Cortical fibrosis and blood-vessels damage in human ovaries exposed to chemotherapy. Potential mechanisms of ovarian injury

Meirow, Dror; Dor, Jehoshua; Kaufman, Brian; Shrim, Alon; Rabinovici, Jaron; Schiff, Eyal; Raanani, Hila; Levron, Jacob; Fridman, Eduard

doi:10.1093/humrep/dem027

Cited by 281 publications

(202 citation statements)

References 28 publications

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“…As such, early menopause has been described in patients with peritoneal endometriosis, with no ovarian involvement [20]. Tissue pathological changes seen in endometriosis, such as focal fibrosis and vascular deficiency have also been observed in the cortex of ovaries exposed to chemotherapy [40] and similarly, no follicles are seen in the fibrotic zone. Thus, this pattern of damage to the entire organ may be common among different harmful processes that, in general, tend to diminish the ovarian reserve [41].…”

Section: Reduced Ovarian Reserve In Patients Affected By Endometriosismentioning

confidence: 99%

The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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Patients affected with severe endometriosis are at significant risk for ovarian tissue damage, which may lead to infertility, reduced response to ovarian stimulation, and occasionally, premature ovarian failure. The risk for a compromised ovarian reserve in young patients is especially high following repeated surgical intervention and in the presence of bilateral endometriomas. In many cases, enhanced loss of ovarian reserve may also result from the damaging effect of the pathologic process on follicle reservoir even without surgical interventions. Women diagnosed with severe endometriosis and those designated for extensive ovarian surgical intervention are frequently not planning to conceive. In light of recent advances in fertility preservation techniques (FPT), such as oocytes and ovarian tissue freezing, as well as their increasing success rates, we critically evaluate the options for FPT in patients suffering from endometriosis. Personalized counseling should be offered to all patients with endometriosis taking into account age, extent of ovarian involvement, current ovarian reserve, previous and impending surgeries for endometriosis, along with current success rates and possible risks associated with FPT.

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Section: Reduced Ovarian Reserve In Patients Affected By Endometriosismentioning

confidence: 99%

The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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“…The question is then asked as whether it would be better to perform the cryopreservation after first lines of chemotherapy in order to decrease the risk of cancer recurrence after auto-transplantation. Ovarian cryopreservation aims to preserve primordial follicles, which are presumably less damaged by chemotherapy than growing follicles [4]. Meirow et al reported a live birth after autotransplantation of ovarian tissue that had been cryopreserved after a first line of chemotherapy [37].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of NHL has increased 2-fold over the past twenty years. Chemotherapy regimens for NHL always include cyclophosphamide, which is well-known to be gonadotoxic in an age-and dose-dependant manner [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Detection of Non-Hodgkin’s Lymphoma in ovarian cortex pieces during the process of cryopreservation

Gronier

Terriou

Robin

et al. 2014

J Assist Reprod Genet

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“…Alkylating agents are reported to be of high risk of gonadotoxicity, while vinca alkaloids, anthracyclic antibiotics, and antimetabolites are of relatively low risk [93]. Histological examination of ovaries in patients after treatments with alkylating agents, antimetabolites, anthracycline antibiotics, vinca alkaloids, or prednisolone showed cortical fibrosis, blood vessel damage, and reduced follicle numbers [94,95]. Anticancer drugs are presumed to interrupt essential cell processes, arrest cell proliferation and therefore cause ovarian follicular and stromal damage [93].…”

Section: Iatrogenic Causesmentioning

confidence: 99%

An update on primary ovarian insufficiency

Jin

Huang

2012

Sci. China Life Sci.

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Primary ovarian insufficiency (POI) occurs in about 1% of female population under the age of 40, leading to reproductive problems, an earlier encounter with menopausal symptoms, and complicated diseases. There are three presumable mechanisms involved in the development of POI, namely apoptosis acceleration, follicular maturation blocking and premature follicle activation, through the following studied causes: (i) chromosomal abnormalities or gene mutations: mostly involve X chromosome, such as FMR1 premutation; more and more potentially causal genes have been screened recently; (ii) metabolic disorders such as classic galactosaemia and 17-OH deficiency; (iii) autoimmune mediated ovarian damage: observed alone or with some certain autoimmune disorders and syndromes; but the specificity and sensitivity of antibodies towards ovary are still questionable; (iv) iatrogenic: radiotherapy or chemotherapy used in cancer treatment, as well as pelvic surgery with potential threat to ovaries' blood supply can directly damage ovarian function; (v) virus infection such as HIV and mumps; (vi) toxins and other environmental/lifestyle factors: cigarette smoking, toxins (e.g., 4-vinylcyclohexene diepoxide), and other environmental factors are associated with the development of POI. The etiology of a majority of POI cases is not identified, and is believed to be multifactorial. Strategies to POI include hormone replacement and infertility treatment. Assisted conception with donated oocytes has been proven to achieve pregnancy in POI women. Embryo cryopreservation, ovarian tissue cryopreservation and oocyte cryopreservation have been used to preserve ovarian reserve in women undergoing cancer treatments. Primary ovarian insufficiency (POI), commonly referred to as premature ovarian failure (POF), is defined as the occurrence of amenorrhea (for 4 months or more) before the age of 40 in women, accompanied with an increase of serum FSH to menopausal level (usually over 40 IU L 1 , obtained at least 1 month apart), and estradiol levels less than 50 pg mL 1 (which indicate hypoestrogenism) [1]. Primary ovarian insufficiency is first brought to light by Fuller Albright in 1942, who emphasized that the end stage of ovarian function is the primary defect rather than abnormality in gonadotropin secretion [2], and avoided the discomforting and inaccurate stressing on "failure", like death-sentence for ovarian function and conception.Menopause is a destined phase of women, which is expected to occur at around the age of (50±4) years in US women [3]. The age of 40 is two standard deviations below this average [4]. With an incidence of 1% in women under the age of 40, and 0.1% in women under the age of 30 [5], POI renders patients estrogen deficiency and anovulation, resulting in vasomotor symptoms (hot flashes and night sweats), atrophic vaginitis, dyspareunia, primary or secondary amenorrhea, and infertility. 76% of POI cases developed after normal puberty and establishment of regular menses [6]. Some of such conditions occur after stopping...

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Cortical fibrosis and blood-vessels damage in human ovaries exposed to chemotherapy. Potential mechanisms of ovarian injury

Cited by 281 publications

References 28 publications

The role of fertility preservation in patients with endometriosis

The role of fertility preservation in patients with endometriosis

Detection of Non-Hodgkin’s Lymphoma in ovarian cortex pieces during the process of cryopreservation

An update on primary ovarian insufficiency

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