First Ovarian Tissue Cryopreservation and Autotransplantation in Patients with Malignancies in Hungary – Report of the First Three Cases
DOI:
https://doi.org/10.31907/2309-4400.2020.08.11Keywords:
Fertility Preservation, Cryopreservation, Ovarian Tissue Autotransplantation and Malignancies.Abstract
Autotransplantation of cryopreserved ovarian tissue is one of the most advanced methods for fertility preservation of patients suffering from malignant diseases. Even though the method itself is still experimental, nearly a hundred live births have been documented worldwide, and its efficacy is comparable with the efficacy of any other assisted reproductive technology. Our prospective, nonrandomized study was the first in Hungary that aimed to examine the safety and efficacy of fertility preservation based on ovarian tissue cryopreservation and autotransplantation. Patients were included only with stage I-III malignancy confirmed by histological diagnosis with a high risk for post-treatment infertility. 13 patients met the inclusion criteria and were enrolled in the study. After successful treatment and recovery, cryopreserved ovarian tissue was thawed and autotransplanted in three cases. The ultrathin slices of ovarian cortex were transplanted on the remaining ovaries with laparoscopic or minilaparotomic intervention. Patients were discharged home after an uneventful postoperative period and are followed up currently. In summary, cryopreservation and autotransplantation of ovarian tissue is a safe technology for fertility preservation, which should be considered to offer and perform prior to gonadotoxic treatment, after individual evaluation of patients.
References
Kim S, Lee Y, Lee S, Kim T. Ovarian tissue cryopreservation and transplantation in patients with cancer. Obstet Gynecol Sci. [Review]. 2018 Jul;61(4):431-42. https://doi.org/10.5468/ogs.2018.61.4.431
Han HS, Ro J, Lee KS, Nam BH, Seo JA, Lee DH, et al. Analysis of chemotherapy-induced amenorrhea rates by three different anthracycline and taxane containing regimens for early breast cancer. Breast Cancer Res Treat. [Clinical Trial, Phase III Randomized Controlled Trial Research Support, Non-U.S. Gov't]. 2009 May;115(2):335- 42. https://doi.org/10.1007/s10549-008-0071-9
Medrano JV, Andres MDM, Garcia S, Herraiz S, Vilanova-Perez T, Goossens E, et al. Basic and Clinical Approaches for Fertility Preservation and Restoration in Cancer Patients. Trends Biotechnol.
[Research Support, Non-U.S. Gov't Review]. 2018 Feb;36(2):199-215. https://doi.org/10.1016/j.tibtech.2017.10.010
Oktay K, Harvey BE, Loren AW. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update Summary. J Oncol Pract. 2018 Jun;14(6):381-5. https://doi.org/10.1200/jop.18.00160
Benard J, Duros S, El Hachem H, Sonigo C, Sifer C, Grynberg M. Freezing oocytes or embryos after controlled ovarian hyperstimulation in cancer patients: the state of the art. Future Oncol. [Review]. 2016 Jul;12(14):1731-41. https://doi.org/10.2217/fon-2016-0095
Gellert SE, Pors SE, Kristensen SG, Bay-Bjorn AM, Ernst E, Yding Andersen C. Transplantation of frozen-thawed ovarian tissue: an update on worldwide activity published in peer-reviewed papers and on the Danish cohort. J Assist Reprod Genet. [Review Systematic Review]. 2018 Apr;35(4):561-70. https://doi.org/10.1007/s10815-018-1144-2
Pacheco F, Oktay K. Current Success and Efficiency of Autologous Ovarian Transplantation: A Meta-Analysis. Reprod Sci. [Meta-Analysis Review]. 2017 Aug;24(8):1111-20. https://doi.org/10.1177/1933719117702251
Jadoul P, Guilmain A, Squifflet J, Luyckx M, Votino R, Wyns C, et al. Efficacy of ovarian tissue cryopreservation for fertility preservation: lessons learned from 545 cases. Hum Reprod. 2017 May 1;32(5):1046-54. https://doi.org/10.1093/humrep/dex040
Jensen AK, Macklon KT, Fedder J, Ernst E, Humaidan P, Andersen CY. 86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue: focus on birth and perinatal outcome in 40 of these children. J Assist Reprod Genet. [Meta-Analysis]. 2017 Mar;34(3):325-36. https://doi.org/10.1007/s10815-016-0843-9
Wolff M, Sanger N, Liebenthron J. Is Ovarian Tissue Cryopreservation and Transplantation Still Experimental? It Is a Matter of Female Age and Type of Cancer. J Clin Oncol. 2018 Oct 5:JCO1800425. https://doi.org/10.1200/jco.18.00425
Donnez J, Dolmans MM, Pellicer A, Diaz-Garcia C, Sanchez Serrano M, Schmidt KT, et al. Restoration of ovarian activity and pregnancy after transplantation of cryopreserved ovarian tissue: a review of 60 cases of reimplantation. Fertil Steril. [Case Reports Multicenter Study Review]. 2013 May;99(6):1503-13. https://doi.org/10.1016/j.fertnstert.2013.03.030
Van der Ven H, Liebenthron J, Beckmann M, Toth B, Korell M, Krussel J, et al. Ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment in a fertility preservation network: tissue activity, pregnancy and delivery rates. Hum Reprod. [Research Support, Non-U.S. Gov't]. 2016 Sep;31(9):2031-41. https://doi.org/10.1093/humrep/dew165
Pinelli S, Basile S. Fertility Preservation: Current and Future Perspectives for Oncologic Patients at Risk for Iatrogenic Premature Ovarian Insufficiency. Biomed Res Int. [Review]. 2018;2018:6465903. https://doi.org/10.1155/2018/6465903
