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Kutluk Oktay - One of the best experts on this subject based on the ideXlab platform.
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abstract p5 15 02 safety of letrozole gonadotropin controlled ovarian stimulation protocol in women with breast cancer undergoing fertility preservation before or after tumor resection via embryo or Oocyte Cryopreservation a prospective cohort study
Cancer Research, 2015Co-Authors: Kutluk Oktay, Giuliano Bedoschi, Jayeon Kim, Volkan TuranAbstract:Purpose: We have previously described the concurrent use of aromatase inhibitors to reduce estrogen exposure in women with breast cancer undergoing controlled ovarian stimulation (COS) with gonadotropins for fertility preservation (FP) via Oocyte or embryo Cryopreservation. To purpose of this study was to investigate the impact of this letrozole-gonadotropin COS protocol on survival in women who underwent fertility preservation before or after breast surgery. Patients and Methods: A total of 364 women with stage ≤3 breast cancer, who pursued FP consultation or FP treatments at our institution were prospectively evaluated. Of those, 146 elected to undergo COS with letrozole and gonadotropins for FP (120 prior to chemotherapy and 26 after chemotherapy). The remaining 218 patients elected to not to undergo a fertility-preserving procedure and served as controls. Result(s): Demographic information and tumor characteristics at enrollment were similar between patients who pursued COS with letrozole and gonadotropins (COS group) and control groups. The median follow-up after diagnosis was 4.9 years in COS and 6.2 years in the control group. In the COS group, the hazard ratio (HR) for recurrence after IVF was 0.77 (95% CI: 0.28, 2.13) and the survival was not compromised compared with controls (P=0.61). In the COS group, survival was not different between patients with ER-positive and ER-negative breast cancer (P=0.75) and between patients who underwent COS before and after tumor resection (P=0.56). The survival was also not different between patients who pursued COS before and after chemotherapy (P=0.57). Conclusion(s): Here we presented the largest prospective data with longest follow up on the safety of ovarian stimulation in women with breast cancer. COS with letrozole and gonadotropins for FP is unlikely to cause substantially increased recurrence risk in breast cancer, even in patients who have not yet undergone breast surgery. Larger studies are needed to confirm the findings from the subgroup analysis. Support: Supported by NIH RO1 HD053112. Citation Format: Kutluk Oktay, Jayeon Kim, Giuliano Bedoschi, Volkan Turan. Safety of letrozole-gonadotropin controlled ovarian stimulation protocol in women with breast cancer undergoing fertility preservation before or after tumor resection via embryo or Oocyte Cryopreservation: A prospective cohort study [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-15-02.
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Oocyte Cryopreservation for fertility preservation in postpubertal female children at risk for premature ovarian failure due to accelerated follicle loss in turner syndrome or cancer treatments
Journal of Pediatric and Adolescent Gynecology, 2014Co-Authors: Kutluk Oktay, Giuliano BedoschiAbstract:Abstract Objective To preliminarily study the feasibility of Oocyte Cryopreservation in postpubertal girls aged between 13 and 15 years who were at risk for premature ovarian failure due to the accelerated follicle loss associated with Turner syndrome or cancer treatments. Design Retrospective cohort and review of literature. Setting Academic fertility preservation unit. Participants Three girls diagnosed with Turner syndrome, 1 girl diagnosed with germ-cell tumor. and 1 girl diagnosed with lymphoblastic leukemia. Interventions Assessment of ovarian reserve, ovarian stimulation, Oocyte retrieval, in vitro maturation, and mature Oocyte Cryopreservation. Main Outcome Measure Response to ovarian stimulation, number of mature Oocytes cryopreserved and complications, if any. Results Mean anti-mullerian hormone, baseline follical stimulating hormone, estradiol, and antral follicle counts were 1.30 ± 0.39, 6.08 ± 2.63, 41.39 ± 24.68, 8.0 ± 3.2; respectively. In Turner girls the ovarian reserve assessment indicated already diminished ovarian reserve. Ovarian stimulation and Oocyte Cryopreservation was successfully performed in all female children referred for fertility preservation. A range of 4-11 mature Oocytes (mean 8.1 ± 3.4) was cryopreserved without any complications. All girls tolerated the procedure well. Conclusions Oocyte Cryopreservation is a feasible technique in selected female children at risk for premature ovarian failure. Further studies would be beneficial to test the success of Oocyte Cryopreservation in young girls.
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age specific probability of live birth with Oocyte Cryopreservation an individual patient data meta analysis
Fertility and Sterility, 2013Co-Authors: Heejung Bang, Aylin Pelin Cil, Kutluk OktayAbstract:Objective To estimate age-specific probabilities of live birth with Oocyte Cryopreservation in nondonor (ND) egg cycles. Design Individual patient data meta-analysis. Setting Assisted reproduction centers. Patient(s) Infertile patients undergoing ND mature Oocyte Cryopreservation. Intervention(s) PubMed was searched for clinical studies on Oocyte Cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen–thawed mature Oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data. Main Outcome Measure(s) Live birth probabilities based on age, Cryopreservation method, and the number of Oocytes thawed, injected, or embryos transferred. Result(s) Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified Oocytes, respectively. Estimated probabilities of live birth for vitrified Oocytes were higher than those for slowly frozen. Conclusion(s) The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering Oocyte Cryopreservation. Given the success probabilities, we suggest that policy makers should consider Oocyte freezing as an integral part of prevention and treatment of infertility.
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recent advances in Oocyte and ovarian tissue Cryopreservation and transplantation
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2012Co-Authors: Kenny A Rodriguezwallberg, Kutluk OktayAbstract:Options for preserving fertility in women include well-established methods such as fertility-sparing surgery, shielding to reduce radiation damage to reproductive organs, and emergency in-vitro fertilisation after controlled ovarian stimulation, with the aim of freezing embryos. The practice of transfering frozen or thawed embryos has been in place for over 25 years, and today is a routine clinical treatment in fertility clinics. Oocytes may also be frozen unfertilised for later thawing and fertilisation by intracytoplasmic sperm injection in vitro . In recent years, Oocyte Cryopreservation methods have further developed, reaching promising standards. More than 1000 children are born worldwide after fertilisation of frozen and thawed Oocytes. Nevertheless, this technique is still considered experimental. In this chapter, we focus on options for fertility preservation still in development that can be offered to women. These include freezing of Oocytes and ovarian cortex and the transplantation of ovarian tissue.
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anti mullerian hormone and antral follicle count as predictors for embryo Oocyte Cryopreservation cycle outcomes in breast cancer patients stimulated with letrozole and follicle stimulating hormone
Journal of Assisted Reproduction and Genetics, 2011Co-Authors: Sinan Ozkavukcu, E Heytens, Rose M Alappat, Kutluk OktayAbstract:Purpose To predict embryo/Oocyte Cryopreservation cycle (ECC) outcomes in breast cancer patients stimulated with letrozole and follicle stimulating hormone for fertility preservation based on observed anti-mullerian hormone (AMH) levels and antral follicle counts (AFC).
N Noyes - One of the best experts on this subject based on the ideXlab platform.
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baby budgeting Oocyte Cryopreservation in women delaying reproduction can reduce cost per live birth
Fertility and Sterility, 2015Co-Authors: Kate Devine, B Hodeswertz, S Druckenmiller, Sunni L Mumford, K N Goldman, Anthony M Propst, N NoyesAbstract:Objective To determine whether Oocyte Cryopreservation for deferred reproduction is cost effective per live birth using a model constructed from observed clinical practice. Design Decision-tree mathematical model with sensitivity analyses. Setting Not applicable. Patient(s) A simulated cohort of women wishing to delay childbearing until age 40 years. Intervention(s) Not applicable. Main Outcome Measure(s) Cost per live birth. Result(s) Our primary model predicted that Oocyte Cryopreservation at age 35 years by women planning to defer pregnancy attempts until age 40 years would decrease cost per live birth from $55,060 to $39,946 (and increase the odds of live birth from 42% to 62% by the end of the model), indicating that Oocyte Cryopreservation is a cost-effective strategy relative to forgoing it. If fresh autologous assisted reproductive technology (ART) was added at age 40 years, before thawing Oocytes, 74% obtained a live birth, and cost per live birth increased to $61,887. Separate sensitivity analyses demonstrated that Oocyte Cryopreservation remained cost effective as long as performed before age 38 years, and more than 49% of those women not obtaining a spontaneously conceived live birth returned to thaw Oocytes. Conclusion(s) In women who plan to delay childbearing until age 40 years, Oocyte Cryopreservation before 38 years of age reduces the cost to obtain a live birth.
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what do reproductive age women who undergo Oocyte Cryopreservation think about the process as a means to preserve fertility
Fertility and Sterility, 2013Co-Authors: B Hodeswertz, S Druckenmiller, Meghan B Smith, N NoyesAbstract:Objective To better understand women's beliefs, priorities, and attitudes toward Oocyte Cryopreservation, to appreciate the extent of their reproductive education, and to track the reproductive paths of women who chose to undergo Oocyte Cryopreservation treatment. Design An anonymous 30-question survey. Setting Not applicable. Patient(s) From 2005–2011, 478 women completed ≥1 Oocyte Cryopreservation treatment cycle at our center to defer reproduction. Intervention(s) None. Main Outcome Measure(s) Demographics, motivations, desires, fertility knowledge, and outcomes related to Oocyte Cryopreservation. Result(s) A total of 183 patients (38%) completed the survey with >80% being aged ≥35 years; white; having no partner at time of Oocyte Cryopreservation; undergoing Oocyte Cryopreservation after an optimal reproductive age; feeling they had improved their reproductive future after Oocyte Cryopreservation and being empowered by the process; aware of age-related infertility; sensing popular media falsely portrayed the upper age limit for natural conception; and recorded lack of partner as the primary rationale for not yet starting a family. Nineteen percent of respondents added that workplace inflexibility contributed to their reproductive dilemma. Half stated they learned about Oocyte Cryopreservation from a friend; others became aware through a medical provider, the media, and the internet. Most patients (93%) have not yet returned to use their frozen Oocytes; 11 stated they had. Overall, 20% reported a successful conception after Oocyte Cryopreservation. Conclusion(s) Surveying Oocyte Cryopreservation patients provides a glimpse into the knowledge base and motivations surrounding current female reproductive practices. Oocyte Cryopreservation technology may prove to bridge the gap between reproductive prime and when a woman is realistically "ready" to have children.
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Oocyte Cryopreservation outcomes including pre Cryopreservation and post thaw meiotic spindle evaluation following slow cooling and vitrification of human Oocytes
Fertility and Sterility, 2010Co-Authors: N Noyes, Jaime M. Knopman, P Labella, Caroline Mccaffrey, Melicia Clarkwilliams, Jamie GrifoAbstract:Objective To report our Oocyte Cryopreservation (OC) outcomes including meiotic spindle (MS) evaluation of metaphase II (MII) Oocytes destined for OC and thaw. Design Retrospective. Setting University-based infertility center. Patient(s) Women attempting pregnancy using cryopreserved Oocytes. Intervention(s) OC, MS evaluation. Main Outcome Measure(s) Survival, two pronuclear (2PN) fertilization, achieving embryo quality suitable for transfer or refreezing, blastocyst formation. Result(s) Thirty-two OC-thaw cycles resulted in 20 pregnancies, 18 either ongoing or delivered. In 26 cycles, MS evaluation was performed: 262/303 (86%) thawed/recovered Oocytes survived, 218/262 (83%) achieved 2PN fertilization, 133/218 (61%) became suitable for day-3 and 122/218 (56%) for day-5 transfer. In total, 58 embryos were transferred resulting in a 62% pregnancy and a 41% implantation rate. Of Oocytes evaluated before Cryopreservation, 247 (82%) were spindle-positive; 96% of these were also spindle-positive after thawing. Blastocyst formation and suitability for day-5 transfer was achieved more often if a post-thaw spindle was visualized. Of all slow-cooled and vitrified Oocytes, a higher percentage of those slow-cooled achieved 2PN fertilization and usability. MS evaluation of Oocytes cryopreserved by either method was associated with similar outcomes. Conclusion(s) OC outcomes are improving. An MS was almost always exhibited both before Cryopreservation and after thawing, suggesting that, with appropriate technique, OC presents minimal harm to the MII Oocyte. A meiotic spindle evaluation might help to further OC technology.
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cryopreserved Oocytes can serve as the treatment for secondary infertility a novel model for egg donation
Fertility and Sterility, 2010Co-Authors: Jaime M. Knopman, N Noyes, Jamie GrifoAbstract:Objective To report the use of previously cryopreserved Oocytes for the treatment of secondary infertility. Design Case report. Setting University-based IVF program. Patient(s) A 41-year-old woman with 18 months of secondary infertility and a previous history (age 38) of elective Oocyte Cryopreservation. Intervention(s) Previously cryopreserved Oocytes. Main Outcome Measure(s) Fertilization, embryo development, pregnancy, and outcome. Result(s) The patient achieved pregnancy and delivery following thaw of Oocytes electively cryopreserved 39 months before use. Before thawing the Oocyte, the patient attempted pregnancy naturally for 12 months, followed by two unsuccessful clomiphene citrate ovulation induction cycles with intrauterine insemination and one fresh IVF cycle resulting in a chromosomally abnormal twin gestation that aborted. Conclusion(s) Although Oocyte Cryopreservation is still labeled an experimental procedure, this case demonstrates that Oocyte Cryopreservation used for electively deferred reproduction can subsequently serve in the treatment for secondary infertility when the patient becomes her own Oocyte donor.
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delivery rate using cryopreserved Oocytes is comparable to conventional in vitro fertilization using fresh Oocytes potential fertility preservation for female cancer patients
Fertility and Sterility, 2010Co-Authors: James A Grifo, N NoyesAbstract:Objective To explore the use of Oocyte Cryopreservation as a fertility-conserving option. Cancer treatments administered during the reproductive and adolescent years can result in sterility. Previous fertility preservation efforts focused on embryo rather than Oocyte storage because the latter was deemed inefficient. Recently, several large reports of healthy births resulting from the transfer of embryos derived from frozen/thawed Oocytes have been published. We sought to establish an Oocyte Cryopreservation program at our center. Design Twenty-three Oocyte Cryopreservation cycles were performed. Collected Oocytes were cryopreserved by either the slow or the vitrification method. Approximately 1–4 months later, a programmed cycle of thawing/warming, fertilization with intracytoplasmic sperm injection, and ET was performed; cycle and pregnancy outcomes were assessed. Setting University-based fertility center. Patient(s) Twenty-two infertile women. Intervention(s) Oocyte Cryopreservation. Main Outcome Measure(s) Oocyte survival, embryo development, pregnancy outcomes. Result(s) Oocyte survival, 2-pronuclei fertilization, and blastocyst formation rates were 92%, 79%, and 43%, respectively. Fourteen women became pregnant; one miscarried; 10 have delivered 13 viable infants, and three pregnancies are ongoing for an ongoing/delivered pregnancy rate of 57%. This result was not statistically different from cycles performed consecutively in age-matched controls using fresh, nonfrozen autologous or donor Oocytes during a similar time period. Conclusion(s) Oocyte Cryopreservation appears to be a viable option for fertility preservation in some centers.
Aylin Pelin Cil - One of the best experts on this subject based on the ideXlab platform.
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decision regret and associated factors following Oocyte Cryopreservation in patients with diminished ovarian reserve and or age related fertility decline
Journal of Assisted Reproduction and Genetics, 2021Co-Authors: Aysen Gurbuz, Aylin Pelin Cil, Lale Suzan Karakis, Remzi Abali, Mehmet Ceyhan, Ece Aksakal, Azer Kilic, Mustafa Bahceci, Bulent UrmanAbstract:To evaluate the prevalence and factors associated with decision regret following Oocyte Cryopreservation (OC) in women with diminished ovarian reserve (DOR) and/or age-related fertility decline (ARFD). A cross-sectional survey study was conducted to five hundred fifty-two women with DOR and/or ARFD who underwent OC between 2014 and 2019 in two private-assisted reproductive units in Istanbul, Turkey. Decision regret was measured using the validated Decision Regret Scale (DRS). The median and mean DRS scores were 10 (interquartile range: 25) and 13.4 (SD: 13.2, range 0–70), respectively. Eighty-five (52.5%) women reported mild regret and 26 (16%) had moderate to severe regret. Decision regret was inversely associated with the belief in fate regarding childbearing and trust in the efficacy of OC. The prevalence of severe decision regret among patients with DOR and/or ARFD undergoing OC is low. Women who had belief in fate and trusted in the efficacy of Oocyte Cryopreservation had significantly lower decisional regret.
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age specific probability of live birth with Oocyte Cryopreservation an individual patient data meta analysis
Fertility and Sterility, 2013Co-Authors: Heejung Bang, Aylin Pelin Cil, Kutluk OktayAbstract:Objective To estimate age-specific probabilities of live birth with Oocyte Cryopreservation in nondonor (ND) egg cycles. Design Individual patient data meta-analysis. Setting Assisted reproduction centers. Patient(s) Infertile patients undergoing ND mature Oocyte Cryopreservation. Intervention(s) PubMed was searched for clinical studies on Oocyte Cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen–thawed mature Oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data. Main Outcome Measure(s) Live birth probabilities based on age, Cryopreservation method, and the number of Oocytes thawed, injected, or embryos transferred. Result(s) Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified Oocytes, respectively. Estimated probabilities of live birth for vitrified Oocytes were higher than those for slowly frozen. Conclusion(s) The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering Oocyte Cryopreservation. Given the success probabilities, we suggest that policy makers should consider Oocyte freezing as an integral part of prevention and treatment of infertility.
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letrozole reduces estrogen and gonadotropin exposure in women with breast cancer undergoing ovarian stimulation before chemotherapy
The Journal of Clinical Endocrinology and Metabolism, 2006Co-Authors: Kutluk Oktay, Aylin Pelin Cil, Ariel Hourvitz, G Sahin, Ozgur Oktem, Bradley Safro, Heejung BangAbstract:Context: Women with breast cancer are not typically offered embryo or Oocyte Cryopreservation to preserve their fertility before chemotherapy because of the potential risks associated with high estrogen levels arising from ovarian stimulation. Objective: We aimed to determine whether the combination of an aromatase inhibitor with gonadotropin treatment in breast cancer patients produces comparable results to standard in vitro fertilization (IVF), without a significant increase in estradiol levels and delay in the initiation of chemotherapy. Patients and Methods: Stages I-IIIA breast cancer patients (n = 47) received 5 mg/d letrozole and 150–300 IU FSH to cryopreserve embryos or Oocytes. Age-matched retrospective controls (n = 56) were selected from women who underwent IVF for tubal disease. Results: Whereas letrozole and FSH stimulation resulted in significantly lower peak estradiol levels (mean ± sd 483.4 ± 278.9 vs. 1464.6 ± 644.9 pg/ml; P < 0.001) and 44% reduction in gonadotropin requirement, compared...
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efficiency of Oocyte Cryopreservation a meta analysis
Fertility and Sterility, 2006Co-Authors: Kutluk Oktay, Aylin Pelin Cil, Heejung BangAbstract:Objective To determine the efficiency of Oocyte Cryopreservation relative to IVF with unfrozen Oocytes. Design Meta-analysis. Setting Academic assisted reproduction center. Patient(s) Results of all reports from January 1997 to June 2005 with the patients undergoing IVF-intracytoplasmic sperm injection (ICSI) with cryopreserved cycles between 1996 and 2004 were compared with those of patients who underwent IVF-ICSI with unfrozen Oocytes in 2002 and 2003 in our program. Intervention(s) Mean age and number of ET cycles originating from unfrozen Oocytes was matched with those for thaw cycles originating from Oocytes cryopreserved with a slow-freezing (SF) protocol. Vitrification (VF) reports were not included in the comparative analysis because of a small number of pregnancies (10) before June 2005. Main Outcome Measure(s) The comparison of fertilization rate, clinical pregnancy, and live-birth rates per injected Oocyte, clinical pregnancy and live-birth rates per transfer, and implantation rate between IVF-ICSI cycles with frozen and unfrozen Oocytes. Result(s) Live-birth rates per Oocyte thawed were 1.9% and 2.0% for SF and VF, respectively, before June 2005. Live-birth rates per injected Oocyte and ET, respectively, were 3.4% and 21.6% for SF and were 6.6% and 60.4% for IVF with unfrozen Oocytes. Compared to women who underwent IVF after SF, IVF with unfrozen Oocytes resulted in significantly better rates of fertilization (odds ratio [95% confidence interval]); 2.22 (1.80, 2.74), of live birth per injected Oocyte; 1.5 (1.26, 1.79), and of implantation; 4.66 (3.93, 5.52). These odds ratios were lower when Oocyte Cryopreservation success rates from 2002–2004 were compared with those for IVF with unfrozen Oocytes. When the reports after June 2005 were considered, this trend did not appear to continue. With the consideration of VF reports after June 2005, however, higher pregnancy rates were achieved. Conclusion(s) In vitro fertilization success rates with slow-frozen Oocytes are significantly lower when compared with the case of IVF with unfrozen Oocytes. Although Oocyte Cryopreservation with the SF method appears to be justified for preserving fertility when a medical indication exists, its value for elective applications remains to be determined. Pregnancy rates with VF appear to have improved, but further studies will be needed to determine the efficiency and safety of this technique.
Carlo Flamigni - One of the best experts on this subject based on the ideXlab platform.
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clinical outcome of Oocyte Cryopreservation after slow cooling with a protocol utilizing a high sucrose concentration
Human Reproduction, 2006Co-Authors: Andrea Borini, Carlo Flamigni, V Bianchi, Raffaella Sciajno, E Sereni, Giovanni CoticchioAbstract:BACKGROUND: Recently, interest in Oocyte Cryopreservation has steadily increased. Newly developed protocols have dramatically improved survival rates, removing perhaps the major hurdle that has prevented this approach from becoming a fully established form of treatment. However, the clinical efficiency of these protocols has not been exhaustively explored and therefore remains controversial. METHODS: Morphologically normal Oocytes displaying the first polar body were frozen-thawed with a slow cooling protocol that utilized 1.5 mol/l propane-1,2-diol (PrOH) and 0.3 mol/l sucrose. RESULTS: A total of 927 Oocytes from 146 patients were frozen-thawed, achieving a 74.1% survival rate. Over 76% of microinjected Oocytes displayed two pronuclei 16 h post-insemination, while the proportion of embryos at 44-46 h post-insemination was 90.2%. At this time point, the majority (68.3%) of embryos were at the two-cell stage, showing in most cases (78.7%) minimal or moderate fragmentation. Eighteen clinical pregnancies, three of which were twin, were observed, giving rise to rates of 12.3 and 9.7%, calculated per patient and per embryo transfer, respectively. The implantation rate was 5.2%. To date, four children have been born and three pregnancies resulted in spontaneous abortions, while the remaining pregnancies are ongoing. CONCLUSIONS: Our data indicate that although the combination of slow cooling and high sucrose concentration ensures high rates of Oocyte survival, it is not sufficient to guarantee a high standard of clinical efficiency.
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pregnancies and births after Oocyte Cryopreservation
Fertility and Sterility, 2004Co-Authors: Andrea Borini, Giovanni Coticchio, V Bianchi, M A Bonu, Monica Cattoli, Carlo FlamigniAbstract:Objective To determine the potential of Oocyte Cryopreservation techniques. Design Retrospective data analysis. Setting A tertiary infertility center. Patient(s) Sixty-eight patients (29 to 37 years of age) undergoing assisted reproduction procedures for infertility problems. Intervention(s) Oocytes from women treated for infertility were cryopreserved with a slow cooling/rapid thawing protocol in which 1,2 propanediol and sucrose were used as cryoprotectants. Eighty-six thawing cycles were performed. Main outcome measure(s) Rates of survival after thawing, fertilization after intracytoplasmic sperm injection, cleavage, implantation, and pregnancy. Result(s) We treated 68 patients through 86 thawing cycles.. Seven hundred thirty-seven Oocytes were thawed, and 59 transfer cycles were performed. The survival rate was 37%. The fertilization and cleavage rates were 45.4% and 86.3%, respectively. A total of 15 clinical pregnancies were achieved with pregnancy rates of 25.4% per transfer and 22% per patient. There were three miscarriages, resulting in an abortion rate of 20%. Seventeen of the 104 transferred embryos implanted, corresponding to an implantation rate of 16.4%. Thirteen babies were born, 8 females and 5 males. Conclusion(s) Statistically significant results were obtained for fertilization, cleavage, and pregnancy rates. Our results show Oocyte Cryopreservation may represent an alternative to embryo storage in selected cases.
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Human Oocyte Cryopreservation: new perspectives regarding Oocyte survival
Human reproduction (Oxford England), 2001Co-Authors: Raffaella Fabbri, Eleonora Porcu, Tiziana Marsella, G. Rocchetta, Stefano Venturoli, Carlo FlamigniAbstract:The success of human Oocyte Cryopreservation depends on morphological and biophysical factors that could influence Oocyte survival after thawing. Various attempts to cryopreserve human Oocytes have been performed with contrasting results. Therefore the effect of some factors, such as the presence or absence of the cumulus oophorus, the sucrose concentration in the freezing solution and the exposure time to cryoprotectants, on human Oocyte survival after thawing were investigated. The Oocytes were cryopreserved in 1,2-propanediol added with sucrose, using a slow-freezing-rapid-thawing programme. After thawing, the Oocytes were inseminated by intracytoplasmic sperm injection (ICSI) and the outcomes of insemination and subsequent embryo development were also recorded. The post-thaw cryosurvival rate was not different for the Oocytes cryopreserved with their cumuli partially removed mechanically (56%) when compared with those cryopreserved with their cumuli totally removed enzymatically (53%). On the contrary, a significantly higher survival rate was obtained when the Oocytes were cryopreserved in the presence of a doubled sucrose concentration (0.2 mol/l) in the freezing solution and the survival rate was even higher when the sucrose concentration was tripled (0.3 mol/l) (60 versus 82% P < 0.001). Furthermore, a longer exposure time (from 10.5 to 15 min) to cryoprotectants, before lowering the temperature, significantly increased the Oocyte survival rate (P < 0.005). Intracytoplasmic sperm injection produced a good fertilization rate (57%) of thawed Oocytes and a high embryo cleavage rate (91%) and a satisfactory embryo morphology was observed (14 and 34% for grade I and grade II embryos respectively).
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Birth of a healthy female after intracytoplasmic sperm injection of cryopreserved human Oocytes
Fertility and Sterility, 1997Co-Authors: Emanuele Porcu, Patrizia M. Ciotti, Rémi Fabbri, Renato Seracchioli, O. Magrini, Carlo FlamigniAbstract:Objective: To describe the first birth achieved after intracytoplasmic sperm injection (ICSI) of cryopreserved human Oocytes. Design: Case report. Setting: University of Bologna Hospital, Department of Obstetrics and Gynecology, Reproductive Endocrinology Unit, IVF and Infertility Center. Patient(s): One patient undergoing IVF. Intervention(s): Transvaginal ultrasound-guided Oocyte retrieval followed by Oocyte freezing. Artificial preparation of the endometrium with E2and P, Oocyte thawing, and ICSI. Result(s): Four of 12 cryopreserved Oocytes survived; using ICSI, 2 underwent normal fertilization but only 1 cleaved. One good-quality 4-cell embryo was transferred. A single gestation was confirmed by ultrasound at the 7th week. Amniocentesis was performed at the 16th week and demonstrated a normal female karyotype of 46,XX. After a normal pregnancy, a healthy female infant was born at the 38th week of gestation. Conclusion(s): The combination of ICSI and Oocyte Cryopreservation is a new tool in assisted reproductive technology.
Kenny A Rodriguezwallberg - One of the best experts on this subject based on the ideXlab platform.
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ovarian tissue Cryopreservation and transplantation among alternatives for fertility preservation in the nordic countries compilation of 20 years of multicenter experience
Acta Obstetricia et Gynecologica Scandinavica, 2016Co-Authors: Kenny A Rodriguezwallberg, Tom Tanbo, Helena Tinkanen, Ann Thurinkjellberg, Elizabeth Nedstrand, Margareta Laczna Kitlinski, Kirsten Tryde Macklon, Erik Ernst, Jens FedderAbstract:Introduction: The aim of this study is to report the current status of ovarian tissue Cryopreservation among alternatives for fertility preservation in the Nordic countries. Material and methods: A questionnaire was sent to 14 Nordic academic reproductive centers with established fertility preservation programs. It covered fertility preservation cases performed up to December 2014, standard procedures for ovarian tissue Cryopreservation and Oocyte Cryopreservation and reproductive outcomes following ovarian tissue transplantation. Results: Among the Nordic countries, Denmark and Norway practice ovarian tissue Cryopreservation as a clinical treatment (822 and 164 cases, respectively) and their programs are centralized. In Sweden (457 cases), ovarian tissue Cryopreservation is practiced at five of six centers and in Finland at all five centers (145 cases). Nearly all considered ovarian tissue Cryopreservation to be experimental. In Iceland, embryo Cryopreservation is the only option for fertility preservation. Most centers use slow-freezing methods for ovarian tissue Cryopreservation. Most patients selected for ovarian tissue Cryopreservation were newly diagnosed with cancer and the tissue was predominantly retrieved laparoscopically by unilateral oophorectomy. Only minor complications were reported. In total, 46 women have undergone ovarian tissue transplantation aiming at recovering fertility, 17 healthy children have been born and several additional pregnancies are currently ongoing. Whenever patients’ clinical condition is permissive, Oocyte Cryopreservation after hormonal stimulation is preferred for fertility preservation. Between 2012 and 2014, a smaller proportion of females have undergone fertility preservation in the Nordic centers, in comparison to males (1:3). Conclusions: Overall, ovarian tissue Cryopreservation was reported to be safe. Slow freezing methods are still preferred. Promising results of recovery of fertility have been reported in Nordic countries that have initiated ovarian tissue transplantation procedures.
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recent advances in Oocyte and ovarian tissue Cryopreservation and transplantation
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2012Co-Authors: Kenny A Rodriguezwallberg, Kutluk OktayAbstract:Options for preserving fertility in women include well-established methods such as fertility-sparing surgery, shielding to reduce radiation damage to reproductive organs, and emergency in-vitro fertilisation after controlled ovarian stimulation, with the aim of freezing embryos. The practice of transfering frozen or thawed embryos has been in place for over 25 years, and today is a routine clinical treatment in fertility clinics. Oocytes may also be frozen unfertilised for later thawing and fertilisation by intracytoplasmic sperm injection in vitro . In recent years, Oocyte Cryopreservation methods have further developed, reaching promising standards. More than 1000 children are born worldwide after fertilisation of frozen and thawed Oocytes. Nevertheless, this technique is still considered experimental. In this chapter, we focus on options for fertility preservation still in development that can be offered to women. These include freezing of Oocytes and ovarian cortex and the transplantation of ovarian tissue.
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fertility preservation by ovarian stimulation and Oocyte Cryopreservation in a 14 year old adolescent with turner syndrome mosaicism and impending premature ovarian failure
Fertility and Sterility, 2010Co-Authors: Kutluk Oktay, Kenny A Rodriguezwallberg, Gulnaz SahinAbstract:Objective To report a novel approach to fertility preservation in adolescents with Turner syndrome mosaicism by repeated controlled ovarian stimulation and Oocyte Cryopreservation. Design Case report. Setting Academic reproductive medicine center. Patient(s) Fourteen-year-old adolescent diagnosed with Turner syndrome mosaicism. Intervention(s) Two cyles of controlled ovarian stimulation and Oocyte Cryopreservation within 1 year. Main Outcome Measure(s) Recovery of Oocytes after controlled ovarian stimulation and Oocyte Cryopreservation. Result(s) Eleven Oocytes were retrieved, of which eight were mature and three were immature during the first cycle. One year later, four mature and three immature Oocytes were retrieved after a treatment cycle with even higher gonadotropin doses. All Oocytes were cryopreserved by vitrification. Conclusion(s) Controlled ovarian stimulation and Oocyte Cryopreservation may be an option for fertility preservation in selected adolescents with Turner syndrome mosaicism and impending ovarian failure.
