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Yvon Englert - One of the best experts on this subject based on the ideXlab platform.
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orthotopic and Heterotopic ovarian tissue Transplantation
Human Reproduction Update, 2009Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:BACKGROUND Transplantation of ovarian tissue is, at present, the only clinical option available to restore fertility using cryopreserved ovarian tissue. More than 30 Transplantations of cryopreserved tissue have been reported, and six babies have been born, worldwide, following this procedure. Despite these encouraging results, it is essential to optimize the procedure by improving the follicular survival, confirming safety and developing alternatives. Here, we review the different factors affecting follicular survival and growth after grafting. METHODS Relevant studies were identified by searching Pubmed up to January 2009 with English language limitation. The following key words were used: (ovarian tissue or whole ovary) AND (Transplantation) AND (cryopreservation or pregnancy). Using the literature and personal experience, we examined relevant data on the different exogenous and clinical factors affecting follicular development after grafting. RESULTS Clinical factors such as the patient's age and the Transplantation sites influenced the lifespan of the graft. A Heterotopic Transplantation site is not optimal but offers some advantages and it may also promote the hormonal environment after a combined Heterotopic and orthotopic Transplantation. Exogenous factors such as antioxidants, growth factors or hormones were tested to improve follicular survival; however, their efficiency regarding further follicular development and fertility potential remains to be established. CONCLUSION Additional evidence is required to define optimal conditions for ovarian tissue Transplantation. Alternatives such as whole ovary or isolated follicles Transplantations require further investigation but are likely to be successful in humans in the future.
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fertility preservation successful Transplantation of cryopreserved ovarian tissue in a young patient previously treated for hodgkin s disease
Oncologist, 2007Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:Cryopreservation of ovarian tissue is now offered as an experimental procedure to preserve the fertility of young patients with a high risk for premature ovarian failure resulting from cancer therapy. This is the only available option to preserve the fertility of prepubertal patients treated with gonadotoxic chemotherapy. At present, thousands of patients all over the world have undergone this procedure with the hope of later restoring their fertility. Although the efficiency of the Transplantation of cryopreserved ovarian tissue to restore ovarian function has been established, reports of pregnancy are still very scarce. Here, we describe the second published full-term spontaneous pregnancy after an orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue in a 31-year-old woman previously treated by conditioning therapy for bone marrow Transplantation for Hodgkin's disease. This birth gives compelling evidence for the graft origin of the gamete and confirms the efficacy of ovarian tissue Transplantation in restoring human natural fertility after oncological treatment. This case report stresses the importance of proposing the ovarian tissue cryopreservation procedure to all young patients who require potentially sterilizing treatment, with all alternative options to preserve fertility being duly taken into consideration.
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ovarian function and spontaneous pregnancy after combined Heterotopic and orthotopic cryopreserved ovarian tissue Transplantation in a patient previously treated with bone marrow Transplantation case report
Human Reproduction, 2006Co-Authors: Isabelle Demeestere, Philippe Simon, Frederic Buxant, Valerie Robin, Sergio Fernandez, Julie Centner, Anne Delbaere, Yvon EnglertAbstract:Cryopreservation of ovarian tissue has been proposed for storing gametes of young patients at high risk of premature ovarian failure. AutoTransplantation has recently provided some promising results and is still the unique option to restore ovarian function from cryopreserved ovarian tissue in humans. In this article, we analyse data from the combined orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue that restored the ovarian function and fertility. Orthotopic Transplantation of cryopreserved ovarian tissue at ovarian and peritoneal sites, together with a Heterotopic Transplantation at the abdominal subcutaneous site, was performed to restore the ovarian function of a 29-year-old woman previously treated with bone marrow Transplantation (BMT) for Hodgkin's disease. Ovarian reserve markers progressively suppress within values 5 months after the Transplantation (basal FSH 5 mUI/ml and inhibin B 119 ng/ml). Follicular development was observed at all Transplantation sites but was predominant at the ovarian site. Six natural cycles were fully documented and analysed. The patient became spontaneously pregnant following the sixth cycle, but unfortunately she later miscarried. Combined orthotopic and Heterotopic Transplantations succeeded in the restoration of normal spontaneous cycles. Furthermore, this spontaneous pregnancy confirmed the efficiency of this procedure for restoring human fertility.
Kutluk Oktay - One of the best experts on this subject based on the ideXlab platform.
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robot assisted orthotopic and Heterotopic ovarian tissue Transplantation techniques surgical advances since our first success in 2000
Fertility and Sterility, 2019Co-Authors: Kutluk Oktay, Enes Taylan, T Kawahara, Giulia M CilloAbstract:Objective To demonstrate the technical advances since the time we reported the first successful case in 2000 and our modern approach to autologous Transplantation of frozen-thawed human ovarian tissue. Design A step-by-step video demonstration of three surgical approaches was created by editing the surgical footage obtained during ovarian Transplantation procedures. Setting Academic. Patient(s) Three patients who previously underwent ovarian tissue harvesting and cryopreservation before gonadotoxic cancer treatments or radical cancer surgery are presented. Intervention(s) The illustrated techniques include robot-assisted orthotopic (technique 1) and Heterotopic (technique 2) approaches using the da Vinci Xi (Intuitive Surgical) robotic system and a decellularized human extracellular tissue matrix (Alloderm; LifeCell Corp.) as a tissue scaffold, as well as a percutaneous autoTransplantation approach (technique 3). Main Outcome Measure(s) Successful completion of procedures without complications and ovarian graft function with demonstration of E2 production and follicle development. Result(s) All cases were completed without complications. Ovarian graft function was confirmed by E2 production, follicle growth by 10–14 weeks after Transplantation, and later embryo development. Conclusion(s) Since our first report of successful restoration of ovarian function after orthotopic Transplantation of frozen-banked ovarian tissue in 2000 (1) , followed by our first reports of subcutaneous Heterotopic Transplantation techniques 2 , 3 , ovarian tissue cryopreservation followed by subsequent Transplantation has become a promising fertility preservation option for young women with cancer who do not have sufficient time to undergo oocyte or embryo cryopreservation and for prepubertal girls 4 , 5 . The same approach also has the advantage of restoring ovarian endocrine function and fertility without a need for assisted reproduction 6 , 7 . In the very first successful procedure that we reported in 2000, we used conventional laparoscopy, and the tissues were reconstructed and mounted on a polycellulose scaffold (Surgicel) 1 , 7 . Since then, we have made significant modifications in our surgical approach with potential improvements in outcomes. Here we illustrate three main techniques of ovarian tissue Transplantation resulting in the restoration of ovarian function in all cases. In the first two cases, we illustrated the robot-assisted orthotopic and Heterotopic approaches using Alloderm. Robotic ovarian Transplantation may increase precision, provide more delicate graft handling, and reduce the time from tissue thawing to Transplantation 6 , 8 . Alloderm is regenerated de-epithelized human cadaver skin, which consists of several extracellular matrix components. It has been safely used in the surgery and dentistry fields for enhancing tissue regeneration and vascularization 10 , 9 . Furthermore, our earlier laboratory work indicated the critical role of extracellular matrix in primordial follicle growth initiation and preantral follicle growth 11 , 12 . Prior to our use of Alloderm as part of ovarian transplant procedures, we tested it in human ovarian xenograft models and found Alloderm to incorporate well with ovarian tissue (8) . Only after that test did we adopt it for use in ovarian transplants. The utility of the extracellular tissue matrix may thus enhance our ovarian autoTransplantation techniques by facilitating ovarian reconstruction and potentially improving neovascularization. In fact, we have seen improved follicle growth and response to ovarian stimulation with the use of Alloderm in our first cases (8) . We use Heterotopic ovarian Transplantation when the pelvis is not suitable for autoTransplantation due to past radiation or scarring or when there are other medical contraindications for Transplantation in the pelvis. The third technique we illustrated was percutaneous Heterotopic ovarian autoTransplantation. This is a simple approach that can be used in surgically high-risk patients, as it is done with local anesthesia or IV sedation and without entering abdominal cavity. Additionally, same approach can be utilized when there is heightened concern that the ovarian tissue may harbor a disease that can recur, requiring close surveillance and easier removal of the ovarian graft. While ovarian endocrine function and follicle growth are restored with efficiency using the percutaneous ovarian transplants, our initial experience suggests that oocyte quality may be impaired in SC locations 13 , 2 , 3 . Hence that technique may be more suitable when the only purpose is restoration of ovarian endocrine function. However, we have encountered recurrent live births from spontaneous conceptions following SC ovarian transplants, prompting the question of whether the grafted tissue can augment the function of in situ menopausal ovary 13 , 14 . While ovarian cryopreservation and Transplantation may no longer be considered experimental, there are many exciting questions remaining to be answered on the full potential of this procedure.
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orthotopic and Heterotopic ovarian tissue Transplantation
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2010Co-Authors: Murat Sonmezer, Kutluk OktayAbstract:Although still experimental, cryopreservation and Transplantation techniques for ovarian tissue have been well described, and a number of successful human pregnancies have occurred. Ovarian cryopreservation is the only fertility preservation procedure that can be offered to prepubertal children, and when cytotoxic treatment is urgent. There are two main approaches for autoTransplantation of human ovarian tissue. In the Heterotopic Transplantation, cortical fragments can be grafted subcutaneously at various sites whereas in orthotopic Transplantation cortical pieces are transplanted into its original location. Both approaches have their own advantages and disadvantages. While natural pregnancy can occur in orthotopic Transplantation, Heterotopic Transplantation may be indicated if the pelvis is not suitable for Transplantation due to previous radiation or severe scar formation. Furthermore, tissue monitoring may be easier in the Heterotopic site. In this article, we reviewed the indications, limitations, risks and Transplantation techniques for ovarian tissue.
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embryo development after Heterotopic Transplantation of cryopreserved ovarian tissue
Obstetrical & Gynecological Survey, 2004Co-Authors: Kutluk Oktay, Erkan Buyuk, Lucinda L Veeck, N Zaninovic, Takumi Takeuchi, Michael S Opsahl, Z RosenwaksAbstract:Patients with cancer might want to avoid infertility and premature menopause as sequelae of chemotherapy and other treatments. Most patients with cancer do not have time for ovarian stimulation as a prelude to in vitro fertilization (IVF). An alternative approach, which could also be useful for single women who do not want to use donor sperm and for children, is to cryopreserve oocytes, but this also requires several weeks of ovarian stimulation. Ovarian function has been preserved experimentally after orthotopic Transplantation of frozen-thawed ovarian tissue and Heterotopic grafting of fresh human ovarian cortical pieces. This study intended to restore fertility by subcutaneously transplanting frozen, banked ovarian tissue. One ovary was removed from a woman aged 30 years with breast cancer before starting gonadotoxic chemotherapy. Cortical pieces were cryopreserved using a slow freezing technique and dimethylsulfoxide as a cryoprotectant. The tissue was transplanted beneath the abdominal skin 6 years later, after the patient had entered menopause. There were an estimated 11,000 follicles that could potentially last for 12 months. All 15 ovarian cortical pieces were transplanted in the lower abdominal wall. Tissue was suppressed with a combination of follicle-stimulating hormone and human menopausal gonadotropin before every cycle of ovarian stimulation. Oocyte maturity was induced by recombinant human chorionic gonadotropin. Oocytes were retrieved 36 to 40 hours later and intracytoplasmic sperm injection was carried out. A lump was felt at the transplant site 85 days after Transplantation, and ovarian endocrine function resumed (Fig. 1). Eight percutaneous oocyte retrievals were carried out over 8 months, 6 of them after ovarian stimulation. Eight of 20 oocytes taken from transplanted tissue were suitable for IVF. One of them fertilized normally and developed into a high-grade 4-cell-stage embryo 24 hours later that was transferred to the patient's uterus. This experience indicates that endocrine function and fertility could be restored by long-term cryopreservation of ovarian tissue.
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embryo development after Heterotopic Transplantation of cryopreserved ovarian tissue
The Lancet, 2004Co-Authors: Kutluk Oktay, Erkan Buyuk, Lucinda L Veeck, N Zaninovic, Takumi Takeuchi, Michael S Opsahl, Z RosenwaksAbstract:Summary Background Cancer treatments, including chemotherapy, radiotherapy, and radical surgery, can induce premature menopause and infertility in hundreds of thousands of women of reproductive age every year. One of the ways to possibly preserve fertility before these treatments is to cryopreserve ovarian tissue for later Transplantation. We aimed to restore fertility by cryopreservation and Transplantation of ovarian tissue. Methods Ovarian tissue was cryopreserved from a 30-yearold woman with breast cancer before chemotherapy-induced menopause, and this tissue was transplanted beneath the skin of her abdomen 6 years later. Findings Ovarian function returned in the patient 3 months after Transplantation, as shown by follicle development and oestrogen production. The patient underwent eight oocyte retrievals percutaneously and 20 oocytes were retrieved. Of the eight oocytes suitable for in-vitro fertilisation, one fertilised normally and developed into a four-cell embryo. Interpretation Fertility and ovarian endocrine function can be preserved in women by long-term ovarian tissue banking.
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preliminary experience with orthotopic and Heterotopic Transplantation of ovarian cortical strips
Seminars in Reproductive Medicine, 2002Co-Authors: Kutluk Oktay, Melissayih YihAbstract:The idea of fresh orthotopic autologous ovarian Transplantation in humans is neither novel nor sophisticated; a New York surgeon reported on this technique as early as in 1906. It is the recent possibility of cryostorage of ovarian tissue and the development of new orthotopic and Heterotopic techniques to autotransplant frozen-thawed ovarian cortical strips that brought a new dimension to the field. With the availability of more effective cryoprotectants, researchers were able to demonstrate that ovarian function and fertility could be restored after Transplantation of cryopreserved ovarian tissue in large mammals. Experimental models of ovarian Transplantation are discussed in the article by Shaw and Trounson; our focus will be on the clinical applications of ovarian Transplantation and new developments in Heterotopic Transplantation. Patient selection and screening, details of the surgical techniques, and safety measures to avoid reseeding cancer cells via transplanted tissue will be discussed. Synchronization between the laboratory and the operating room will be detailed to provide guidance for clinicians who are contemplating ovarian Transplantation with previously frozen ovarian tissue.
Isabelle Demeestere - One of the best experts on this subject based on the ideXlab platform.
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orthotopic and Heterotopic ovarian tissue Transplantation
Human Reproduction Update, 2009Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:BACKGROUND Transplantation of ovarian tissue is, at present, the only clinical option available to restore fertility using cryopreserved ovarian tissue. More than 30 Transplantations of cryopreserved tissue have been reported, and six babies have been born, worldwide, following this procedure. Despite these encouraging results, it is essential to optimize the procedure by improving the follicular survival, confirming safety and developing alternatives. Here, we review the different factors affecting follicular survival and growth after grafting. METHODS Relevant studies were identified by searching Pubmed up to January 2009 with English language limitation. The following key words were used: (ovarian tissue or whole ovary) AND (Transplantation) AND (cryopreservation or pregnancy). Using the literature and personal experience, we examined relevant data on the different exogenous and clinical factors affecting follicular development after grafting. RESULTS Clinical factors such as the patient's age and the Transplantation sites influenced the lifespan of the graft. A Heterotopic Transplantation site is not optimal but offers some advantages and it may also promote the hormonal environment after a combined Heterotopic and orthotopic Transplantation. Exogenous factors such as antioxidants, growth factors or hormones were tested to improve follicular survival; however, their efficiency regarding further follicular development and fertility potential remains to be established. CONCLUSION Additional evidence is required to define optimal conditions for ovarian tissue Transplantation. Alternatives such as whole ovary or isolated follicles Transplantations require further investigation but are likely to be successful in humans in the future.
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fertility preservation successful Transplantation of cryopreserved ovarian tissue in a young patient previously treated for hodgkin s disease
Oncologist, 2007Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:Cryopreservation of ovarian tissue is now offered as an experimental procedure to preserve the fertility of young patients with a high risk for premature ovarian failure resulting from cancer therapy. This is the only available option to preserve the fertility of prepubertal patients treated with gonadotoxic chemotherapy. At present, thousands of patients all over the world have undergone this procedure with the hope of later restoring their fertility. Although the efficiency of the Transplantation of cryopreserved ovarian tissue to restore ovarian function has been established, reports of pregnancy are still very scarce. Here, we describe the second published full-term spontaneous pregnancy after an orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue in a 31-year-old woman previously treated by conditioning therapy for bone marrow Transplantation for Hodgkin's disease. This birth gives compelling evidence for the graft origin of the gamete and confirms the efficacy of ovarian tissue Transplantation in restoring human natural fertility after oncological treatment. This case report stresses the importance of proposing the ovarian tissue cryopreservation procedure to all young patients who require potentially sterilizing treatment, with all alternative options to preserve fertility being duly taken into consideration.
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ovarian function and spontaneous pregnancy after combined Heterotopic and orthotopic cryopreserved ovarian tissue Transplantation in a patient previously treated with bone marrow Transplantation case report
Human Reproduction, 2006Co-Authors: Isabelle Demeestere, Philippe Simon, Frederic Buxant, Valerie Robin, Sergio Fernandez, Julie Centner, Anne Delbaere, Yvon EnglertAbstract:Cryopreservation of ovarian tissue has been proposed for storing gametes of young patients at high risk of premature ovarian failure. AutoTransplantation has recently provided some promising results and is still the unique option to restore ovarian function from cryopreserved ovarian tissue in humans. In this article, we analyse data from the combined orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue that restored the ovarian function and fertility. Orthotopic Transplantation of cryopreserved ovarian tissue at ovarian and peritoneal sites, together with a Heterotopic Transplantation at the abdominal subcutaneous site, was performed to restore the ovarian function of a 29-year-old woman previously treated with bone marrow Transplantation (BMT) for Hodgkin's disease. Ovarian reserve markers progressively suppress within values 5 months after the Transplantation (basal FSH 5 mUI/ml and inhibin B 119 ng/ml). Follicular development was observed at all Transplantation sites but was predominant at the ovarian site. Six natural cycles were fully documented and analysed. The patient became spontaneously pregnant following the sixth cycle, but unfortunately she later miscarried. Combined orthotopic and Heterotopic Transplantations succeeded in the restoration of normal spontaneous cycles. Furthermore, this spontaneous pregnancy confirmed the efficiency of this procedure for restoring human fertility.
Philippe Simon - One of the best experts on this subject based on the ideXlab platform.
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orthotopic and Heterotopic ovarian tissue Transplantation
Human Reproduction Update, 2009Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:BACKGROUND Transplantation of ovarian tissue is, at present, the only clinical option available to restore fertility using cryopreserved ovarian tissue. More than 30 Transplantations of cryopreserved tissue have been reported, and six babies have been born, worldwide, following this procedure. Despite these encouraging results, it is essential to optimize the procedure by improving the follicular survival, confirming safety and developing alternatives. Here, we review the different factors affecting follicular survival and growth after grafting. METHODS Relevant studies were identified by searching Pubmed up to January 2009 with English language limitation. The following key words were used: (ovarian tissue or whole ovary) AND (Transplantation) AND (cryopreservation or pregnancy). Using the literature and personal experience, we examined relevant data on the different exogenous and clinical factors affecting follicular development after grafting. RESULTS Clinical factors such as the patient's age and the Transplantation sites influenced the lifespan of the graft. A Heterotopic Transplantation site is not optimal but offers some advantages and it may also promote the hormonal environment after a combined Heterotopic and orthotopic Transplantation. Exogenous factors such as antioxidants, growth factors or hormones were tested to improve follicular survival; however, their efficiency regarding further follicular development and fertility potential remains to be established. CONCLUSION Additional evidence is required to define optimal conditions for ovarian tissue Transplantation. Alternatives such as whole ovary or isolated follicles Transplantations require further investigation but are likely to be successful in humans in the future.
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fertility preservation successful Transplantation of cryopreserved ovarian tissue in a young patient previously treated for hodgkin s disease
Oncologist, 2007Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:Cryopreservation of ovarian tissue is now offered as an experimental procedure to preserve the fertility of young patients with a high risk for premature ovarian failure resulting from cancer therapy. This is the only available option to preserve the fertility of prepubertal patients treated with gonadotoxic chemotherapy. At present, thousands of patients all over the world have undergone this procedure with the hope of later restoring their fertility. Although the efficiency of the Transplantation of cryopreserved ovarian tissue to restore ovarian function has been established, reports of pregnancy are still very scarce. Here, we describe the second published full-term spontaneous pregnancy after an orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue in a 31-year-old woman previously treated by conditioning therapy for bone marrow Transplantation for Hodgkin's disease. This birth gives compelling evidence for the graft origin of the gamete and confirms the efficacy of ovarian tissue Transplantation in restoring human natural fertility after oncological treatment. This case report stresses the importance of proposing the ovarian tissue cryopreservation procedure to all young patients who require potentially sterilizing treatment, with all alternative options to preserve fertility being duly taken into consideration.
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ovarian function and spontaneous pregnancy after combined Heterotopic and orthotopic cryopreserved ovarian tissue Transplantation in a patient previously treated with bone marrow Transplantation case report
Human Reproduction, 2006Co-Authors: Isabelle Demeestere, Philippe Simon, Frederic Buxant, Valerie Robin, Sergio Fernandez, Julie Centner, Anne Delbaere, Yvon EnglertAbstract:Cryopreservation of ovarian tissue has been proposed for storing gametes of young patients at high risk of premature ovarian failure. AutoTransplantation has recently provided some promising results and is still the unique option to restore ovarian function from cryopreserved ovarian tissue in humans. In this article, we analyse data from the combined orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue that restored the ovarian function and fertility. Orthotopic Transplantation of cryopreserved ovarian tissue at ovarian and peritoneal sites, together with a Heterotopic Transplantation at the abdominal subcutaneous site, was performed to restore the ovarian function of a 29-year-old woman previously treated with bone marrow Transplantation (BMT) for Hodgkin's disease. Ovarian reserve markers progressively suppress within values 5 months after the Transplantation (basal FSH 5 mUI/ml and inhibin B 119 ng/ml). Follicular development was observed at all Transplantation sites but was predominant at the ovarian site. Six natural cycles were fully documented and analysed. The patient became spontaneously pregnant following the sixth cycle, but unfortunately she later miscarried. Combined orthotopic and Heterotopic Transplantations succeeded in the restoration of normal spontaneous cycles. Furthermore, this spontaneous pregnancy confirmed the efficiency of this procedure for restoring human fertility.
Anne Delbaere - One of the best experts on this subject based on the ideXlab platform.
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orthotopic and Heterotopic ovarian tissue Transplantation
Human Reproduction Update, 2009Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:BACKGROUND Transplantation of ovarian tissue is, at present, the only clinical option available to restore fertility using cryopreserved ovarian tissue. More than 30 Transplantations of cryopreserved tissue have been reported, and six babies have been born, worldwide, following this procedure. Despite these encouraging results, it is essential to optimize the procedure by improving the follicular survival, confirming safety and developing alternatives. Here, we review the different factors affecting follicular survival and growth after grafting. METHODS Relevant studies were identified by searching Pubmed up to January 2009 with English language limitation. The following key words were used: (ovarian tissue or whole ovary) AND (Transplantation) AND (cryopreservation or pregnancy). Using the literature and personal experience, we examined relevant data on the different exogenous and clinical factors affecting follicular development after grafting. RESULTS Clinical factors such as the patient's age and the Transplantation sites influenced the lifespan of the graft. A Heterotopic Transplantation site is not optimal but offers some advantages and it may also promote the hormonal environment after a combined Heterotopic and orthotopic Transplantation. Exogenous factors such as antioxidants, growth factors or hormones were tested to improve follicular survival; however, their efficiency regarding further follicular development and fertility potential remains to be established. CONCLUSION Additional evidence is required to define optimal conditions for ovarian tissue Transplantation. Alternatives such as whole ovary or isolated follicles Transplantations require further investigation but are likely to be successful in humans in the future.
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fertility preservation successful Transplantation of cryopreserved ovarian tissue in a young patient previously treated for hodgkin s disease
Oncologist, 2007Co-Authors: Isabelle Demeestere, Philippe Simon, Anne Delbaere, Serena Emiliani, Yvon EnglertAbstract:Cryopreservation of ovarian tissue is now offered as an experimental procedure to preserve the fertility of young patients with a high risk for premature ovarian failure resulting from cancer therapy. This is the only available option to preserve the fertility of prepubertal patients treated with gonadotoxic chemotherapy. At present, thousands of patients all over the world have undergone this procedure with the hope of later restoring their fertility. Although the efficiency of the Transplantation of cryopreserved ovarian tissue to restore ovarian function has been established, reports of pregnancy are still very scarce. Here, we describe the second published full-term spontaneous pregnancy after an orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue in a 31-year-old woman previously treated by conditioning therapy for bone marrow Transplantation for Hodgkin's disease. This birth gives compelling evidence for the graft origin of the gamete and confirms the efficacy of ovarian tissue Transplantation in restoring human natural fertility after oncological treatment. This case report stresses the importance of proposing the ovarian tissue cryopreservation procedure to all young patients who require potentially sterilizing treatment, with all alternative options to preserve fertility being duly taken into consideration.
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ovarian function and spontaneous pregnancy after combined Heterotopic and orthotopic cryopreserved ovarian tissue Transplantation in a patient previously treated with bone marrow Transplantation case report
Human Reproduction, 2006Co-Authors: Isabelle Demeestere, Philippe Simon, Frederic Buxant, Valerie Robin, Sergio Fernandez, Julie Centner, Anne Delbaere, Yvon EnglertAbstract:Cryopreservation of ovarian tissue has been proposed for storing gametes of young patients at high risk of premature ovarian failure. AutoTransplantation has recently provided some promising results and is still the unique option to restore ovarian function from cryopreserved ovarian tissue in humans. In this article, we analyse data from the combined orthotopic and Heterotopic Transplantation of cryopreserved ovarian tissue that restored the ovarian function and fertility. Orthotopic Transplantation of cryopreserved ovarian tissue at ovarian and peritoneal sites, together with a Heterotopic Transplantation at the abdominal subcutaneous site, was performed to restore the ovarian function of a 29-year-old woman previously treated with bone marrow Transplantation (BMT) for Hodgkin's disease. Ovarian reserve markers progressively suppress within values 5 months after the Transplantation (basal FSH 5 mUI/ml and inhibin B 119 ng/ml). Follicular development was observed at all Transplantation sites but was predominant at the ovarian site. Six natural cycles were fully documented and analysed. The patient became spontaneously pregnant following the sixth cycle, but unfortunately she later miscarried. Combined orthotopic and Heterotopic Transplantations succeeded in the restoration of normal spontaneous cycles. Furthermore, this spontaneous pregnancy confirmed the efficiency of this procedure for restoring human fertility.