A dozen years of ovarian tissue cryopreservation at a pediatric hospital: tracking program and patient metrics while adapting to increasing needs

McElhinney, Kathryn L.; Kennedy, Tara; Rowell, Erin E.; Laronda, Monica M.

doi:10.1016/j.xfre.2024.02.009

Cited by 3 publications

(2 citation statements)

References 67 publications

(95 reference statements)

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“…OTC then OTT is the only option for individuals with ovaries to cryopreserve their fertility and restore the ability to have a biological child if they are unable to freeze eggs prior to treatment. While there are significant benefits to this approach, there are limitations in long-term fertility preservation and endocrine restoration that a bioprosthetic ovary could alleviate [ 3 , 40 ]. Many patients that undergo OTC have metastatic disease and are unable to utilize OTT.…”

Section: Discussionmentioning

confidence: 99%

Generation of Tailored Extracellular Matrix Hydrogels for the Study of In Vitro Folliculogenesis in Response to Matrisome-Dependent Biochemical Cues

McDowell,

McElhinney,

Tsui

et al. 2024

Bioengineering

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While ovarian tissue cryopreservation (OTC) is an important fertility preservation option, it has its limitations. Improving OTC and ovarian tissue transplantation (OTT) must include extending the function of reimplanted tissue by reducing the extensive activation of primordial follicles (PMFs) and eliminating the risk of reimplanting malignant cells. To develop a more effective OTT, we must understand the effects of the ovarian microenvironment on folliculogenesis. Here, we describe a method for producing decellularized extracellular matrix (dECM) hydrogels that reflect the protein composition of the ovary. These ovarian dECM hydrogels were engineered to assess the effects of ECM on in vitro follicle growth, and we developed a novel method for selectively removing proteins of interest from dECM hydrogels. Finally, we validated the depletion of these proteins and successfully cultured murine follicles encapsulated in the compartment-specific ovarian dECM hydrogels and these same hydrogels depleted of EMILIN1. These are the first, optically clear, tailored tissue-specific hydrogels that support follicle survival and growth comparable to the “gold standard” alginate hydrogels. Furthermore, depleted hydrogels can serve as a novel tool for many tissue types to evaluate the impact of specific ECM proteins on cellular and molecular behavior.

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Section: Discussionmentioning

confidence: 99%

Generation of Tailored Extracellular Matrix Hydrogels for the Study of In Vitro Folliculogenesis in Response to Matrisome-Dependent Biochemical Cues

McDowell,

McElhinney,

Tsui

et al. 2024

Bioengineering

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“…While OTC and OTT are important breakthroughs from the last 20 years, these techniques have additional limitations. For example, a recent publication of a cohort of pediatric patients who have undergone OTC at an academic medical center indicates that more than 20% received a diagnosis of leukemia or lymphoma [ 27 ]. In these patients, OTT may be contraindicated as in vivo xenograft studies using ovarian tissue showed migration of cells with leukemia-specific markers outside the transplanted tissue [ 28 ].…”

mentioning

confidence: 99%

Restoring Ovarian Fertility and Hormone Function: Recent Advancements, Ongoing Efforts and Future Applications

Tsui,

McDowell,

Laronda

2024

Journal of the Endocrine Society

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The last twenty years have seen significant improvements in fertility and hormone preservation and restoration technologies for a growing number of cancer survivors. However, further advancements are required to fill the gaps for those who cannot use current technologies or to improve the efficacy and longevity of current fertility and hormone restoration technologies. Ovarian tissue cryopreservation (OTC) followed by ovarian tissue transplantation (OTT) offers those unable to undergo ovarian stimulation for egg retrieval and cryopreservation an option that restores both fertility and hormone function. However, those with metastatic disease in their ovaries are unable to transplant this tissue. Therefore, new technologies to produce good quality eggs and restore long-term cyclic ovarian function are being investigated and developed to expand options for a variety of patients. This mini-review describes current and near future technologies including in vitro maturation, in vitro follicle growth and maturation, bioprosthetic ovaries, and stem cell applications in fertility restoration research by their proximity to clinical application.

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Comprehensive fertility preservation can be offered in a timely manner around gonadotoxic therapy in children and adolescents

McElhinney,

McLean,

Zarnegar‐Lumley

et al. 2024

Pediatric Blood & Cancer

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BackgroundTreatment for certain childhood cancers and nonmalignant conditions can lead to future infertility and gonadal failure. The risk of treatment delay must be considered when offering fertility preservation (FP) options. We examined the timeline from FP referral to return to treatment (RTT) in pediatric patients who underwent FP due to iatrogenic risk for infertility.MethodsA retrospective review was performed of patients with FP consultation due to an increased risk of iatrogenic infertility at Ann & Robert H. Lurie Children's Hospital of Chicago from 2018 to 2022. Data on diagnosis, age, treatment characteristics, and procedure were collected.ResultsA total of 337 patients (n = 149 with ovaries, n = 188 with testes) had an FP consultation. Of patients with ovaries, 106 (71.1%) underwent ovarian tissue cryopreservation (OTC), 10 (6.7%) completed ovarian stimulation/egg retrieval (OSER), and 33 (22.1%) declined FP. Of the patients with testes, 98 (52.1%) underwent testicular tissue cryopreservation (TTC), 48 (25.5%) completed sperm banking (SB), and 42 (22.3%) declined FP. Median time from referral to FP consultation was short (ovaries: 2 days, range: 0–6; testes: 1 day, range: 0–5). OSER had a significantly longer RTT versus OTC and no FP (52.5 vs.19.5 vs. 12 days, p = .01). SB had a significantly quicker RTT compared to TTC or no FP (9.0 vs. 21.0 vs. 13.5 days; p = .008). For patients who underwent OTC/TTC and those who declined FP, there was no significant difference in time from consultation to treatment.ConclusionsIt is feasible to promptly offer and complete FP with minimal delay to disease‐directed treatment.

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A dozen years of ovarian tissue cryopreservation at a pediatric hospital: tracking program and patient metrics while adapting to increasing needs

Cited by 3 publications

References 67 publications

Generation of Tailored Extracellular Matrix Hydrogels for the Study of In Vitro Folliculogenesis in Response to Matrisome-Dependent Biochemical Cues

Generation of Tailored Extracellular Matrix Hydrogels for the Study of In Vitro Folliculogenesis in Response to Matrisome-Dependent Biochemical Cues

Restoring Ovarian Fertility and Hormone Function: Recent Advancements, Ongoing Efforts and Future Applications

Comprehensive fertility preservation can be offered in a timely manner around gonadotoxic therapy in children and adolescents

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