Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Cryopreservation of ovarian tissue for fertility preservation in a large cohort of young girls: focus on pubertal development

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Accelerated loss of oogonia and impaired folliculogenesis in females with Turner syndrome start during early fetal development

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Parenthood among men diagnosed with cancer in childhood and early adulthood: trends over time in a Danish national cohort

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Prenatal exposure to maternal stressful life events and earlier age at menarche: the Raine Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Chance of live birth: a nationwide, registry-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Familial resemblance in markers of testicular function in fathers and their young sons: a cross-sectional study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Parenthood among men diagnosed with cancer in childhood and early adulthood: trends over time in a Danish national cohort

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Declining mortality rates in children admitted to ICU following HCT

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Proteome of fluid from human ovarian small antral follicles reveals insights in folliculogenesis and oocyte maturation

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

STUDY QUESTION: Is there an association between the need for medical puberty induction and the diagnosis or treatment received in girls who have undergone cryopreservation of ovarian tissue for fertility preservation?

SUMMARY ANSWER: There was a clear association between the intensity of treatment received and requirement for medical puberty induction but no association with the diagnosis.

WHAT IS KNOWN ALREADY: Although it cannot be predicted which girls will become infertile or develop premature ovarian insufficiency (POI) following intensive chemotherapy or irradiation, patients who are at high risk of POI should be offered ovarian tissue cryopreservation (OTC). This includes girls who are planned to receive either high doses of alkylating agents, conditioning regimen before stem cell transplantation (SCT), total body irradiation (TBI) or high radiation doses to the craniospinal, abdominal or pelvic area.

STUDY DESIGN, SIZE, DURATION: This is a retrospective cohort study. In total, 176 Danish girls under 18 years of age have had OTC performed over a period of 15 years. An overview of the girls' diagnoses and mean age at OTC as well as the number of deceased is presented. Of the 176 girls, 38 had died and 46 girls were still younger than 12 years so their pubertal development cannot be evaluated yet. For the 60 girls who had OTC performed after 12 years of age, the incidence of POI was evaluated and in the group of 32 girls who were younger than 12 years at OTC, the association between the diagnosis and received treatment and the requirement for medical puberty induction was examined.

PARTICIPANTS/MATERIALS, SETTING, METHODS: The need for medical puberty induction was assessed in 32 girls who were prepubertal at the time of OTC.

MAIN RESULTS AND THE ROLE OF CHANCE: Indications for OTC were allogeneic SCT for leukaemia, myelodysplastic syndrome or benign haematological disorders, autologous SCT for lymphoma or sarcoma, and irradiation to the pelvis or to the spinal axis. The mean age at OTC of the 176 girls were 11.3 years. The two most prevalent diagnoses of the 176 girls were malignant tumours and malignant haematological diseases. Among the 32 prepubertal girls, 12 received high dose chemotherapy and either TBI prior to SCT or irradiation to the pelvis, abdomen or the spinal axis, 13 received high dose alkylating agents but no irradiation prior to SCT, six received alkylating agents as part of conventional chemotherapy and one patient had a genetic metabolic disorder and did not receive gonadotoxic treatment. Among these 32 girls, 23 did not undergo puberty spontaneously and thus received medical puberty induction. Among the nine girls, who went through spontaneous puberty, four had received high dose alkylating agents and five had received conventional chemotherapy.

LIMITATIONS REASONS FOR CAUTION: All information was retrieved retrospectively from patient records, and thus some information was not available.

WIDER IMPLICATIONS OF THE FINDINGS: OTC should be recommended to all young girls, who present a high risk of developing ovarian insufficiency and/or infertility following high dose chemotherapy and/or irradiation.

STUDY FUNDING/COMPETING INTERESTS: The Childhood Cancer Foundation (2012-2016) and the EU interregional project ReproHigh are thanked for having funded this study. They had no role in the study design, collection and analysis of the data or writing of the report. The authors have no conflict of interest to disclose.

Original languageEnglish
JournalHuman reproduction (Oxford, England)
Volume32
Issue number1
Pages (from-to)154-164
ISSN0268-1161
DOIs
Publication statusPublished - Jan 2017

ID: 49663041