Stine Gry Kristensen1, Veronica Giorgione2, Peter Humaidan3, Birgit Alsbjerg3, Anne-Mette Bay Bjørn4, Erik Ernst4, Claus Yding Andersen2. 1. Laboratory of Reproductive Biology, Juliane Marie Center for Women, Children, and Reproduction, University Hospital of Copenhagen, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. Electronic address: stine.gry.kristensen@regionh.dk. 2. Laboratory of Reproductive Biology, Juliane Marie Center for Women, Children, and Reproduction, University Hospital of Copenhagen, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. 3. The Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Skive, Denmark. 4. Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark.
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. 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.
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 cancerpatients with a risk of malignant cell recurrence, but also certain groups of patients with genetic conditions.
Authors: Anna K Dietl; Ralf Dittrich; Inge Hoffmann; Dominik Denschlag; Aida Hanjalic-Beck; Andreas Müller; Matthias W Beckmann; Laura Lotz Journal: J Ovarian Res Date: 2022-05-05 Impact factor: 5.506