2 patients had additional viable embryos, 2.2 %). This means that it is possible to fulfil the wishes of individual patients while complying with the German Embryo Protection Law.
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Affiliation(s)
- S Cupisti
- Gynaecology and Obstetrics, University Hospital, Erlangen
| | - A Müller
- Städtisches Klinikum, Frauenklinik, Karlsruhe
| | - T Hildebrandt
- Gynaecology and Obstetrics, University Hospital, Erlangen
| | - J Hackl
- Gynaecology and Obstetrics, University Hospital, Erlangen
| | - M W Beckmann
- Gynaecology and Obstetrics, University Hospital, Erlangen
| | - R Dittrich
- Gynaecology and Obstetrics, University Hospital, Erlangen
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Kleffner I, Hanning U, Dittrich R. Reversibles Hirnödem infolge einer psychogenen Polydipsie. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1359853] [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] [Indexed: 10/25/2022]
Affiliation(s)
- I. Kleffner
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
| | - U. Hanning
- Institut für Klinische Radiologie, Universitätsklinikum Münster
| | - R. Dittrich
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
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Zellerhoff S, Ritter MA, Kochhauser S, Dittrich R, Kobe J, Milberg P, Korsukewitz C, Dechering DG, Pott C, Wasmer K, Leitz P, Guner F, Eckardt L, Monnig G. Modified phased radiofrequency ablation of atrial fibrillation reduces the number of cerebral microembolic signals. Europace 2013; 16:341-6. [DOI: 10.1093/europace/eut282] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Fibromuscular dysplasia (FMD) is a rare, non-inflammatory angiopathy, which can affect the brain supplying arteries. Usually, the diagnosis is based on conventional and/or MR angiography. We present a patient with multisegmental stenoses of the internal carotid artery (ICA) where the diagnosis of FMD is based on an eye-catching ultrasound finding.
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Affiliation(s)
- R Dittrich
- Department of Neurology, University Hospital of Muenster, Muenster, Germany.
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Bernhardt A, Dittrich R, Lode A, Despang F, Gelinsky M. Nanocrystalline spherical hydroxyapatite granules for bone repair: in vitro evaluation with osteoblast-like cells and osteoclasts. J Mater Sci Mater Med 2013; 24:1755-1766. [PMID: 23625348 DOI: 10.1007/s10856-013-4933-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/18/2013] [Indexed: 06/02/2023]
Abstract
Conventionally sintered hydroxyapatite-based materials for bone repair show poor resorbability due to the loss of nanocrystallinity. The present study describes a method to establish nanocrystalline hydroxyapatite granules. The material was prepared by ionotropic gelation of an alginate sol containing hydroxyapatite (HA) powder. Subsequent thermal elimination of alginate at 650 °C yielded non-sintered, but unexpectedly stable hydroxyapatite granules. By adding stearic acid as an organic filler to the alginate/HA suspension, the granules exhibited macropores after thermal treatment. A third type of material was achieved by additional coating of the granules with silica particles. Microstructure and specific surface area of the different materials were characterized in comparison to the already established granular calcium phosphate material Cerasorb M(®). Cytocompatibility and potential for bone regeneration of the materials was evaluated by in vitro examinations with osteosarcoma cells and osteoclasts. Osteoblast-like SaOS-2 cells proliferated on all examined materials and showed the typical increase of alkaline phosphatase (ALP) activity during cultivation. Expression of bone-related genes coding for ALP, osteonectin, osteopontin, osteocalcin and bone sialoprotein II on the materials was proven by RT-PCR. Human monocytes were seeded onto the different granules and osteoclastogenesis was examined by activity measurement of tartrate-specific acid phosphatase (TRAP). Gene expression analysis after 23 days of cultivation revealed an increased expression of osteoclast-related genes TRAP, vitronectin receptor and cathepsin K, which was on the same level for all examined materials. These results indicate, that the nanocrystalline granular materials are of clinical interest, especially for bone regeneration.
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Affiliation(s)
- A Bernhardt
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty of Technische Universität Dresden and University Hospital Carl Gustav Carus, Fetscher Str. 74, 01307, Dresden, Germany.
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Tan CW, Lee YH, Choolani M, Tan HH, Griffith L, Chan J, Chuang PC, Wu MH, Lin YJ, Tsai SJ, Rahmati M, Petitbarat M, Dubanchet S, Bensussan A, Chaouat G, Ledee N, Bissonnette L, Haouzi D, Monzo C, Traver S, Bringer S, Faidherbe J, Perrochia H, Ait-Ahmed O, Dechaud H, Hamamah S, Ibrahim MG, de Arellano MLB, Sachtleben M, Chiantera V, Frangini S, Younes S, Schneider A, Plendl J, Mechsner S, Ono M, Hamai H, Chikawa A, Teramura S, Takata R, Sugimoto T, Iwahashi K, Ohhama N, Nakahira R, Shigeta M, Park IH, Lee KH, Sun HG, Kim SG, Lee JH, Kim YY, Kim HJ, Jeon GH, Kim CM, Bocca S, Wang H, Anderson S, Yu L, Horcajadas J, Oehninger S, Bastu E, Mutlu MF, Celik C, Yasa C, Dural O, Buyru F, Quintana F, Cobo A, Remohi J, Ferrando M, Matorras R, Bermejo A, Iglesias C, Cerrillo M, Ruiz M, Blesa D, Simon C, Garcia-Velasco JA, Chamie L, Ribeiro DMF, Riboldi M, Pereira R, Rosa MB, Gomes C, de Mello PH, Fettback P, Domingues T, Cambiaghi A, Soares ACP, Kimati C, Motta ELA, Serafini P, Hapangama DK, Valentijn AJ, Al-Lamee H, Palial K, Drury JA, von Zglinicki T, Saretzki G, Gargett CE, Liao CY, Lee KH, Sung YJ, Li HY, Morotti M, Remorgida V, Venturini PL, Ferrero S, Nabeta M, Iki A, Hashimoto H, Koizumi M, Matsubara Y, Hamada K, Fujioka T, Matsubara K, Kusanagi Y, Nawa A, Zanatta A, Riboldi M, da Rocha AM, Guerra JL, Cogliati B, Pereira R, Motta ELA, Serafini P, Bianchi PDM, Zanatta A, Riboldi M, da Rocha AM, Cogliati B, Guerra JL, Pereira R, Motta ELA, Serafini P, Prieto B, Exposito A, Mendoza R, Rabanal A, Matorras R, Bedaiwy M, Yi L, Dahoud W, Liu J, Hurd W, Falcone T, Biscotti C, Mesiano S, Sugiyama R, Nakagawa K, Nishi Y, Kuribayashi Y, Akira S, Germeyer A, Rosner S, Jauckus J, Strowitzki T, von Wolff M, Khan KN, Kitajima M, Fujishita A, Nakashima M, Masuzaki H, Kajihara T, Ishihara O, Brosens J, Ledee N, Petitbarat M, Rahmati M, Vezmar K, Savournin V, Dubanchet S, Chaouat G, Balet R, Bensussan A, Chaouat G, Lee YH, Loh SF, Tannenbaum SR, Chan JKY, Scarella A, Chamy V, Devoto L, Abrao M, Sovino H, Krasnopolskaya K, Popov A, Kabanova D, Beketova A, Ivakhnenko V, Shohayeb A, Wahba A, Abousetta A, al-inany H, Wahba A, El Daly A, Zayed M, Kvaskoff M, Han J, Missmer SA, Navarro P, Meola J, Ribas CP, Paz CP, Ferriani RA, Donabela FC, Tafi E, Maggiore ULR, Scala C, Remorgida V, Venturini PL, Ferrero S, Hackl J, Strehl J, Wachter D, Dittrich R, Cupisti S, Hildebrandt T, Lotz L, Attig M, Hoffmann I, Renner S, Hartmann A, Beckmann MW, Urquiza F, Ferrer C, Incera E, Azpiroz A, Junovich G, Pappalardo C, Guerrero G, Pasqualini S, Gutierrez G, Corti L, Sanchez AM, Bordignon PP, Santambrogio P, Levi S, Persico P, Vigano P, Papaleo E, Ferrari S, Candiani M, van der Houwen LEE, Schreurs AMF, Lambalk CB, Schats R, Hompes PGA, Mijatovic V, Xu SY, Li J, Chen XY, Chen SQ, Guo LY, Mathew D, Nunes Q, Lane B, Fernig D, Hapangama D, Lind T, Hammarstrom M, Golmann D, Rodriguez-Wallberg K, Hestiantoro A, Cakra A, Aulia A, Al-Inany H, Houston B, Farquhar C, Abousetta A, Tagliaferri V, Gagliano D, Immediata V, Tartaglia C, Zumpano A, Campagna G, Lanzone A, Guido M, Matsuzaki S, Darcha C, Botchorishvili R, Pouly JL, Mage G, Canis M, Shivhare SB, Bulmer JN, Innes BA, Hapangama DK, Lash GE, de Graaff AA, Zandstra H, Smits LJ, Van Beek JJ, Dunselman GAJ, Bozdag G, Calis PT, Demiralp DO, Ayhan B, Igci N, Yarali H, Acar N, Er H, Ozmen A, Ustunel I, Korgun ET, Kuroda K, Kuroda M, Arakawa A, Kitade M, Brosens AI, Brosens JJ, Takeda S, Yao T. Endometriosis, endometrium, implantation and fallopian tube. Hum Reprod 2013. [DOI: 10.1093/humrep/det211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Berthelot-ricou A, Perrin J, Roustan A, Di Giorgio C, De Meo M, Botta A, Orsiere T, Courbiere B, Martinez JG, Botella IM, Casas IP, Novella-Maestre E, Colom PJF, Rubio J, Martinez AP, Rodriguez-Wallberg KA, de Mena SA, Malm E, Larsson A, Kuiper R, Hassan M, Herraiz S, Novella-Maestre E, Rodriguez-Iglesias B, Diaz-Garcia C, Mirabet V, Pellicer A, Aljaser FS, Medrano JH, Rhodes S, Tomlinson MJ, Campbell BK, Dong F, Shi S, Dai S, Liu X, Su Y, Guo Y, Wang F, Xin Z, Song W, Jin H, Jin H, Sun Y, Ortega-Hrepich C, Stoop D, Guzman L, Van Landuyt L, Tournaye H, Smitz J, De Vos M, Rodriguez-Iglesias B, Herraiz S, Novella-Maestre E, Diaz C, Vera F, Pellicer A, Novella-Maestre E, Herraiz S, Rodriguez-Iglesias B, Diaz-Garcia C, Pellicer A, Youm H, Lee J, Lee JR, Lee JY, Jee BC, Suh CS, Kim SH, Lotz L, Hoffmann I, Muller A, Hackl J, Schulz C, Reissmann C, Cupisti S, Oppelt PG, Heusinger K, Hildebrandt T, Beckmann MW, Dittrich R, Klinger F, Rossi V, Lispi M, Longobardi S, De Felici M, Fabbri R, Vicenti R, Martino NA, Parazza I, Macciocca M, Magnani V, Pasquinelli G, Dell'Aquila ME, Venturoli S, Fisch B, Orvieto R, Fisher N, Ben-Haroush A, Stein A, Abir R, Al-Samerria S, McFarlane J, Almahbobi G, Klocke S, Tappehorn C, Griesinger G. Male and female fertility preservation. Hum Reprod 2013. [DOI: 10.1093/humrep/det215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Despang F, Bernhardt A, Lode A, Dittrich R, Hanke T, Shenoy SJ, Mani S, John A, Gelinsky M. Synthesis and physicochemical,in vitroandin vivoevaluation of an anisotropic, nanocrystalline hydroxyapatite bisque scaffold with parallel-aligned pores mimicking the microstructure of cortical bone. J Tissue Eng Regen Med 2013; 9:E152-66. [DOI: 10.1002/term.1729] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/12/2012] [Accepted: 01/28/2013] [Indexed: 02/06/2023]
Affiliation(s)
- F. Despang
- Technische Universität Dresden; Medical Faculty and University Hospital, Centre for Translational Bone, Joint and Soft Tissue Research; Dresden Germany
- Technische Universität Dresden; Institute for Materials Science, Max Bergmann Centre of Biomaterials; Dresden Germany
| | - A. Bernhardt
- Technische Universität Dresden; Medical Faculty and University Hospital, Centre for Translational Bone, Joint and Soft Tissue Research; Dresden Germany
- Technische Universität Dresden; Institute for Materials Science, Max Bergmann Centre of Biomaterials; Dresden Germany
| | - A. Lode
- Technische Universität Dresden; Medical Faculty and University Hospital, Centre for Translational Bone, Joint and Soft Tissue Research; Dresden Germany
- Technische Universität Dresden; Institute for Materials Science, Max Bergmann Centre of Biomaterials; Dresden Germany
| | - R. Dittrich
- TU Bergakademie Freiberg; Institute of Electronic und Sensor Materials; Freiberg Germany
| | - T. Hanke
- Technische Universität Dresden; Institute for Materials Science, Max Bergmann Centre of Biomaterials; Dresden Germany
| | - S. J. Shenoy
- Sree Chitra Tirunal Institute for Medical Sciences and Technology; Thiruvananthapuram Kerala India
| | - S. Mani
- Sree Chitra Tirunal Institute for Medical Sciences and Technology; Thiruvananthapuram Kerala India
| | - A. John
- Sree Chitra Tirunal Institute for Medical Sciences and Technology; Thiruvananthapuram Kerala India
| | - M. Gelinsky
- Technische Universität Dresden; Medical Faculty and University Hospital, Centre for Translational Bone, Joint and Soft Tissue Research; Dresden Germany
- Technische Universität Dresden; Institute for Materials Science, Max Bergmann Centre of Biomaterials; Dresden Germany
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Ritter MA, Theismann K, Schmiedel M, Ringelstein EB, Dittrich R. Vascularization of carotid plaque in recently symptomatic patients is associated with the occurrence of transcranial microembolic signals. Eur J Neurol 2012; 20:1218-21. [PMID: 23163829 DOI: 10.1111/ene.12030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 06/27/2012] [Accepted: 10/08/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Microembolic signals (MES) are detectable in the middle cerebral artery by transcranial ultrasound downstream to atherosclerotic lesions of the internal carotid artery (ICA) in patients with stroke or transient ischaemic attack. The occurrence of MES predicts future risk of stroke in patients with symptomatic and asymptomatic carotid stenosis. The detection of intra-plaque neo-vascularization by contrast-enhanced ultrasound (CEUS) in atherosclerotic plaques of the ICA is associated with future cardiovascular/cerebrovascular events. We investigated whether there is an association between both surrogate markers of future vascular events. METHODS Forty-one patients with symptomatic atherosclerotic plaques underwent ipsilateral transcranial ultrasound MES detection for 30 min followed by a CEUS investigation of the plaque. The occurrence and number of MES was documented, and the degree of intra-plaque neo-vascularization was measured semi-quantitatively. RESULTS During the 30 min investigation, 17 patients had MES and nine of them showed neo-vascularization of the atherosclerotic plaque. The remaining 24 patients did not have MES, and only in four patients of this group could plaque neo-vascularization be demonstrated (P = 0.020). CONCLUSIONS We found an association between the occurrence of MES and the presence of neo-vascularization in patients with symptomatic atherosclerotic carotid plaque. Therefore, plaque neo-vascularization might also be a surrogate marker of future stroke risk.
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Affiliation(s)
- M A Ritter
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
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Isachenko V, Dittrich R, Keck G, Isachenko E, Rahimi G, van der Ven H, Montag M, Hoffmann I, Müller A, Distler W, Beckmann MW, Mallmann P. Cryopreservation of Ovarian Tissue: Detailed Description of Methods for Transport, Freezing and Thawing. Geburtshilfe Frauenheilkd 2012; 72:927-932. [PMID: 25258453 PMCID: PMC4168540 DOI: 10.1055/s-0032-1327812] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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: 02/24/2012] [Revised: 07/31/2012] [Accepted: 08/07/2012] [Indexed: 10/27/2022] Open
Abstract
Purpose: In many cases cancer therapy leads to an irreversible reduction or even loss of ovarian reserve. Cryopreservation of ovarian tissue with subsequent thawing and re-transplantation of tissue after the cancer is in remission constitutes a promising method to preserve fertility in women. To date, more than 25 cases of live births after re-transplantation of cryopreserved ovarian tissue have been published worldwide. In Germany the first live birth after re-transplantation of cryopreserved tissue was in 2011. Material and Methods: After surgical removal of ovarian tissue in the Gynaecological Clinic of Dresden University, the tissue was sent to the Gynaecological Clinic of Bonn University in a special transport container at 5 °C and was frozen the next day using 1.5 M dimethyl sulfoxide cryosolution. In 2010 this ovarian tissue was thawed using a sucrose solution in the Gynaecological Clinic of Erlangen University Clinical Centre and was laparoscopically re-transplanted into the patient. Results: The patient became pregnant, the pregnancy was uneventful, and she gave birth to a healthy boy. Conclusion: Freezing of ovarian tissue with subsequent re-transplantation as described here is a viable method to preserve fertility in cancer patients.
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Affiliation(s)
| | - R. Dittrich
- Frauenklinik des Universitätsklinikums Erlangen, Erlangen
| | - G. Keck
- Universitätsfrauenklinik Dresden, Dresden
| | | | - G. Rahimi
- Universitätsfrauenklinik Köln, Cologne
| | | | - M. Montag
- Universitätsfrauenklinik Heidelberg, Heidelberg
| | - I. Hoffmann
- Frauenklinik des Universitätsklinikums Erlangen, Erlangen
| | - A. Müller
- Frauenklinik des Universitätsklinikums Erlangen, Erlangen
| | - W. Distler
- Universitätsfrauenklinik Dresden, Dresden
| | - M. W. Beckmann
- Frauenklinik des Universitätsklinikums Erlangen, Erlangen
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