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Richard A. Anderson - One of the best experts on this subject based on the ideXlab platform.

  • Characterization of follicles in girls and young women with Turner syndrome who underwent Ovarian Tissue Cryopreservation.
    Fertility and Sterility, 2019
    Co-Authors: Linn Salto Mamsen, Richard A. Anderson, Evelyn E. Telfer, Erik Ernst, Tom Kelsey, Stine Gry Kristensen, Karol Charkiewicz, Marie Mclaughlin, Debra A. Gook, Claus Yding Andersen
    Abstract:

    Objective To characterize Ovarian follicles of girls and young women with Turner syndrome (TS) who underwent Ovarian Tissue Cryopreservation (OTC). Design Retrospective case–control study. Setting University hospital. Patient(s) Fifteen girls and young women with TS aged 5–22 years at OTC were included, together with 42 control girls and young women aged 1–25 years who underwent OTC because of cancer. Intervention(s) None. Main Outcome Measure(s) Follicle density (follicles/mm3), morphology, and health were assessed in Ovarian cortex biopsies from TS patients and compared with controls. Hormone concentrations were measured in serum and follicle fluids. Immature cumulus oocyte complexes were obtained and matured in vitro. Result(s) Follicles were found in 60% of the biopsies (9 of 15) from TS ovaries. In 78% of the ovaries (7 of 9) with follicles, the follicle density was within the 95% confidence interval of the control group. There was a high rate of abnormal follicle morphology. Six follicle-specific proteins were expressed similarly in TS and control ovaries. However, apoptosis and zona pellucida protein expression were found to be abnormal in TS. Turner syndrome follicle fluid from small antral follicles had lower concentrations of estrogen and testosterone and higher concentrations of antimullerian hormone than controls. Thirty-one cumulus oocyte complexes were collected from one patient and cultured for 48 hours in vitro, resulting in five metaphase II oocytes (maturation rate 16%, degeneration rate 19%). Conclusion(s) The benefits of OTC may be limited to a highly selected group of TS mosaic patients in whom a sizeable pool of normal follicles is present at OTC.

  • The development of Ovarian Tissue Cryopreservation in Edinburgh: Translation from a rodent model through validation in a large mammal and then into clinical practice.
    Acta Obstetricia et Gynecologica Scandinavica, 2019
    Co-Authors: Richard A. Anderson, D T Baird
    Abstract:

    Ovarian Tissue Cryopreservation has developed rapidly from its origins in experiments in sheep in the 1990s, and is now becoming recognized as a standard, rather than experimental, procedure. This review summarizes the origins of the technique, and key milestones in its development since the first reported sheep pregnancy in 1994 to the first successful human pregnancy in 2004, and now to the first baby born following Cryopreservation of prepubertal Ovarian Tissue. Many challenges remain to optimize this technique, to improve the survival of follicles within the reimplanted Ovarian Tissue, to improve its reproducibility and hence the success rate and the lifespan of the graft. The other key area remains the possibility of the grafted Tissue containing malignant cells, most importantly in leukemia.

  • Ovarian Tissue Cryopreservation for fertility preservation: clinical and research perspectives.
    Human Reproduction Open, 2017
    Co-Authors: Richard A. Anderson, W. Hamish B. Wallace, Evelyn E. Telfer
    Abstract:

    Background Small case series have reported successful live births after Ovarian Tissue Cryopreservation and orthotopic transplantation, demonstrating that it can be of value in increasing the chance of successful pregnancy after treatment for cancer and other fertility-impacting diseases in adult women. Objective and rationale This review is intended to set out the current clinical issues in the field of Ovarian Tissue Cryopreservation, and elucidate the status of laboratory studies to address these. Search methods We reviewed the English-language literature on Ovarian Tissue Cryopreservation and in vitro maturation (IVM) of Ovarian follicles. Outcomes Ovarian Tissue Cryopreservation is increasingly used for fertility preservation and, whilst areas for development remain (optimal patient selection, minimizing risk of contamination by malignant cells and IVM protocols), there are emerging data as to its efficacy. We review the current status of Ovarian Tissue Cryopreservation in girls and young women facing loss of fertility from treatment of cancer and other serious diseases. Increasingly large cohort studies are reporting on success rates from Ovarian Tissue Cryopreservation giving an indication of likely success rates. Patient selection is necessary to ensure the safety and effectiveness of this approach, especially in the very experimental situation of its application to prepubertal girls. There are continuing developments in supporting follicle development in vitro. Limitations reasons for caution The evidence base consists largely of case series and cohort studies, thus there is the possibility of bias in key outcomes. In vitro development of human Ovarian follicles remains some way from clinical application. Wider implications of the findings Ovarian Tissue Cryopreservation is becoming established as a valuable approach to the preservation of fertility in women. Its application in prepubertal girls may be of particular value, as it offers the only approach in this patient group. For both girls and young women, more accurate data are needed on the likelihood of successful childbirth after this procedure and the factors that underpin successful application of this approach, which will lead to its more effective use. Study funding/competing interests The author's work in this field is supported by Medical Research Grant (MRC) grants G0901839 and MR/L00299X/1 and partially undertaken in the MRC Centre for Reproductive Health which is funded by MRC Centre grant MR/N022556/1. The authors declare that there is no conflict of interest that could prejudice the impartiality of the present research.

  • Fertility preservation in pre-pubertal girls with cancer: the role of Ovarian Tissue Cryopreservation
    Fertility and Sterility, 2015
    Co-Authors: W. Hamish B. Wallace, Tom Kelsey, Richard A. Anderson
    Abstract:

    With the increasing numbers of survivors of cancer in young people, future fertility and Ovarian function are important considerations that should be discussed before treatment commences. Some young people, by nature of the treatment they will receive, are at high risk of premature Ovarian insufficiency and infertility. For them, Ovarian Tissue Cryopreservation (OTC) is one approach to fertility preservation that remains both invasive and for young patients experimental. There are important ethical and consent issues that need to be explored and accepted before OTC can be considered established in children with cancer. In this review we have discussed a framework for patient selection which has been shown to be effective in identifying those patients at high risk of premature Ovarian insufficiency and who can be offered OTC safely.

  • fertility preservation for girls and young women with cancer population based validation of criteria for Ovarian Tissue Cryopreservation
    Lancet Oncology, 2014
    Co-Authors: Alice Grove Smith, Hamish W B Wallace, Tom Kelsey, Angela E Edgar, Richard A. Anderson
    Abstract:

    Background Ovarian Tissue Cryopreservation with later reimplantation has been shown to preserve fertility in adult women, but this approach remains unproven and experimental in children and adolescents. We aimed to assess the use of the Edinburgh selection criteria for Ovarian Tissue Cryopreservation in girls and young women with cancer to determine whether we are off ering this invasive procedure to the patients who are most at risk of premature Ovarian insuffi ciency . Findings 34 (8%) of the 410 patients met the Edinburgh selection criteria and were off ered Ovarian Tissue cryo- preservation before starting cancer treatment. 13 patients declined the procedure and 21 consented, and the procedure was completed successfully in 20 patients. Of the 20 patients who had Ovarian Tissue successfully cryopreserved, 14 were available for assessment of Ovarian function. Of the 13 patients who had declined the procedure, six were available for assessment of Ovarian function. Median age at the time of follow-up for the 20 assessable patients was 16·9 years (IQR 15·5-21·8). Of the 14 assessable patients who had successfully undergone Ovarian Cryopreservation, six had developed premature Ovarian insuffi ciency at a median age of 13·4 years (IQR 12·5-14·6), one of whom also had a natural pregnancy. Of the six assessable patients who had declined the procedure, one had developed premature Ovarian insuffi ciency. Assessment of Ovarian function was possible for 141 of the 376 patients who were not off ered Cryopreservation; one of these patients had developed premature Ovarian insuffi ciency. The cumulative probability of developing premature Ovarian insuffi ciency after treatment was completed was signifi cantly higher for patients who met the criteria for Ovarian Tissue Cryopreservation than for those who did not (15-year probability 35% (95% CI 10-53) vs 1% (0-2); p<0·0001; hazard ratio 56·8 (95% CI 6·2-521·6) at 10 years). Interpretation The results of this analysis show that the Edinburgh selection criteria accurately identify the few girls and young women who will develop premature Ovarian insuffi ciency, and validate their use for selection of patients for Ovarian Tissue Cryopreservation. Further follow-up of this cohort of patients is likely to allow refi nement of the criteria for this experimental procedure in girls and young women with cancer.

Claus Yding Andersen - One of the best experts on this subject based on the ideXlab platform.

  • Characterization of follicles in girls and young women with Turner syndrome who underwent Ovarian Tissue Cryopreservation.
    Fertility and Sterility, 2019
    Co-Authors: Linn Salto Mamsen, Richard A. Anderson, Evelyn E. Telfer, Erik Ernst, Tom Kelsey, Stine Gry Kristensen, Karol Charkiewicz, Marie Mclaughlin, Debra A. Gook, Claus Yding Andersen
    Abstract:

    Objective To characterize Ovarian follicles of girls and young women with Turner syndrome (TS) who underwent Ovarian Tissue Cryopreservation (OTC). Design Retrospective case–control study. Setting University hospital. Patient(s) Fifteen girls and young women with TS aged 5–22 years at OTC were included, together with 42 control girls and young women aged 1–25 years who underwent OTC because of cancer. Intervention(s) None. Main Outcome Measure(s) Follicle density (follicles/mm3), morphology, and health were assessed in Ovarian cortex biopsies from TS patients and compared with controls. Hormone concentrations were measured in serum and follicle fluids. Immature cumulus oocyte complexes were obtained and matured in vitro. Result(s) Follicles were found in 60% of the biopsies (9 of 15) from TS ovaries. In 78% of the ovaries (7 of 9) with follicles, the follicle density was within the 95% confidence interval of the control group. There was a high rate of abnormal follicle morphology. Six follicle-specific proteins were expressed similarly in TS and control ovaries. However, apoptosis and zona pellucida protein expression were found to be abnormal in TS. Turner syndrome follicle fluid from small antral follicles had lower concentrations of estrogen and testosterone and higher concentrations of antimullerian hormone than controls. Thirty-one cumulus oocyte complexes were collected from one patient and cultured for 48 hours in vitro, resulting in five metaphase II oocytes (maturation rate 16%, degeneration rate 19%). Conclusion(s) The benefits of OTC may be limited to a highly selected group of TS mosaic patients in whom a sizeable pool of normal follicles is present at OTC.

  • Time from referral to Ovarian Tissue Cryopreservation in a cohort of Danish women
    Acta Obstetricia et Gynecologica Scandinavica, 2019
    Co-Authors: Stine Gry Kristensen, Susanne Elisabeth Pors, Liv La Cour Poulsen, Signe Taasti Andersen, Yu Wakimoto, Claus Yding Andersen
    Abstract:

    INTRODUCTION Young women with a cancer diagnosis often have very little time to decide whether or not to commence fertility-preserving strategies before initiating potentially sterilizing cancer treatment. Minimizing the interval from opting for fertility preservation to completion of the procedure will reduce the potential risk of delaying cancer treatment. In the current study, we have evaluated the period of time from referral to Ovarian Tissue Cryopreservation (OTC) to actual freezing of the Tissue in a cohort of Danish women. MATERIAL AND METHODS The study population comprised 277 consecutive patients with both malignant and nonmalignant diseases referred for OTC from four centers in the Danish network. Statistical analysis was conducted to analyze the impact of age, diagnosis, and referring center on the time from OTC-referral to OTC. A literature search for "random start" protocols for controlled Ovarian stimulation (COS) for fertility preservation in cancer patients was performed. RESULTS The time from OTC-referral to OTC was significantly influenced by diagnosis, age, and referring center. Women with malignant diseases other than breast cancer, such as sarcomas, pelvic cancers, and hematological cancers, experienced a significantly shorter interval to OTC (5 days) than women with breast cancer (7 days) and nonmalignant diseases including systemic, Ovarian, and hereditary conditions (13-17.5 days). Women over the age of 30 years experienced a significantly longer time to OTC (P 

  • Should you be putting all your eggs into one basket? A look into the current state and future of Ovarian Tissue Cryopreservation.
    Journal of Cancer Biology and Therapeutics, 2015
    Co-Authors: Shakina Rauff, Zaraq Khan, Claus Yding Andersen
    Abstract:

     Ovarian Tissue Cryopreservation has its primary goal in fertility preservation for women diagnosed with a malignancy and who may be rendered infertile because of the potential gonadotoxic chemotherapy and/or radiotherapy involved in treating their disease. Unlike the standard and endorsed methods of fertility preservation like mature oocyte and embryo Cryopreservation, Ovarian Tissue freezing not only conserves the reproductive capacity of the woman but additionally, maintains the steroidogenic competence of the ovary due to the fact that the frozen cortex contains numerous Ovarian follicles – the functional unit of the ovary. Not every follicle is fated to aid procreation. In fact more than 99% are destined to end up in atresia, which may be viewed as an enormous waste of inherent resources. In light of this, there have been propositions to expand the scope of Ovarian Tissue Cryopreservation and transplantation beyond its traditional purpose of fertility preservation for medical indications. Some of these ideas include utilizing cryopreserved Ovarian Tissue for induction of puberty, delaying the menopause and fertility preservation for social motives. Needless to say, these novel ideas will evoke questions, controversy and a plethora of criticism about the safety, superiority, cost-effectiveness, implications and necessity of these different utilities. In this article, we aim to explore some of the issues that shroud these new indications and discuss the advantages for and diatribe against these evolving suggestions.

  • Optimizing outcomes from Ovarian Tissue Cryopreservation and transplantation; activation versus preservation
    Human Reproduction, 2015
    Co-Authors: Dror Meirow, Hadassa Roness, S.g. Kristensen, Claus Yding Andersen
    Abstract:

    Ovarian Tissue Cryopreservation and transplantation (OTCP) is gaining increasing traction in the field of fertility preservation as a result of accumulated successes. We now have a decade of experience with the technique, with tens of live births and greater than 90% return of Ovarian function in graft recipients. Recently, a novel method of OTCP has been described, termed in vitro activated OTCP which proposes significant changes to the standard protocol. This method aims to stimulate activation of dormant follicles within the grafts prior to transplantation and ensure that mature oocytes can be generated in the immediate short term after transplantation. By contrast, conventional OTCP seeks to maintain dormancy and thus preserve the follicle reserve in the graft with the aim of maximizing graft lifespan. This opinion paper will compare the two methods of OTCP, highlighting their respective advantages and disadvantages, and provide suggestions as to when to apply either one of these methods in a clinical setting.

  • Risk of transferring malignant cells with transplanted frozen-thawed Ovarian Tissue
    Fertility and Sterility, 2013
    Co-Authors: Marie-madeleine Dolmans, Claus Yding Andersen, Jacques Donnez, Valérie Luyckx, Tine Greve
    Abstract:

    Ovarian Tissue Cryopreservation and transplantation is a real option to preserve and restore fertility in young cancer patients. However, there is a concern regarding the possible presence of malignant cells in the Ovarian Tissue, which could lead to recurrence of the primary disease after reimplantation. A review of the existing literature was done to evaluate the risk of transplanting malignant cells in case of the main malignant indications for Ovarian Tissue Cryopreservation. For Ovarian Tissue from patients with hematologic malignancies, it is of paramount importance to identify minimal residual disease before Ovarian Tissue transplantation. Indeed, these pathologies, reviewed here in detail, are considered to be most at risk of Ovarian metastasis.

Tom Kelsey - One of the best experts on this subject based on the ideXlab platform.

  • Characterization of follicles in girls and young women with Turner syndrome who underwent Ovarian Tissue Cryopreservation.
    Fertility and Sterility, 2019
    Co-Authors: Linn Salto Mamsen, Richard A. Anderson, Evelyn E. Telfer, Erik Ernst, Tom Kelsey, Stine Gry Kristensen, Karol Charkiewicz, Marie Mclaughlin, Debra A. Gook, Claus Yding Andersen
    Abstract:

    Objective To characterize Ovarian follicles of girls and young women with Turner syndrome (TS) who underwent Ovarian Tissue Cryopreservation (OTC). Design Retrospective case–control study. Setting University hospital. Patient(s) Fifteen girls and young women with TS aged 5–22 years at OTC were included, together with 42 control girls and young women aged 1–25 years who underwent OTC because of cancer. Intervention(s) None. Main Outcome Measure(s) Follicle density (follicles/mm3), morphology, and health were assessed in Ovarian cortex biopsies from TS patients and compared with controls. Hormone concentrations were measured in serum and follicle fluids. Immature cumulus oocyte complexes were obtained and matured in vitro. Result(s) Follicles were found in 60% of the biopsies (9 of 15) from TS ovaries. In 78% of the ovaries (7 of 9) with follicles, the follicle density was within the 95% confidence interval of the control group. There was a high rate of abnormal follicle morphology. Six follicle-specific proteins were expressed similarly in TS and control ovaries. However, apoptosis and zona pellucida protein expression were found to be abnormal in TS. Turner syndrome follicle fluid from small antral follicles had lower concentrations of estrogen and testosterone and higher concentrations of antimullerian hormone than controls. Thirty-one cumulus oocyte complexes were collected from one patient and cultured for 48 hours in vitro, resulting in five metaphase II oocytes (maturation rate 16%, degeneration rate 19%). Conclusion(s) The benefits of OTC may be limited to a highly selected group of TS mosaic patients in whom a sizeable pool of normal follicles is present at OTC.

  • Fertility preservation in pre-pubertal girls with cancer: the role of Ovarian Tissue Cryopreservation
    Fertility and Sterility, 2015
    Co-Authors: W. Hamish B. Wallace, Tom Kelsey, Richard A. Anderson
    Abstract:

    With the increasing numbers of survivors of cancer in young people, future fertility and Ovarian function are important considerations that should be discussed before treatment commences. Some young people, by nature of the treatment they will receive, are at high risk of premature Ovarian insufficiency and infertility. For them, Ovarian Tissue Cryopreservation (OTC) is one approach to fertility preservation that remains both invasive and for young patients experimental. There are important ethical and consent issues that need to be explored and accepted before OTC can be considered established in children with cancer. In this review we have discussed a framework for patient selection which has been shown to be effective in identifying those patients at high risk of premature Ovarian insufficiency and who can be offered OTC safely.

  • fertility preservation for girls and young women with cancer population based validation of criteria for Ovarian Tissue Cryopreservation
    Lancet Oncology, 2014
    Co-Authors: Alice Grove Smith, Hamish W B Wallace, Tom Kelsey, Angela E Edgar, Richard A. Anderson
    Abstract:

    Background Ovarian Tissue Cryopreservation with later reimplantation has been shown to preserve fertility in adult women, but this approach remains unproven and experimental in children and adolescents. We aimed to assess the use of the Edinburgh selection criteria for Ovarian Tissue Cryopreservation in girls and young women with cancer to determine whether we are off ering this invasive procedure to the patients who are most at risk of premature Ovarian insuffi ciency . Findings 34 (8%) of the 410 patients met the Edinburgh selection criteria and were off ered Ovarian Tissue cryo- preservation before starting cancer treatment. 13 patients declined the procedure and 21 consented, and the procedure was completed successfully in 20 patients. Of the 20 patients who had Ovarian Tissue successfully cryopreserved, 14 were available for assessment of Ovarian function. Of the 13 patients who had declined the procedure, six were available for assessment of Ovarian function. Median age at the time of follow-up for the 20 assessable patients was 16·9 years (IQR 15·5-21·8). Of the 14 assessable patients who had successfully undergone Ovarian Cryopreservation, six had developed premature Ovarian insuffi ciency at a median age of 13·4 years (IQR 12·5-14·6), one of whom also had a natural pregnancy. Of the six assessable patients who had declined the procedure, one had developed premature Ovarian insuffi ciency. Assessment of Ovarian function was possible for 141 of the 376 patients who were not off ered Cryopreservation; one of these patients had developed premature Ovarian insuffi ciency. The cumulative probability of developing premature Ovarian insuffi ciency after treatment was completed was signifi cantly higher for patients who met the criteria for Ovarian Tissue Cryopreservation than for those who did not (15-year probability 35% (95% CI 10-53) vs 1% (0-2); p<0·0001; hazard ratio 56·8 (95% CI 6·2-521·6) at 10 years). Interpretation The results of this analysis show that the Edinburgh selection criteria accurately identify the few girls and young women who will develop premature Ovarian insuffi ciency, and validate their use for selection of patients for Ovarian Tissue Cryopreservation. Further follow-up of this cohort of patients is likely to allow refi nement of the criteria for this experimental procedure in girls and young women with cancer.

  • Fertility preservation for girls and young women with cancer: population-based validation of criteria for Ovarian Tissue Cryopreservation
    Lancet Oncology, 2014
    Co-Authors: W. Hamish B. Wallace, Alice Grove Smith, Tom Kelsey, Angela E Edgar, Richard A. Anderson
    Abstract:

    Background Ovarian Tissue Cryopreservation with later reimplantation has been shown to preserve fertility in adult women, but this approach remains unproven and experimental in children and adolescents. We aimed to assess the use of the Edinburgh selection criteria for Ovarian Tissue Cryopreservation in girls and young women with cancer to determine whether we are off ering this invasive procedure to the patients who are most at risk of premature Ovarian insuffi ciency . Findings 34 (8%) of the 410 patients met the Edinburgh selection criteria and were off ered Ovarian Tissue cryo- preservation before starting cancer treatment. 13 patients declined the procedure and 21 consented, and the procedure was completed successfully in 20 patients. Of the 20 patients who had Ovarian Tissue successfully cryopreserved, 14 were available for assessment of Ovarian function. Of the 13 patients who had declined the procedure, six were available for assessment of Ovarian function. Median age at the time of follow-up for the 20 assessable patients was 16·9 years (IQR 15·5-21·8). Of the 14 assessable patients who had successfully undergone Ovarian Cryopreservation, six had developed premature Ovarian insuffi ciency at a median age of 13·4 years (IQR 12·5-14·6), one of whom also had a natural pregnancy. Of the six assessable patients who had declined the procedure, one had developed premature Ovarian insuffi ciency. Assessment of Ovarian function was possible for 141 of the 376 patients who were not off ered Cryopreservation; one of these patients had developed premature Ovarian insuffi ciency. The cumulative probability of developing premature Ovarian insuffi ciency after treatment was completed was signifi cantly higher for patients who met the criteria for Ovarian Tissue Cryopreservation than for those who did not (15-year probability 35% (95% CI 10-53) vs 1% (0-2); p

Erik Ernst - One of the best experts on this subject based on the ideXlab platform.

  • Characterization of follicles in girls and young women with Turner syndrome who underwent Ovarian Tissue Cryopreservation.
    Fertility and Sterility, 2019
    Co-Authors: Linn Salto Mamsen, Richard A. Anderson, Evelyn E. Telfer, Erik Ernst, Tom Kelsey, Stine Gry Kristensen, Karol Charkiewicz, Marie Mclaughlin, Debra A. Gook, Claus Yding Andersen
    Abstract:

    Objective To characterize Ovarian follicles of girls and young women with Turner syndrome (TS) who underwent Ovarian Tissue Cryopreservation (OTC). Design Retrospective case–control study. Setting University hospital. Patient(s) Fifteen girls and young women with TS aged 5–22 years at OTC were included, together with 42 control girls and young women aged 1–25 years who underwent OTC because of cancer. Intervention(s) None. Main Outcome Measure(s) Follicle density (follicles/mm3), morphology, and health were assessed in Ovarian cortex biopsies from TS patients and compared with controls. Hormone concentrations were measured in serum and follicle fluids. Immature cumulus oocyte complexes were obtained and matured in vitro. Result(s) Follicles were found in 60% of the biopsies (9 of 15) from TS ovaries. In 78% of the ovaries (7 of 9) with follicles, the follicle density was within the 95% confidence interval of the control group. There was a high rate of abnormal follicle morphology. Six follicle-specific proteins were expressed similarly in TS and control ovaries. However, apoptosis and zona pellucida protein expression were found to be abnormal in TS. Turner syndrome follicle fluid from small antral follicles had lower concentrations of estrogen and testosterone and higher concentrations of antimullerian hormone than controls. Thirty-one cumulus oocyte complexes were collected from one patient and cultured for 48 hours in vitro, resulting in five metaphase II oocytes (maturation rate 16%, degeneration rate 19%). Conclusion(s) The benefits of OTC may be limited to a highly selected group of TS mosaic patients in whom a sizeable pool of normal follicles is present at OTC.

  • 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, 2016
    Co-Authors: Kenny A Rodriguezwallberg, Tom Tanbo, Helena Tinkanen, Ann Thurinkjellberg, Elizabeth Nedstrand, Margareta Laczna Kitlinski, Kirsten Tryde Macklon, Erik Ernst, Jens Fedder
    Abstract:

    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.

Ralf Dittrich - One of the best experts on this subject based on the ideXlab platform.

  • The safety and satisfaction of Ovarian Tissue Cryopreservation in prepubertal and adolescent girls.
    Reproductive Biomedicine Online, 2020
    Co-Authors: Laura Lotz, Inge Hoffmann, Matthias W. Beckmann, Patricia Reis Barbosa, Christian Knorr, Louisa Hofbeck, Sophia Antoniadis, Ralf Dittrich
    Abstract:

    Abstract Research question Is Ovarian Tissue Cryopreservation (OTC) for fertility preservation in prepubertal and adolescent girls safe, and who would benefit most from the procedure? Design Survey and retrospective study including patients who had OTC under the age of 18 years in a single centre for fertility preservation. Serum anti-Mullerian hormone levels were measured as a marker for detection of diminished Ovarian reserve. Results Fifty-three from 102 women participated in the survey (12 deceased, 19 declined, 17 unreachable, 1 palliative). The average age at OTC was 14.8 ± 2.3 (range: 6–17) years and at survey 21.9 ± 4.3 (range: 16–33) years. Ovarian Tissue retrieval (laparoscopy: n = 45, laparotomy: n = 8) was without complications in 52 cases. In 23 (53.5%) of the 43 women who were post-menarchal at OTC, transient amenorrhoea occurred. At survey, 15 women reported a regular menstrual cycle, 25 used oral contraceptives, 9 women reported hormone replacement therapy due to primary ovary insufficiency and 4 had amenorrhoea. Two patients reported the birth of a healthy child after IVF, while 51 patients are still childless, mostly due to their young age (mean: 21.2 years). To date, one patient has had transplantation of the Ovarian Tissue (17 years at Cryopreservation). Forty-nine of the interviewees would again decide on OTC, while three argued against it on the basis of the previous financial cost; one woman was unsure. Conclusions Children with cancer may be at risk for gonadal insufficiency. OTC is practically the only technique that can be offered to young girls. The procedure is safe and well accepted.

  • Ovarian Tissue Cryopreservation and retransplantation what do patients think about it
    Reproductive Biomedicine Online, 2016
    Co-Authors: Laura Lotz, Amina Maktabi, Inge Hoffmann, S Findeklee, Matthias W. Beckmann, Ralf Dittrich
    Abstract:

    Cryopreservation of Ovarian Tissue has been successfully applied clinically, with over 60 live births to date. The aim of the present study was to perform a survey of patients who have had Ovarian Tissue cryopreserved in the Department of Obstetrics and Gynecology, Erlangen University Hospital, in order to obtain information about: why patients opt for fertility preservation; their current fertility; pregnancy attempts and outcomes; and their intended plans for the cryopreserved Ovarian Tissue. In total, 147 women took part in the survey (average age 25.0 ± 7.0 years; response rate 48%; mean follow-up period 6 years). Sixty-six reported regular menstrual cycles; 48 were amenorrhoeic. Sixty-two women had tried to conceive; 33 reported pregnancies. Twenty-five had delivered healthy children after conceiving naturally; eight had conceived with assisted reproduction. Five patients had had their Ovarian Tissue retransplanted. Although many patients continued to have Ovarian function, none of them regretted choosing Cryopreservation of Ovarian Tissue. Cryopreservation of Ovarian Tissue is an effective option and is very important for women diagnosed with cancer. Analyses of the clinical outcomes in these patients are essential in order to identify those patients capable of benefiting most from the procedure and in order to improve the technique.

  • Ovarian Tissue Cryopreservation and retransplantation – what do patients think about it?
    Reproductive Biomedicine Online, 2016
    Co-Authors: Laura Lotz, Amina Maktabi, Inge Hoffmann, S Findeklee, Matthias W. Beckmann, Ralf Dittrich
    Abstract:

    Cryopreservation of Ovarian Tissue has been successfully applied clinically, with over 60 live births to date. The aim of the present study was to perform a survey of patients who have had Ovarian Tissue cryopreserved in the Department of Obstetrics and Gynecology, Erlangen University Hospital, in order to obtain information about: why patients opt for fertility preservation; their current fertility; pregnancy attempts and outcomes; and their intended plans for the cryopreserved Ovarian Tissue. In total, 147 women took part in the survey (average age 25.0 ± 7.0 years; response rate 48%; mean follow-up period 6 years). Sixty-six reported regular menstrual cycles; 48 were amenorrhoeic. Sixty-two women had tried to conceive; 33 reported pregnancies. Twenty-five had delivered healthy children after conceiving naturally; eight had conceived with assisted reproduction. Five patients had had their Ovarian Tissue retransplanted. Although many patients continued to have Ovarian function, none of them regretted choosing Cryopreservation of Ovarian Tissue. Cryopreservation of Ovarian Tissue is an effective option and is very important for women diagnosed with cancer. Analyses of the clinical outcomes in these patients are essential in order to identify those patients capable of benefiting most from the procedure and in order to improve the technique.