Does it make sense to refreeze ovarian tissue after unexpected occurrence of endometriosis when transplanting the tissue?
Cancer
Chemotherapy
Cryopreservation
Endometriosis
Fertility preservation
Iatrogenic ovarian failure
Ovarian tissue transplantation
Refreezing
Journal
Journal of ovarian research
ISSN: 1757-2215
Titre abrégé: J Ovarian Res
Pays: England
ID NLM: 101474849
Informations de publication
Date de publication:
05 May 2022
05 May 2022
Historique:
received:
10
02
2021
accepted:
26
03
2022
entrez:
5
5
2022
pubmed:
6
5
2022
medline:
10
5
2022
Statut:
epublish
Résumé
Ovarian insufficiency is a major concern for long-term cancer survivors. Ovarian tissue cryopreservation for fertility preservation is an emerging technique that has proven successful over the past decade through transplantation of frozen-thawed ovarian tissue. Compared to other established techniques, such as oocyte freezing, ovarian tissue cryopreservation preserves actual organ function and thus the production of sex hormones. Endometriosis in perimenopausal women is rare, however it can be surprising diagnosis in the planned transplantation of cryopreserved ovarian tissue and the already thawed tissue may not be transplanted, so that it has to be refrozen. Ovarian function returned in the patient two months after transplantation, as shown by estrogen production. Ten months after the ovarian tissue transplantation mild stimulation with FSH was initiated in accordance with a low-dose protocol. When ultrasonography revealed a follicle 17 mm in size in the ovarian graft, hCG was added and after follicular puncture one oocyte was obtained. The oocyte could be fertilized by IVF and transferred to the uterus. On day 14 after embryo-transfer, a positive hCG-Level was detected and after an uncomplicated pregnancy a healthy child was delivered. We report the first pregnancy and live birth achieved using transplantation of thawed and refrozen ovarian tissue in a woman treated by chemotherapy and subsequent endometriosis surgery. Refreezing of cryopreserved ovarian tissue is not a hindrance to successful transplantation of ovarian tissue. Against the background of increasing numbers of candidates for transplantation of ovarian tissue is expected that the combination chemotherapy followed by endometriosis will increase.
Sections du résumé
BACKGROUND
BACKGROUND
Ovarian insufficiency is a major concern for long-term cancer survivors. Ovarian tissue cryopreservation for fertility preservation is an emerging technique that has proven successful over the past decade through transplantation of frozen-thawed ovarian tissue. Compared to other established techniques, such as oocyte freezing, ovarian tissue cryopreservation preserves actual organ function and thus the production of sex hormones. Endometriosis in perimenopausal women is rare, however it can be surprising diagnosis in the planned transplantation of cryopreserved ovarian tissue and the already thawed tissue may not be transplanted, so that it has to be refrozen.
RESULTS
RESULTS
Ovarian function returned in the patient two months after transplantation, as shown by estrogen production. Ten months after the ovarian tissue transplantation mild stimulation with FSH was initiated in accordance with a low-dose protocol. When ultrasonography revealed a follicle 17 mm in size in the ovarian graft, hCG was added and after follicular puncture one oocyte was obtained. The oocyte could be fertilized by IVF and transferred to the uterus. On day 14 after embryo-transfer, a positive hCG-Level was detected and after an uncomplicated pregnancy a healthy child was delivered.
CONCLUSIONS
CONCLUSIONS
We report the first pregnancy and live birth achieved using transplantation of thawed and refrozen ovarian tissue in a woman treated by chemotherapy and subsequent endometriosis surgery. Refreezing of cryopreserved ovarian tissue is not a hindrance to successful transplantation of ovarian tissue. Against the background of increasing numbers of candidates for transplantation of ovarian tissue is expected that the combination chemotherapy followed by endometriosis will increase.
Identifiants
pubmed: 35513873
doi: 10.1186/s13048-022-00972-8
pii: 10.1186/s13048-022-00972-8
pmc: PMC9074247
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
53Informations de copyright
© 2022. The Author(s).
Références
Gynecol Endocrinol. 2018 Jul;34(7):558-562
pubmed: 29318892
Hum Reprod. 2013 Aug;28(8):2023
pubmed: 23861497
Fertil Steril. 2020 Oct;114(4):722-724
pubmed: 32958206
Nat Rev Endocrinol. 2019 Nov;15(11):666-682
pubmed: 31488888
Fertil Steril. 2012 Feb;97(2):387-90
pubmed: 22177311
Fertil Steril. 2017 May;107(5):1206-1213
pubmed: 28433369
Fertil Steril. 2005 Oct;84(4):1018
pubmed: 16213862
Lancet. 2004 Oct 16-22;364(9443):1405-10
pubmed: 15488215
J Menopausal Med. 2013 Dec;19(3):151-3
pubmed: 25371883
Diseases. 2019 Mar 12;7(1):
pubmed: 30870972
Hum Reprod. 1996 Jun;11(6):1268-72
pubmed: 8671438
Fertil Steril. 2019 Dec;112(6):1022-1033
pubmed: 31843073
Endocrinol Metab Clin North Am. 2003 Sep;32(3):653-67
pubmed: 14560892
Hum Reprod. 1996 Jul;11(7):1487-91
pubmed: 8671490
Geburtshilfe Frauenheilkd. 2012 Oct;72(10):927-932
pubmed: 25258453
N Engl J Med. 2020 Mar 26;382(13):1244-1256
pubmed: 32212520
Hum Reprod. 2016 Sep;31(9):2031-41
pubmed: 27378768
Reprod Biomed Online. 2005 Oct;11(4):455-7
pubmed: 16274608
Hum Reprod. 2017 May 1;32(5):1046-1054
pubmed: 28333228
Fertil Steril. 2010 Feb;93(3):762-8
pubmed: 19013568
Obstet Gynecol. 2018 Mar;131(3):557-571
pubmed: 29420391
Cryobiology. 2006 Feb;52(1):166
pubmed: 16403490
Int J Mol Sci. 2020 Oct 21;21(20):
pubmed: 33096794
Fertil Steril. 2014 Apr;101(4):1031-7
pubmed: 24502890
Fertil Steril. 2015 Feb;103(2):462-8
pubmed: 25487750
Hum Reprod Update. 2009 Nov-Dec;15(6):649-65
pubmed: 19474206
Eur J Obstet Gynecol Reprod Biol. 2020 Nov;254:218-225
pubmed: 33011504
Obstet Gynecol. 2004 Nov;104(5 Pt 1):965-74
pubmed: 15516386