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Kutluk Oktay - One of the best experts on this subject based on the ideXlab platform.
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evaluation of ovarian and testicular Tissue Cryopreservation in children undergoing gonadotoxic therapies
Journal of Assisted Reproduction and Genetics, 2013Co-Authors: M Samir D Babayev, Erol Arslan, Stanley J Kogan, Fred Moy, Kutluk OktayAbstract:Objective Ovarian and testicular Tissue Cryopreservation are the only fertility preservation options for sexually immature individuals. Because of their experimental nature, it is important to determine safety and possible bundling with other medicallyindicated procedures.
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Evaluation of ovarian and testicular Tissue Cryopreservation in children undergoing gonadotoxic therapies
Journal of Assisted Reproduction and Genetics, 2013Co-Authors: Samir N. Babayev, Fred Moy, Erol Arslan, Stanley Kogan, Kutluk OktayAbstract:Objective Ovarian and testicular Tissue Cryopreservation are the only fertility preservation options for sexually immature individuals. Because of their experimental nature, it is important to determine safety and possible bundling with other medicallyindicated procedures. Study design Prospective observational. Results Cryopreservation indications included cancer in 75 % of females and 50 % of males, while non-cancer indications included various hematological conditions. Similar numbers of females (12/28) and males (3/9) underwent prior chemotherapy. Females underwent laparoscopic (27/28) or robotic (1/28) approaches while incisional biopsy was used in males. Bundling of ovarian and testicular harvesting with other medicallyindicated procedures was performed in 42 % and 22 %, respectively. The operative time inclusive of bundled procedures was similar (1.6 ± 0.1 vs. 0.9 ± 0.3 h) but the discharge time was significantly longer for females than males (10.4 ± 0.6 vs. 4.6 ± 0.6 h, p
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Oocyte and ovarian Tissue Cryopreservation: indications, techniques, and applications.
Seminars in Reproductive Medicine, 2005Co-Authors: Mousa I. Shamonki, Kutluk OktayAbstract:With recent advances in cryobiology, Cryopreservation of the oocyte and ovarian Tissue is rapidly becoming an important service provided by medical centers throughout the world. The general indication for oocyte or ovarian Tissue Cryopreservation is to retain future fertility potential for women who face the possibility of premature or imminent ovarian failure resulting from treatments for various disease states including cancer. Considering limitations imposed by age, lack of a partner, or sufficient time to undergo embryo Cryopreservation, these patients have few options if they desire preservation of their fertility. The objective of this manuscript is to review the basic aspects of oocyte and ovarian Tissue Cryopreservation, and to discuss the current and future applications of these technologies in fertility' preservation.
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Ovarian Tissue Cryopreservation: benefits and risks.
Cell and Tissue Research, 2005Co-Authors: Murat Sönmezer, Mousa I. Shamonki, Kutluk OktayAbstract:An increasing number of women have been subjected to cytotoxic chemoradiotherapy for various malignant and nonmalignant diseases. Women who face the possibility of premature or imminent ovarian failure caused by cytotoxic therapy may retain their fertility potential with ovarian Tissue Cryopreservation. Until recently, this technique could only be performed in a few highly specialized institutions. However, with the latest advances in cryobiology, ovarian Tissue Cryopreservation is rapidly becoming a more widely offered technique by many medical centers around the world. The indications now extend beyond cancer. Even though the risk of reimplanting pre-existing cancer cells is minimal or non-existent for most types of cancer, this risk needs to be ascertained according to the cancer type and disease stage. The objective of this manuscript is to review the indications, risks and benefits of ovarian Tissue Cryopreservation.
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Ovarian Tissue Cryopreservation and transplantation: preliminary findings and implications for cancer patients
Human Reproduction Update, 2001Co-Authors: Kutluk OktayAbstract:Cancer treatment modalities are increasingly more effective in achieving complete remission and cure. Aggressive chemotherapy and radiotherapy, as well as bone marrow transplantation, results in >90% cure in many cancers of children and young women. As a result of this success however, a new problem has arisen. Many young women survive to live the rest of their lives in menopause, and have no chance of conceiving on their own. Oocyte Cryopreservation has resulted in a handful of pregnancies, but the technique may not be applicable to young women and children. Ovarian Tissue Cryopreservation and transplantation has emerged against this background, first in successful rodent studies, and then in sheep and human ovarian xenograft studies. Because of the encouraging results with animals and xenografts, a human ovarian transplantation trial was launched. Pelvic auto-transplantation of frozen-banked ovarian Tissue resulted in ovulation in one patient. Several other patients received fresh grafts subcutaneously, and preliminary results indicated antral follicle development at least in one patient. With the addition of promising data from humans, ovarian Tissue Cryopreservation from selected patients before cancer treatment, and in those requiring oophorectomy for benign causes, is now advocated.
Richard A. Anderson - One of the best experts on this subject based on the ideXlab platform.
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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, 2019Co-Authors: Richard A. Anderson, D T BairdAbstract: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.
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Ovarian Tissue Cryopreservation for fertility preservation: clinical and research perspectives.
Human Reproduction Open, 2017Co-Authors: Richard A. Anderson, W. Hamish B. Wallace, Evelyn E. TelferAbstract: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.
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Fertility preservation in pre-pubertal girls with cancer: the role of ovarian Tissue Cryopreservation
Fertility and Sterility, 2015Co-Authors: W. Hamish B. Wallace, Tom Kelsey, Richard A. AndersonAbstract: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.
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a european perspective on testicular Tissue Cryopreservation for fertility preservation in prepubertal and adolescent boys
Human Reproduction, 2015Co-Authors: H M Picton, Richard A. Anderson, Christine Wyns, Ellen Goossens, Kirsi Jahnukainen, Sabine Kliesch, Rod T Mitchell, Guido PenningsAbstract:What clinical practices, patient management strategies and experimental methods are currently being used to preserve and restore the fertility of prepubertal boys and adolescent males? Based on a review of the clinical literature and research evidence for sperm freezing and testicular Tissue Cryopreservation, and after consideration of the relevant ethical and legal challenges, an algorithm for the Cryopreservation of sperm and testicular Tissue is proposed for prepubertal boys and adolescent males at high risk of fertility loss. A known late effect of the chemotherapy agents and radiation exposure regimes used to treat childhood cancers and other non-malignant conditions in males is the damage and/or loss of the proliferating spermatogonial stem cells in the testis. Cryopreservation of spermatozoa is the first line treatment for fertility preservation in adolescent males. Where sperm retrieval is impossible, such as in prepubertal boys, or it is unfeasible in adolescents prior to the onset of ablative therapies, alternative experimental treatments such as testicular Tissue Cryopreservation and the harvesting and banking of isolated spermatogonial stem cells can now be proposed as viable means of preserving fertility. Advances in clinical treatments, patient management strategies and the research methods used to preserve sperm and testicular Tissue for prepubertal boys and adolescents were reviewed. A snapshot of the up-take of testis Cryopreservation as a means to preserve the fertility of young males prior to December 2012 was provided using a questionnaire. A comprehensive literature review was conducted. In addition, survey results of testis freezing practices in young patients were collated from 24 European centres and Israeli University Hospitals. There is increasing evidence of the use of testicular Tissue Cryopreservation as a means to preserve the fertility of pre- and peri-pubertal boys of up to 16 year-old. The survey results indicate that of the 14 respondents, half of the centres were actively offering testis Tissue cryobanking as a means of safeguarding the future fertility of boys and adolescents as more than 260 young patients (age range less than 1 year old to 16 years of age), had already undergone testicular Tissue retrieval and storage for fertility preservation. The remaining centres were considering the implementation of a Tissue-based fertility preservation programme for boys undergoing oncological treatments. The data collected were limited by the scope of the questionnaire, the geographical range of the survey area, and the small number of respondents. The clinical and research questions identified and the ethical and legal issues raised are highly relevant to the multi-disciplinary teams developing treatment strategies to preserve the fertility of prepubertal and adolescent boys who have a high risk of fertility loss due to ablative interventions, trauma or genetic pre-disposition
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A European perspective on testicular Tissue Cryopreservation for fertility preservation in prepubertal and adolescent boys
Human reproduction (Oxford England), 2015Co-Authors: H M Picton, Richard A. Anderson, Guido Pennings, Christine Wyns, Ellen Goossens, Kirsi Jahnukainen, Sabine Kliesch, Rod T Mitchell, Natalie Rives, Herman TournayeAbstract:STUDY QUESTION What clinical practices, patient management strategies and experimental methods are currently being used to preserve and restore the fertility of prepubertal boys and adolescent males? SUMMARY ANSWER Based on a review of the clinical literature and research evidence for sperm freezing and testicular Tissue Cryopreservation, and after consideration of the relevant ethical and legal challenges, an algorithm for the Cryopreservation of sperm and testicular Tissue is proposed for prepubertal boys and adolescent males at high risk of fertility loss. WHAT IS KNOWN ALREADY A known late effect of the chemotherapy agents and radiation exposure regimes used to treat childhood cancers and other non-malignant conditions in males is the damage and/or loss of the proliferating spermatogonial stem cells in the testis. Cryopreservation of spermatozoa is the first line treatment for fertility preservation in adolescent males. Where sperm retrieval is impossible, such as in prepubertal boys, or it is unfeasible in adolescents prior to the onset of ablative therapies, alternative experimental treatments such as testicular Tissue Cryopreservation and the harvesting and banking of isolated spermatogonial stem cells can now be proposed as viable means of preserving fertility. STUDY DESIGN, SIZE, DURATION Advances in clinical treatments, patient management strategies and the research methods used to preserve sperm and testicular Tissue for prepubertal boys and adolescents were reviewed. A snapshot of the up-take of testis Cryopreservation as a means to preserve the fertility of young males prior to December 2012 was provided using a questionnaire. PARTICIPANTS/MATERIALS, SETTING, METHODS A comprehensive literature review was conducted. In addition, survey results of testis freezing practices in young patients were collated from 24 European centres and Israeli University Hospitals. MAIN RESULTS AND THE ROLE OF CHANCE There is increasing evidence of the use of testicular Tissue Cryopreservation as a means to preserve the fertility of pre- and peri-pubertal boys of up to 16 year-old. The survey results indicate that of the 14 respondents, half of the centres were actively offering testis Tissue cryobanking as a means of safeguarding the future fertility of boys and adolescents as more than 260 young patients (age range less than 1 year old to 16 years of age), had already undergone testicular Tissue retrieval and storage for fertility preservation. The remaining centres were considering the implementation of a Tissue-based fertility preservation programme for boys undergoing oncological treatments. LIMITATIONS, REASONS FOR CAUTION The data collected were limited by the scope of the questionnaire, the geographical range of the survey area, and the small number of respondents. WIDER IMPLICATIONS OF THE FINDINGS The clinical and research questions identified and the ethical and legal issues raised are highly relevant to the multi-disciplinary teams developing treatment strategies to preserve the fertility of prepubertal and adolescent boys who have a high risk of fertility loss due to ablative interventions, trauma or genetic pre-disposition. STUDY FUNDING/COMPETING INTEREST(S) The work was funded by the European Society of Human Reproduction and Embryology (ESHRE).
Tak Kim - One of the best experts on this subject based on the ideXlab platform.
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Comparison between Slow Freezing and Vitrification for Human Ovarian Tissue Cryopreservation and Xenotransplantation
International Journal of Molecular Sciences, 2019Co-Authors: Sang Hoon Lee, Ki Jin Ryu, Boram Kim, Dahyeon Kang, Yoon Young Kim, Tak KimAbstract:Two methods for the Cryopreservation of human ovarian Tissue were compared using a xenotransplantation model to establish a safe and effective Cryopreservation method. Ovarian Tissues were obtained from women who underwent benign ovarian surgery in the gynecology research unit of a university hospital. The Tissues were transplanted into 112 ovariectomized female severe combined immunodeficient mice 4 weeks after slow freezing or vitrification Cryopreservation. Tissues were retrieved 4 weeks later. Primordial follicular counts decreased after Cryopreservation and xenotransplantation, and were significantly higher in the slow freezing group than in the vitrification group (p < 0.001). Immunohistochemistry and TUNEL assay showed that the Ki-67 and CD31 markers of follicular proliferation and angiogenesis were higher in the slow freezing group (p < 0.001 and p = 0.006, respectively) and DNA damage was greater in the vitrification group (p < 0.001). Western blotting showed that vitrification increased cellular apoptosis. Anti-Mullerian hormone expression was low in transplanted samples subjected to both Cryopreservation techniques. Electron microscopy revealed primordial follicle deformation in the vitrification group. Slow freezing for ovarian Tissue Cryopreservation is superior to vitrification in terms of follicle survival and growth after xenotransplantation. These results will be useful for fertility preservation in female cancer patients.
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Ovarian Tissue Cryopreservation and transplantation in patients with cancer
Obstetrics & gynecology science, 2018Co-Authors: Soo Young Kim, Younji Lee, Sang Hoon Lee, Tak KimAbstract:Chemotherapy and radiotherapy improved survival rates of patients with cancer. However, they can cause ovarian failure and infertility in women of reproductive age. Infertility following cancer treatment is considered a major quality of life issue. Ovarian Tissue Cryopreservation and transplantation is an important option for fertility preservation in adult patients with cancer who need immediate chemotherapy or do not want to undergo ovarian stimulation. Ovarian Tissue freezing is the only option for preserving the fertility of prepubertal patients with cancer. In a recent review, it was reported that frozen-thawed ovarian transplantation has lead to about 90 live births and the conception rate was about 30%. Endocrine function recovery was observed in 92.9% between 3.5 and 6.5 months after transplantation. Based on our review, ovarian Tissue Cryopreservation and transplantation may be carefully considered before cancer treatment in order to preserve fertility and endocrine function in young cancer survivors.
Gennady T. Sukhikh - One of the best experts on this subject based on the ideXlab platform.
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Umbilical cord Tissue Cryopreservation: a short review.
Stem cell research & therapy, 2018Co-Authors: I. V. Arutyunyan, Timur Fatkhudinov, Gennady T. SukhikhAbstract:In this review we present current evidence on the possibility of umbilical cord Tissue Cryopreservation for subsequent clinical use. Protocols for obtaining umbilical cord-derived vessels, Wharton’s jelly-based grafts, multipotent stromal cells, and other biomedical products from cryopreserved umbilical cords are highlighted, and their prospective clinical applications are discussed. Examination of recent literature indicates we should expect high demand for Cryopreservation of umbilical cord Tissues in the near future.
Erin E. Rowell - One of the best experts on this subject based on the ideXlab platform.
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feasibility of laparoscopic ovarian Tissue Cryopreservation after open abdominopelvic tumor surgery
American Journal of Surgery, 2020Co-Authors: Erin E. Rowell, Timothy B. Lautz, Courtney J. HarrisAbstract:abstract Background Laparoscopic oophorectomy with Tissue Cryopreservation (OTC) for fertility preservation is usually performed prior to therapy. When fertility preservation is considered after prior open abdominopelvic tumor surgery there may be a perceived barrier to laparoscopic OTC. This study evaluates the feasibility of OTC with a laparoscopic approach after open surgery. Methods This is a single institution retrospective study from 2011 to 2019. Results Planned laparoscopic OTC was performed after open surgery in 17 of 113 patients. Median age was 4.2 years. The most common diagnoses were Wilms Tumor (35%) and neuroblastoma (35%). The most common procedures were nephrectomy (41%) and exploratory laparotomy with biopsy (35%). The median amount of time between open surgery and OTC was 29 days. Sixteen (94%) had a laparoscopic OTC. Regardless of operative technique, patients resumed therapy a median of 3 days after OTC. Conclusions Prior abdominopelvic surgery should not be a barrier to OTC. Laparoscopic OTC is feasible after a variety of open oncologic operations, regardless of time-interval between the procedures and without incurring a significant delay in resuming oncologic therapy.
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Establishing an Institutional Gonadal Tissue Cryopreservation Protocol for Patients with Differences of Sex Development.
The Journal of urology, 2020Co-Authors: Courtney J. Harris, Erin E. Rowell, Kristine S. Corkum, Monica M. Laronda, Elizabeth B. Yerkes, Earl Y. Cheng, Courtney Finlayson, Molly B. Reimann, Emilie K. JohnsonAbstract:Purpose:Many individuals with differences of sex development experience subfertility. We describe a novel gonadal Tissue Cryopreservation protocol for those individuals.Materials and Methods:Before...
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Gonadal Tissue Cryopreservation for Children with Differences of Sex Development.
Hormone research in paediatrics, 2019Co-Authors: Emilie K. Johnson, Erin E. Rowell, Monica M. Laronda, Esther L. Finney, Diane Chen, Courtney Finlayson, Courtney J. Harris, Barbara Lockart, Serena Y. Tan, Earl Y. ChengAbstract:Introduction: Infertility is common for individuals with differences of sex development (DSD) and is a significant concern to these individuals. Fertility potential in many DSD conditions is poorly understood. Gonadal Tissue Cryopreservation (GTC) for fertility preservation (FP) is offered to children with cancer undergoing gonadotoxic therapy. Our team sought to expand the field of FP by offering and evaluating the success of GTC for individuals with DSD. Materials and Methods: GTC was offered to patients with DSD undergoing prophylactic gonadectomy, after extensive multidisciplinary counseling. For those who elected to attempt GTC, data were retrospectively abstracted, including: DSD diagnosis, age at gonadectomy, indication for gonadectomy, pathology results, and final decision about long-term gonadal Tissue storage. Results: Ten patients were enrolled to attempt GTC, with a mean age of 11.5 years (range 1–18). Five of the 10 patients had germ cells (GCs) present. Diagnoses (age at gonadectomy) for patients with GCs included ovotesticular DSD (13 months), mixed gonadal dysgenesis (17 months), partial gonadal dysgenesis (3 years), partial androgen insensitivity syndrome (11 years), and mixed gonadal dysgenesis (12 years). Four of the 5 subjects with GCs elected for GTC. One opted against GTC, citing immature gametes that did not match gender identity. Conclusion: GTC at the time of gonadectomy for patients with DSD is feasible. In many patients, GCs are present. While questions remain about the timing of gonadectomy, quality of GCs, and future success for use of the Tissue based on technological advancement, GTC represents a novel approach to experimental FP for individuals with DSD.
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Gonadal Tissue Cryopreservation for a Girl With Partial Androgen Insensitivity Syndrome.
Journal of the Endocrine Society, 2019Co-Authors: Esther L. Finney, Barbara Lockart, Erin E. Rowell, Mary Beth Madonna, Emilie K. Johnson, Diane Chen, Elizabeth B. Yerkes, Earl Y. Cheng, Courtney FinlaysonAbstract:Individuals with differences/disorders of sex development (DSD) have increased rates of infertility. For children and youth undergoing prophylactic gonadectomy for malignancy risk, our institution offers gonadal Tissue Cryopreservation, an experimental technique to preserve fertility cryopotential. An 11-year-old girl with partial androgen insensitivity syndrome presented for evaluation for fertility preservation in the setting of a planned bilateral gonadectomy at an outside institution. At presentation, the patient had begun puberty with an elevated serum androgen level and was experiencing undesired virilization. She expressed a strong female gender identity, an understanding of the various treatment options, and a preference for gonadectomy to prevent further virilization. After thorough counseling with the patient and family in our institution's multidisciplinary DSD clinic, she underwent bilateral gonadectomy with gonadal Tissue Cryopreservation. Her gonadal pathologic examination demonstrated well-developed peripubertal testes, with present, albeit decreased, numbers of spermatogonial germ cells, decreased Leydig cells, and nonspecific degenerative changes. The patient and her family chose to maintain the cryopreserved Tissue for the patient's potential future use. To the best of our knowledge, the present case is the first reported case of gonadal Tissue Cryopreservation in a patient with partial androgen insensitivity syndrome. Storage of gonadal Tissue is a feasible method of germ cell preservation in patients with DSD undergoing gonadectomy, although further research advances are required to facilitate development of this Tissue into mature gametes capable of biological fertility.
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Laparoscopic unilateral oophorectomy for ovarian Tissue Cryopreservation in children.
Journal of Pediatric Surgery, 2018Co-Authors: Erin E. Rowell, Barbara Lockart, Kristine S. Corkum, Timothy B. Lautz, Monica M. Laronda, Amy L. Walz, Mary Beth Madonna, Marleta ReynoldsAbstract:Abstract Background/Purpose Many survivors of childhood cancer will experience premature gonadal insufficiency or infertility as a consequence of their medical treatments. Ovarian Tissue Cryopreservation (OTC) remains an experimental means of fertility preservation with few reports focused on the surgical technique and postoperative outcomes for OTC in children. Methods This is a single institution, retrospective review of OTC cases from January 2011 to December 2017. Children were eligible for OTC if they had a greater than 80% risk of premature ovarian insufficiency or infertility owing to their anticipated gonadotoxic medical treatment. Results OTC was performed in 64 patients. Median age was 12 years old (range: 5 months–23 years). Nearly half (48%) of the patients were premenarchal. Laparoscopic unilateral oophorectomy was performed in 84% of patients. There were no surgical complications. In 76% of patients, OTC was performed in conjunction with an ancillary procedure. The majority (96%) of patients were discharged within 24 hours. Median time from operation to medical therapy was six days, with no unanticipated treatments delays attributable to OTC. Conclusions Laparoscopic unilateral oophorectomy for OTC can be performed safely, in combination with other ancillary procedures, as an outpatient procedure without delaying medical therapy for children facing a fertility-threatening diagnosis or treatment. Level of Evidence IV.
