Ovarian tissue cryopreservation in cancer patients – six years of clinical experience


Authors: M. Huser 1;  J. Žáková 1;  I. Crha 1;  L. Šmardová 2;  Z. Král 2;  A. Revel 3;  P. Ventruba 1
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a Fakultní nemocnice Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA 1;  Interní hemato-onkologická klinika LF MU a Fakultní nemocnice Brno, přednosta prof. MUDr. J. Mayer, CSc. 2;  Department of Obstetrics and Gynecology, Hadassah University Hospital Ein-Karem, Jerusalem, Izrael, Head prof. N. Laufer 3
Published in: Čes. Gynek.2012, 77, č. 2 s. 118-126
Category: Original Article

Overview

Objective:
Presentation of clinical results and experience with this technique during past six years.

Design:
Original paper.

Settings:
Gynekologicko-porodnická klinika LF MU a FN Brno, Interní hemato-onkologická klinika LF MU a FN Brno, Department of Obstetrics and Gynecology. Hadassah University Hospital Ein-Karem, Jerusalem, Izrael.

Introduction:
Ovarian tissue cryopreservation (OTC) and its future auto-transplantation becomes an alternative for patients to prevent serious damage of ovarian function by oncology treatment.

Methods:
Patient is indicated to OTC in case of high risk of ovarian failure due to planned chemotherapy and impossibility to use other oncofertility techniques. Ovarian tissue harvesting is done by laparoscopy in short-term general anesthesia. After tissue processing the samples are cryopreserved in programmable automatic freezer or by vitrification. The auto-transplantation of ovarian tissue is planned after the complete cure of patient’s malignancy. Our workplace doesn’t have own experience with tissue transplantation – until now cryopreserved tissue has not yet been utilized by the patients. Clinical experience with this technique gained by our team during academic stay in abroad Israeli clinic is presented.

Results:
During the years of 2005–2011 the OTC was performed in 19 cancer patients before chemotherapy. In majority of cases, patients suffered from blood or lymph node systemic malignancy (84%). Average age of women was 26 years. The patient set consisted of mostly nulliparous women (88%). Patient’s average body mass index was 23,9 kg/m2. The length of systemic chemotherapy averaged 7.1 months. Time from fertility preservation counseling to chemotherapy was not exceeding one week (7.2 days on average). Ovarian tissue harvesting was conducted by laparoscopic surgery in all cases. The length of surgery did not exceed 60 minutes and no surgical complications were observed. The case of ovarian tissue transplantation performed on abroad university settings is discussed.

Conclusion:
In the consensus of with international guidelines OTC is offered to patients with high risk of ovarian failure doe to cytotoxic oncology treatment. Research in the field of oncofertility is focused on the techniques of in-vitro folliculogenesis in retrieved ovarian tissue.

Key words:
cancer, infertility, fertility preservation, ovarian tissue cryopreservation, oncofertility.


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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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