Pregnancy after autografting and allografting vascularized ovaries and en bloc vascularized ovaries with adnexa in rabbits

Abstract

Summary. Initially, techniques for autografting ovaries with or without adnexa were developed but a 30% vascular failure rate was experienced by day 14. Of the technically successful grafts, 50% proved fertile. Single vascularized ovaries with their oviducts were then allografted into bilaterally ovariectomized rabbits by microsurgical techniques and the vascular failure rate was reduced to 5% of 40 grafts. The time‐course of rejection in untreated recipients was mapped by histological examination and by 24‐h culture of fallopian tubes after autopsy at different times after transplantation. Control allografts were consistently rejected by day 20. Striking prolongation of both types of graft was obtained with a short 17‐day course of cyclosporin A at 10 or 15 mg day−1kg−1. Indeed, significant evidence of rejection was found in only two ovaries out of 20 so far examined histologically. Mating behaviour, ovulation, ciliary function and transport of ova appeared normal in 80% of the recipients as long as 18 weeks after stopping cyclosporin A treatment. Only one of the ovarian allografted rabbits has so far been mated and this produced seven normal young 126 days after transplantation. However, none of the five animals mated after being allografted with en bloc adnexa have so far become pregnant.

Análise histológica da viabilidade do transplante autólogo de hemi-ovário em retroperitônio de ratos

“…A opção da via de administração a ser utilizada é realizada de acordo com o perfil clínico da paciente. A reposição visa aliviar os sintomas vasomotores e psicológicos, prevenir a osteoporose e minimizar as alterações sofridas pelo aparelho cardiovascular na vigência de hipoestrogenismo 4,12 . Apesar de a TRH já estar estabelecida pela literatura como tratamento para o hipoestrogenismo 5,6 , a opção de transplante ovariano tem sido estudada, ainda em animais de experimentação, como possível via alternativa para a resolução do problema.…”

Gestação obtida em coelha após ooforectomia bilateral e transplante ovariano homógeno

“…Ovários já haviam sido transplantados, com relativo sucesso em pequenos roedores, porém sem índices satisfatórios de fertilidade e de restabelecimento de função ovulatória 8,[14][15][16][17] . No presente trabalho, o transplante ovariano ortotópico avascular foi tecnicamente fácil de ser realizado e mostrou-se um bom método para completa restauração de função ovariana, tanto sob aspecto hormonal (Tabela 1), quanto reprodutivo, já que a maioria das coelhas engravidou.…”

“…Na quarta semana, os ovários deterioram-se completamente e desaparecem, provavelmente destruídos pelo sistema mononuclear fagocitário. Esse achado também contradiz uma pesquisa da literatura que registrou a sobrevida de ovários homógenos por várias semanas após a administração de apenas 17 dias de ciclosporina 15 . Os resultados do presente estudo mostram que, em coelhas o transplante homógeno de ovário é exeqüível e restabelece a fertilidade do animal.…”

Microsurgery in the clinic and laboratory

“…It is also possible to transplant an ovary complete with its oviduct by Green incorporating the tributaries from the ovarian vessels in the en bloc graft (Green et al, 1982). In rats, it is best to transplant an ovary together with a portion of uterine horn by end-to-side anastomosis of the ovarian vessels to the recipient aorta and vena cava just posterior to the left renal vessels.…”

“…Most of these procedures had previously been assessed in animal studies. For example, simple transection and re-anastomosis was evaluated in monkeys and rabbits (Winston, 1975); implantation of the oviduct ectopically into uterus has been studied in rabbits (Mroueh, 1969); oviduct has been transplanted on a vascular pedicle in sheep (Cohen et al, 1976); en bloc ovarian adnexa have been transplanted in rabbits with a subsequent 50% preg~ncy rate (Green et al, 1982).…”