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Fertility preservation and refreezing of transplanted ovarian tissue-a potential new way of managing patients with low risk of malignant cell recurrence.
- Source :
-
Fertility and sterility [Fertil Steril] 2017 May; Vol. 107 (5), pp. 1206-1213. Date of Electronic Publication: 2017 Apr 19. - Publication Year :
- 2017
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Abstract
- 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.<br />Design: Evaluation of cryopreserved and grafted ovarian tissue.<br />Setting: University hospital.<br />Patient(s): A 23-year-old woman diagnosed with stage 1C ovarian mucinous cystadenocarcinoma.<br />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.<br />Main Outcome Measure(s): Live birth and histologic evaluation of the distribution of pre-antral follicle stages.<br />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.<br />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.<br /> (Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Feasibility Studies
Female
Humans
Infertility, Female diagnosis
Live Birth
Neoplasm Recurrence, Local
Oocyte Retrieval methods
Ovarian Neoplasms complications
Risk Factors
Treatment Outcome
Young Adult
Cryopreservation methods
Fertility Preservation methods
Infertility, Female etiology
Infertility, Female therapy
Ovarian Neoplasms surgery
Ovary transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1556-5653
- Volume :
- 107
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Fertility and sterility
- Publication Type :
- Academic Journal
- Accession number :
- 28433369
- Full Text :
- https://doi.org/10.1016/j.fertnstert.2017.03.017