TY - JOUR
T1 - Fertility preservation and refreezing of transplanted ovarian tissue—a potential new way of managing patients with low risk of malignant cell recurrence
AU - Kristensen, Stine Gry
AU - Giorgione, Veronica
AU - Humaidan, Peter
AU - Alsbjerg, Birgit
AU - Bjørn, Anne Mette Bay
AU - Ernst, Erik
AU - Andersen, Claus Yding
PY - 2017/5
Y1 - 2017/5
N2 - Objective To report the first successful refreezing of ovarian tissue recovered more than 3 years after transplantation in a woman previously treated for early-stage ovarian cancer. Design Evaluation of cryopreserved and grafted ovarian tissue. Setting University hospital. Patient(s) A 23-year-old woman diagnosed with stage 1C ovarian mucinous cystadenocarcinoma. Intervention(s) The patient underwent ovarian tissue cryopreservation for fertility preservation and subsequent heterotopic transplantation for fertility restoration 9 years after freezing. After a successful IVF twin pregnancy, grafted tissue was laparoscopically removed for safety reasons. The recovered tissue was refrozen. Main Outcome Measure(s) Live birth and histologic evaluation of the distribution of pre-antral follicle stages. Result(s) The previously grafted ovarian tissue was successfully refrozen, presenting follicular survival 4 weeks after xenografting. The follicular distribution in the recovered grafts showed a shift toward growing-stage follicles compared with the fresh tissue. The patient subsequently entered menopause, and histologic evaluation revealed a total of five follicles in two remaining grafts which had supported ovarian function a few months earlier. Conclusion(s) This is the second case of delivery following heterotopic grafting as well as the second case of successful transplantation of ovarian tissue from a patient with early-stage ovarian cancer. The recovered grafts showed that a lower number of functional follicles than previously estimated can actually support ovarian function. Removing and refreezing grafted tissue could be a new way of handling not only cancer patients with a risk of malignant cell recurrence, but also certain groups of patients with genetic conditions.
AB - Objective To report the first successful refreezing of ovarian tissue recovered more than 3 years after transplantation in a woman previously treated for early-stage ovarian cancer. Design Evaluation of cryopreserved and grafted ovarian tissue. Setting University hospital. Patient(s) A 23-year-old woman diagnosed with stage 1C ovarian mucinous cystadenocarcinoma. Intervention(s) The patient underwent ovarian tissue cryopreservation for fertility preservation and subsequent heterotopic transplantation for fertility restoration 9 years after freezing. After a successful IVF twin pregnancy, grafted tissue was laparoscopically removed for safety reasons. The recovered tissue was refrozen. Main Outcome Measure(s) Live birth and histologic evaluation of the distribution of pre-antral follicle stages. Result(s) The previously grafted ovarian tissue was successfully refrozen, presenting follicular survival 4 weeks after xenografting. The follicular distribution in the recovered grafts showed a shift toward growing-stage follicles compared with the fresh tissue. The patient subsequently entered menopause, and histologic evaluation revealed a total of five follicles in two remaining grafts which had supported ovarian function a few months earlier. Conclusion(s) This is the second case of delivery following heterotopic grafting as well as the second case of successful transplantation of ovarian tissue from a patient with early-stage ovarian cancer. The recovered grafts showed that a lower number of functional follicles than previously estimated can actually support ovarian function. Removing and refreezing grafted tissue could be a new way of handling not only cancer patients with a risk of malignant cell recurrence, but also certain groups of patients with genetic conditions.
KW - fertility preservation
KW - follicular distribution post-grafting
KW - Ovarian cancer
KW - ovarian tissue cryopreservation
KW - refreezing ovarian tissue
U2 - 10.1016/j.fertnstert.2017.03.017
DO - 10.1016/j.fertnstert.2017.03.017
M3 - Journal article
C2 - 28433369
AN - SCOPUS:85017504909
SN - 1546-2501
VL - 107
SP - 1206
EP - 1213
JO - Sexuality, Reproduction and Menopause
JF - Sexuality, Reproduction and Menopause
IS - 5
ER -
