Cryopreservation of ovarian cortex in young patients with cancer and indication of gonadotoxic treatment
Keywords:
CRYOPRESERVATION., OVARY, CHEMOTHERAPY, NEOPLASMS, PRESERVATION OF TISSUEAbstract
Background: the improvement of curation rates in young patients with cancer leads to plan strategies that decrease treatment sequelae, specially reproductive repercussions.
Objective: to present the Preservation of the Ovarian Function Program in patients with cancer ant to publish the Cryopreservation of Ovarian Cortex Protocol.
Methods: we included the first 15 patients that met the inclusion criteria, and who would be undergoing cryopreservation of ovarian tissue prior to chimiotherapy.
Cryopreservation of one ovary with bilateral ovarian biopsy as a unique procedure was performed in 12 patients. In the remaining 3 patients, heterotopic translocation was associated with the left ovary. We describe the cryopreservation protocol we used.
Results: successful cryopreservation was performed in 15 patients carriers of diverse cancers who needed gonadotoxic treatment.
Discussion and conclusions: multidisciplinary and multi-institutional efforts have allowed to develop this program that orchestrate a still emerging technique. It is a procedure to be incorporated in a specific protocol. It is for many women, an opportunity to preserve hormonal and occasionaly reproductive ovarian function.
References
(1) Sklar C. Endocrine complications of the successful treatment of neoplastic diseases in childhood. GGH 2001; 17(3): 37. Disponible en: http://gghjournal.com.
(2) Chiarelli A, Marrett L, Darlington G. Early menopause and infertility in females after treatment for childhood cancer diagnosed in 1964-1988 in Ontario, Canada. Am J Epidemiol 1999; 150:245-54.
(3) Wallace W, Thomson AB, Saran F, Kelsey T. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys 2005; 62(3): 738-44.
(4) Wallace W, Thomson A, Kelsey T. The radiosensitivity of the human oocyte. Hum Reprod 2003; 18(1): 117-21.
(5) Byrne J, Fears T, Gail M, Pee D, Connelly R, Austin D, et al. Early menopause in long-term survivors of cancer during adolescence. Am J Obstet Gynecol 1992; 166: 788-93.
(6) Coppola F, Nader J. Visión neuroendócrina de la menopausia. Arch Ginecol Obstet 2002; 40(3): 129-33.
(7) Faddy M, Gosden R, Gougeon A, Richardson S, Nelson J. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod 1992; 7(10): 1342-6.
(8) Larsen E, Müller J, Rechnitzer C, Schmiegelow K, Andersen A. Diminished ovarian reserve in female childhood cancer survivors with regular menstrual cycles and basal FSH <10 IU/l. Hum Reprod 2003; 18: 417-22.
(9) Clark S, Redford J, Crowther D, Swindell R, Shale S. Gonadal function following chemotherapy for Hodgkin’s disease: a comparative study of MVPP and a seven-drug hybrid regimen. J Clin Oncol 1995; 13: 134-9.
(10) Meirow D. Reproduction post-chemotherapy in young cancer patients. Mol Cell Endocrinol 2000; 169: 123-31.
(11) Lovelock J. The haemolysis of human red blood-cells by freezing and thawing. Biochem Biophys Acta 1953; 10: 414-26.
(12) Arav A, Zeron Y, Ocheretny A. A new device and method for vitrification increases the cooling rate and allows successful cryopreservation of bovine oocytes. Theriogenology 2000; 53(1): 248.
(13) Mazur P. Kinetics of water loss from cells at subzero temperatures and the likelihood of intracellular freezing. J Gen Physiol 1963; 47: 347-69.
(14) Mazur P. Freezing of living cells: mechanisms and implications. Am J Physiol 1984; 247(3 Pt1): C125-42.
(15) Fahy GM. The relevance of cryoprotectant "toxicity" to cryobilogy. Cryobilogy 1986; 23: 1-13.
(16) Karow A. Biological effects of cryoprotectant perfusion, delivery and removal to nonfroze organ. In: Pegg D, Karow A Jr. ed. The biophysics of organ preservation. NewYork: Plenum, 1987: 25-41.
(17) Anchordoguy T, Cecchini C, Croswe J. Insights into the cryoprotective mechanism of dimethyl sulfoxide for phospholid bilayers. Cryobiology 1991; 28: 467-73.
(18) McGann L. Differing actions of penetrating and nonpenetrating cryoprotective agents. Cryobiology 1978; 15: 382-90.
(19) Fahy G, MacFarlane D, Angell C, Meryman H. Vitrification as an approach to cryopreservation. Cryobiology 1984: 407-26.
(20) Parkes A, Smith A. Regeneration of rat ovarian tissue grafted after exposure to low temperatures. Proc R Soc Lond B Biol Sci 1953; 140: 455-67.
(21) Parkes A. Grafting of mouse ovarian tissue after freezing and thawing. J Endocrinol 1956; 14(3): 30-1.
(22) Parkes A. Viability of ovarian tissue after freezing. Proc R Soc Lond B Biol Sci 1957; 147: 520-8.
(23) Deanesly R. Immature rat ovaries grafted after freezing and thawing. J Endocrinol 1954; 11: 197-200.
(24) Deanesly R, Parkes A. Delayed development of grafts from frozen ovarian tissue. J Endocrinol 1956; 14: 35-6.
(25) Newton H. The cryopreservation of ovarian tissue as a strategy for preserving the fertility of cancer patients. Hum Reprod Update 1998; 4(3): 237-47.
(26) Hovatta O, Silye R, Krausz T, Abrir R, Margara R, Trew G, et al. Cryopreservation of human ovarian tissue using dime-thyulsulphoxide and propanediol-sucrose as cryporotectans. Hum Reprod 1996; 45: 898-906.
(27) Oktay K, Nugent D, Newton H, Salha O, Chatterjee P, Gosden R. Isolation and characterisation of primordial follicles from fresh and cryopreserved human ovarian tissue. Fertil Steril 1997; 67: 481-6.
(28) Donnez J, Dolmans M, Demylle D, Jadoul P, Pirard C, Squifflet J, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364(9443): 1405-10.
(29) FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health. Ethical considerations and recommendations on oocyte and ovarian cryopreservation. Int J Gynaecol Obstet 2006; 92(3): 335-6.
(30) Multidisciplinary Working Group convened by the British Fertility Society. A strategy for fertility services for survivors of childhood cancer. Hum Fertil (Camb) 2003; 6: A1-A39.
(31) Callejo J, Salvador C, Miralles A, Vilaseca S, Lailla JM, Balasch J. Long-term ovarian function evaluation after autografting by implantation with fresh and frozen-thawed human ovarian tissue. J Clin Endocrinol Metab 2001; 86(9): 4489-94.
(32) Schmidt K, Byskov A, Nyboe Andersen A, Mueller J, Yding Andersen C. Density and distribution of primordial follicles in single pieces of cortex from 21 patients and in individual pieces of cortex from three entire human ovaries. Human Reprod 2003; 18(6):1158-64.
(33) Oktay K, Gosden R, Schwarz R. Ovarian function after autologus transplantation of frozen-banked human ovarian tissue. ASRM 1999. Toronto, Ontario, Canada.
(34) Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med 2000; 342: 1919.
(35) Radford J, Liebermann B, Brison D, Smith A, Critchlow J, Russell S, et al. Orthotopic reimplantation of cryopreserved ovarian cortical strips after high-dose chemotherapy for Hodgkin’s lymphoma. Lancet 2001; 357: 1172-5.
(36) Kim S, Hwang I, Lee H. Heterotopic autotransplantation of cryobanked human ovarian tissue as a strategy to restore ovarian function. Fertil Steril 2004; 82(4): 930-2.
(37) Oktay K, Buyuk E, Veeck L, Zaninivic N, Xu K, Takeuchi T, et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 363: 837-40.
(38) Kirsten L, Schmidt T, Yding Andersen C, Starup J, Loft A, Grete Byskov A, et al. Orthotopic autotransplantation of cryopreserved ovarian tissue to a woman cured of cancer-follicular growth, steroid production and oocyte retrieval Reproductive Bio Medicine Online 2004; 8(4): 448-53.
(39) Meirow D, Levron J, Eldar-Geva T, Hardan I, Fridman E, Zalel Y, et al. Pregnancy after Transplantation of Cryopreserved Ovarian Tissue in a Patient with Ovarian Failure after Chemotherapy. BMJ 2005; 353(3): 318-21.
(40) Wallace W, Pritchard J. Livebirth after cryopreserved ovarian tissue autotransplantation. Lancet 2004; 364: 2093-4.
(41) Oktay K, Tilly J. Livebirth after cryopreserved ovarian tissue autotransplantation. Lancet 2004; 364: 2091-2.
(42) Oktay K. Spontaneous conceptions and live birth after heterotopic ovarian transplantation: is there a germline stem cell connection? Hum Reprod 2006; 21: 1345-8.
(43) Johnson J, Canning J, Kaneko T, Pru J, Tilly J. Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 2004; 428: 145-50.
(44) Johnson J, Bagley J, Skaznik-Wikiel M, Lee H, Adams G, Niikura Y, et al. Oocyte generation in adult mammalian ovaries by putative germ cells in bone marrow and peripheral blood. Cell 2005; 122: 303-15.
(45) Oktay K, Sonmezer M. Ovarian tissue banking for cancer patients: fertility preservation, not just ovarian cryopreservation. Hum Reprod 2004; 19(3): 477-80.
(46) Abir R, Nitke S, Ben-Haroush A, Fisch B. In vitro maturation of human primordial ovarian follicles: clinical significance, progress in mammals, and methods for growth evaluation. Histol Histopathol 2006; 21(8): 887-98.
(2) Chiarelli A, Marrett L, Darlington G. Early menopause and infertility in females after treatment for childhood cancer diagnosed in 1964-1988 in Ontario, Canada. Am J Epidemiol 1999; 150:245-54.
(3) Wallace W, Thomson AB, Saran F, Kelsey T. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys 2005; 62(3): 738-44.
(4) Wallace W, Thomson A, Kelsey T. The radiosensitivity of the human oocyte. Hum Reprod 2003; 18(1): 117-21.
(5) Byrne J, Fears T, Gail M, Pee D, Connelly R, Austin D, et al. Early menopause in long-term survivors of cancer during adolescence. Am J Obstet Gynecol 1992; 166: 788-93.
(6) Coppola F, Nader J. Visión neuroendócrina de la menopausia. Arch Ginecol Obstet 2002; 40(3): 129-33.
(7) Faddy M, Gosden R, Gougeon A, Richardson S, Nelson J. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod 1992; 7(10): 1342-6.
(8) Larsen E, Müller J, Rechnitzer C, Schmiegelow K, Andersen A. Diminished ovarian reserve in female childhood cancer survivors with regular menstrual cycles and basal FSH <10 IU/l. Hum Reprod 2003; 18: 417-22.
(9) Clark S, Redford J, Crowther D, Swindell R, Shale S. Gonadal function following chemotherapy for Hodgkin’s disease: a comparative study of MVPP and a seven-drug hybrid regimen. J Clin Oncol 1995; 13: 134-9.
(10) Meirow D. Reproduction post-chemotherapy in young cancer patients. Mol Cell Endocrinol 2000; 169: 123-31.
(11) Lovelock J. The haemolysis of human red blood-cells by freezing and thawing. Biochem Biophys Acta 1953; 10: 414-26.
(12) Arav A, Zeron Y, Ocheretny A. A new device and method for vitrification increases the cooling rate and allows successful cryopreservation of bovine oocytes. Theriogenology 2000; 53(1): 248.
(13) Mazur P. Kinetics of water loss from cells at subzero temperatures and the likelihood of intracellular freezing. J Gen Physiol 1963; 47: 347-69.
(14) Mazur P. Freezing of living cells: mechanisms and implications. Am J Physiol 1984; 247(3 Pt1): C125-42.
(15) Fahy GM. The relevance of cryoprotectant "toxicity" to cryobilogy. Cryobilogy 1986; 23: 1-13.
(16) Karow A. Biological effects of cryoprotectant perfusion, delivery and removal to nonfroze organ. In: Pegg D, Karow A Jr. ed. The biophysics of organ preservation. NewYork: Plenum, 1987: 25-41.
(17) Anchordoguy T, Cecchini C, Croswe J. Insights into the cryoprotective mechanism of dimethyl sulfoxide for phospholid bilayers. Cryobiology 1991; 28: 467-73.
(18) McGann L. Differing actions of penetrating and nonpenetrating cryoprotective agents. Cryobiology 1978; 15: 382-90.
(19) Fahy G, MacFarlane D, Angell C, Meryman H. Vitrification as an approach to cryopreservation. Cryobiology 1984: 407-26.
(20) Parkes A, Smith A. Regeneration of rat ovarian tissue grafted after exposure to low temperatures. Proc R Soc Lond B Biol Sci 1953; 140: 455-67.
(21) Parkes A. Grafting of mouse ovarian tissue after freezing and thawing. J Endocrinol 1956; 14(3): 30-1.
(22) Parkes A. Viability of ovarian tissue after freezing. Proc R Soc Lond B Biol Sci 1957; 147: 520-8.
(23) Deanesly R. Immature rat ovaries grafted after freezing and thawing. J Endocrinol 1954; 11: 197-200.
(24) Deanesly R, Parkes A. Delayed development of grafts from frozen ovarian tissue. J Endocrinol 1956; 14: 35-6.
(25) Newton H. The cryopreservation of ovarian tissue as a strategy for preserving the fertility of cancer patients. Hum Reprod Update 1998; 4(3): 237-47.
(26) Hovatta O, Silye R, Krausz T, Abrir R, Margara R, Trew G, et al. Cryopreservation of human ovarian tissue using dime-thyulsulphoxide and propanediol-sucrose as cryporotectans. Hum Reprod 1996; 45: 898-906.
(27) Oktay K, Nugent D, Newton H, Salha O, Chatterjee P, Gosden R. Isolation and characterisation of primordial follicles from fresh and cryopreserved human ovarian tissue. Fertil Steril 1997; 67: 481-6.
(28) Donnez J, Dolmans M, Demylle D, Jadoul P, Pirard C, Squifflet J, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364(9443): 1405-10.
(29) FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health. Ethical considerations and recommendations on oocyte and ovarian cryopreservation. Int J Gynaecol Obstet 2006; 92(3): 335-6.
(30) Multidisciplinary Working Group convened by the British Fertility Society. A strategy for fertility services for survivors of childhood cancer. Hum Fertil (Camb) 2003; 6: A1-A39.
(31) Callejo J, Salvador C, Miralles A, Vilaseca S, Lailla JM, Balasch J. Long-term ovarian function evaluation after autografting by implantation with fresh and frozen-thawed human ovarian tissue. J Clin Endocrinol Metab 2001; 86(9): 4489-94.
(32) Schmidt K, Byskov A, Nyboe Andersen A, Mueller J, Yding Andersen C. Density and distribution of primordial follicles in single pieces of cortex from 21 patients and in individual pieces of cortex from three entire human ovaries. Human Reprod 2003; 18(6):1158-64.
(33) Oktay K, Gosden R, Schwarz R. Ovarian function after autologus transplantation of frozen-banked human ovarian tissue. ASRM 1999. Toronto, Ontario, Canada.
(34) Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue. N Engl J Med 2000; 342: 1919.
(35) Radford J, Liebermann B, Brison D, Smith A, Critchlow J, Russell S, et al. Orthotopic reimplantation of cryopreserved ovarian cortical strips after high-dose chemotherapy for Hodgkin’s lymphoma. Lancet 2001; 357: 1172-5.
(36) Kim S, Hwang I, Lee H. Heterotopic autotransplantation of cryobanked human ovarian tissue as a strategy to restore ovarian function. Fertil Steril 2004; 82(4): 930-2.
(37) Oktay K, Buyuk E, Veeck L, Zaninivic N, Xu K, Takeuchi T, et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 363: 837-40.
(38) Kirsten L, Schmidt T, Yding Andersen C, Starup J, Loft A, Grete Byskov A, et al. Orthotopic autotransplantation of cryopreserved ovarian tissue to a woman cured of cancer-follicular growth, steroid production and oocyte retrieval Reproductive Bio Medicine Online 2004; 8(4): 448-53.
(39) Meirow D, Levron J, Eldar-Geva T, Hardan I, Fridman E, Zalel Y, et al. Pregnancy after Transplantation of Cryopreserved Ovarian Tissue in a Patient with Ovarian Failure after Chemotherapy. BMJ 2005; 353(3): 318-21.
(40) Wallace W, Pritchard J. Livebirth after cryopreserved ovarian tissue autotransplantation. Lancet 2004; 364: 2093-4.
(41) Oktay K, Tilly J. Livebirth after cryopreserved ovarian tissue autotransplantation. Lancet 2004; 364: 2091-2.
(42) Oktay K. Spontaneous conceptions and live birth after heterotopic ovarian transplantation: is there a germline stem cell connection? Hum Reprod 2006; 21: 1345-8.
(43) Johnson J, Canning J, Kaneko T, Pru J, Tilly J. Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 2004; 428: 145-50.
(44) Johnson J, Bagley J, Skaznik-Wikiel M, Lee H, Adams G, Niikura Y, et al. Oocyte generation in adult mammalian ovaries by putative germ cells in bone marrow and peripheral blood. Cell 2005; 122: 303-15.
(45) Oktay K, Sonmezer M. Ovarian tissue banking for cancer patients: fertility preservation, not just ovarian cryopreservation. Hum Reprod 2004; 19(3): 477-80.
(46) Abir R, Nitke S, Ben-Haroush A, Fisch B. In vitro maturation of human primordial ovarian follicles: clinical significance, progress in mammals, and methods for growth evaluation. Histol Histopathol 2006; 21(8): 887-98.
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Published
2007-06-30
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Pérez Campos H, Cóppola Gonzálvez F, Martínez Torena J, Afonzo Y, Domínguez Álvaro, Aguirre R, et al. Cryopreservation of ovarian cortex in young patients with cancer and indication of gonadotoxic treatment. Rev. Méd. Urug. [Internet]. 2007 Jun. 30 [cited 2024 Sep. 7];23(2):99-108. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/624
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