Successful fresh whole ovarian autotransplantation without vascular anastomosis

Kodama, Yasuo; Sameshima, Hiroshi; Ikenoue, Tsuyomu; Ikeda, Tomoaki; Kawagoe, Yasuyuki

doi:10.1016/j.fertnstert.2010.03.059

Cited by 3 publications

(1 citation statement)

References 10 publications

(9 reference statements)

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“…Thus far, four reports have described fresh whole ovary grafts with vascular anastomoses in adults [35][36][37][38]; an additional one involved fresh whole ovarian autotransplantation in the retroperitoneum of the psoas muscles without vascular anastomoses [39]. In this case, resumption of hormonal function occurred 4 months later.…”

Section: Whole Ovary Transplantmentioning

confidence: 90%

Applicability of adult techniques for ovarian preservation to childhood cancer patients

Detti

Williams

2012

J Assist Reprod Genet

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Purpose To appraise the feasibility of current adult medical and surgical techniques for ovarian preservation in prepubertal and adolescent girls with cancer. Methods Literature search using PubMed and SCOPUS up to February 2012. In addition, the reference lists of selected studies and all identified systematic and narrative reviews were scanned for relevant references. Inclusion criteria were ovarian preservation and cancer. Exclusion criteria were non-English publications, letters, personal communications, and ovarian preservation for conditions other than cancer. Results Data from the selected publications was interpreted and discussed in the relevant sections. Cryopreservation of ovarian tissue followed by autologous transplant represents the only surgical option available for pre-pubertal girls and adolescents who cannot delay the start of chemotherapy. Few studies report on pre-pubertal and adolescent girls undergoing ovarian preservation surgeries with good harvesting, and no follow-up has been conveyed, to date. Outcomes of ovarian function after ovarian suppression with GnRH-analogs in adults have been controversial and no reports are available for pre-pubertal girls. Conclusions Autologous transplantation of cryopreserved ovarian cortex probably represents the best option for preservation of fertility and hormonal function in childhood cancer females; however, future research needs to address the safety of this technique, especially in patients with blood-borne cancers. Ovarian suppression with GnRHanalogs at the time of chemotherapy treatment has not proven to be superior to non-suppression for fertility preservation purposes in adults. Not enough evidence is presently available in childhood cancer patients.

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Section: Whole Ovary Transplantmentioning

confidence: 90%

Applicability of adult techniques for ovarian preservation to childhood cancer patients

Detti

Williams

2012

J Assist Reprod Genet

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Ovarian cysts and tumors of the fetus, child, adolescent, and young adult

Altchek¹,

Deligdisch²

2013

Altchek's Diagnosis and Management of Ovarian Disorders

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Fresh and cryopreserved ovarian tissue transplantation for preserving reproductive and endocrine function: a systematic review and individual patient data meta-analysis

Khattak

Malhas

Craciunas

et al. 2022

Human Reproduction Update

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BACKGROUND Ovarian tissue cryopreservation involves freezing and storing of surgically retrieved ovarian tissue in liquid or vapour nitrogen below –190°C. The tissue can be thawed and transplanted back with the aim of restoring fertility or ovarian endocrine function. The techniques for human ovarian tissue freezing and transplantation have evolved over the last 20 years, particularly in the context of fertility preservation in pre-pubertal cancer patients. Fresh ovarian tissue transplantation, using an autograft or donor tissue, is a more recent development; it has the potential to preserve fertility and hormonal function in women who have their ovaries removed for benign gynaecological conditions. The techniques of ovarian tissue cryopreservation and transplantation have progressed rapidly since inception; however, the evidence on the success of this intervention is largely based on case reports and case series. OBJECTIVE AND RATIONALE The aim of this study was to systematically review the current evidence by incorporating study-level and individual patient-level meta-analyses of women who received ovarian transplants, including frozen–thawed transplant, fresh or donor graft. SEARCH METHODS The review protocol was registered with PROSPERO (CRD42018115233). A comprehensive literature search was performed using MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials from database inception to October 2020. Authors were also contacted for individual patient data if relevant outcomes were not reported in the published manuscripts. Meta-analysis was performed using inverse-variance weighting to calculate summary estimates using a fixed-effects model. OUTCOMES The review included 87 studies (735 women). Twenty studies reported on ≥5 cases of ovarian transplants and were included in the meta-analysis (568 women). Fertility outcomes included pregnancy, live birth and miscarriage rates, and endocrine outcomes included oestrogen, FSH and LH levels. The pooled rates were 37% (95% CI: 32–43%) for pregnancy, 28% (95% CI: 24–34%) for live birth and 37% (95% CI: 30–46%) for miscarriage following frozen ovarian tissue transplantation. Pooled mean for pre-transplant oestrogen was 101.6 pmol/l (95% CI: 47.9–155.3), which increased post-transplant to 522.4 pmol/l (95% CI: 315.4–729; mean difference: 228.24; 95% CI: 180.5–276). Pooled mean of pre-transplant FSH was 66.4 IU/l (95% CI: 52.8–84), which decreased post-transplant to 14.1 IU/l (95% CI: 10.9–17.3; mean difference 61.8; 95% CI: 57–66.6). The median time to return of FSH to a value <25 IU/l was 19 weeks (interquartile range: 15–26 weeks; range: 0.4–208 weeks). The median duration of graft function was 2.5 years (interquartile range: 1.4–3.4 years; range: 0.7–5 years). The analysis demonstrated that ovarian tissue cryopreservation and transplantation could restore reproductive and hormonal functions in women. Further studies with larger samples of well-characterized populations are required to define the optimal retrieval, cryopreservation and transplantation processes. WIDER IMPLICATIONS Ovarian tissue cryopreservation and transplantation may not only be effective in restoring fertility but also the return of reproductive endocrine function. Although this technology was developed as a fertility preservation option, it may have the scope to be considered for endocrine function preservation.

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Successful fresh whole ovarian autotransplantation without vascular anastomosis

Cited by 3 publications

References 10 publications

Applicability of adult techniques for ovarian preservation to childhood cancer patients

Applicability of adult techniques for ovarian preservation to childhood cancer patients

Ovarian cysts and tumors of the fetus, child, adolescent, and young adult

Fresh and cryopreserved ovarian tissue transplantation for preserving reproductive and endocrine function: a systematic review and individual patient data meta-analysis

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