TY - JOUR
T1 - Orthotopic autotransplantation of cryopreserved ovarian tissue to a woman cured of cancer - follicular growth, steroid production and oocyte retrieval
AU - Tryde Schmidt, Kirsten L
AU - Yding Andersen, Claus
AU - Starup, Jørgen
AU - Loft, Anne
AU - Byskov, Anne Grete
AU - Nyboe Andersen, Anders
PY - 2004/4
Y1 - 2004/4
N2 - Cryopreservation of human ovarian tissue is now an option for cancer patients facing treatment with gonadotoxic regimes, as a means of preserving their fertility. So far, there have been only a few reports on autotransplantation of frozen-thawed tissue with regard to restoration of ovarian function. The present report describes a 32-year-old woman diagnosed with Hodgkin's lymphoma, who had cryopreserved ovarian tissue transplanted orthotopically after secondary ovarian failure due to chemotherapy. Only 8 weeks after transplantation, ultrasonography of the remaining ovary revealed two follicles with diameters of 10 and 15 mm. Concomitantly, circulating concentrations of oestradiol increased, while concentrations of gonadotrophins decreased. In the following months, the patient menstruated three times. Subsequent pituitary down-regulation with a gonadotrophin-releasing hormone (GnRH) agonist and ovarian stimulation resulted in development of one pre-ovulatory follicle from which a metaphase II oocyte was retrieved; however, this oocyte was unable to sustain further development after intracytoplasmic sperm injection (ICSI). Intrafollicular concentrations of oestradiol and progesterone suggested a normal luteinizing response of the follicle to human chorionic gonadotrophin stimulation. A 7-month follow-up revealed continued vivid follicular activity and normal oestradiol concentrations. In conclusion, cryopreserved human ovarian tissue restored ovarian function for several cycles and sustained development of mature oocytes in a woman cured of cancer.
AB - Cryopreservation of human ovarian tissue is now an option for cancer patients facing treatment with gonadotoxic regimes, as a means of preserving their fertility. So far, there have been only a few reports on autotransplantation of frozen-thawed tissue with regard to restoration of ovarian function. The present report describes a 32-year-old woman diagnosed with Hodgkin's lymphoma, who had cryopreserved ovarian tissue transplanted orthotopically after secondary ovarian failure due to chemotherapy. Only 8 weeks after transplantation, ultrasonography of the remaining ovary revealed two follicles with diameters of 10 and 15 mm. Concomitantly, circulating concentrations of oestradiol increased, while concentrations of gonadotrophins decreased. In the following months, the patient menstruated three times. Subsequent pituitary down-regulation with a gonadotrophin-releasing hormone (GnRH) agonist and ovarian stimulation resulted in development of one pre-ovulatory follicle from which a metaphase II oocyte was retrieved; however, this oocyte was unable to sustain further development after intracytoplasmic sperm injection (ICSI). Intrafollicular concentrations of oestradiol and progesterone suggested a normal luteinizing response of the follicle to human chorionic gonadotrophin stimulation. A 7-month follow-up revealed continued vivid follicular activity and normal oestradiol concentrations. In conclusion, cryopreserved human ovarian tissue restored ovarian function for several cycles and sustained development of mature oocytes in a woman cured of cancer.
KW - Adult
KW - Animals
KW - Cryopreservation
KW - Down-Regulation
KW - Estradiol/blood
KW - Female
KW - Follicle Stimulating Hormone/blood
KW - Gonadotropin-Releasing Hormone/agonists
KW - Hodgkin Disease/therapy
KW - Hormones/biosynthesis
KW - Humans
KW - Luteinizing Hormone/blood
KW - Menstrual Cycle
KW - Mice
KW - Oocytes
KW - Ovarian Follicle/anatomy & histology
KW - Ovary/transplantation
KW - Remission Induction
KW - Tissue and Organ Harvesting
KW - Transplantation, Autologous
KW - Ultrasonography
U2 - 10.1016/s1472-6483(10)60929-7
DO - 10.1016/s1472-6483(10)60929-7
M3 - Journal article
C2 - 15149569
SN - 1472-6483
VL - 8
SP - 448
EP - 453
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 4
ER -