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      Outcomes of transplantations of cryopreserved ovarian tissue to 41 women in Denmark.

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          What are the results of transplanting cryopreserved ovarian tissue?

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          Reimplantation of cryopreserved ovarian tissue from patients with acute lymphoblastic leukemia is potentially unsafe.

          P Saussoy, Marie-Madeleine Dolmans, Anne Langendonckt … (2010)
          Ovarian tissue cryopreservation is currently proposed to young cancer patients to preserve their fertility before radiochemotherapy. The potential risk is that the tissue might harbor malignant cells that could induce disease recurrence. We therefore decided to evaluate the presence of leukemic cells in cryopreserved ovarian tissue from 18 leukemic patients: 6 with chronic myeloid leukemia (CML) and 12 with acute lymphoblastic leukemia (ALL). In each case, histology, quantitative reverse-transcribed polymerase chain reaction (RT-PCR) and long-term (6 months) xenografting to immunodeficient mice were used. Histology did not identify any malignant cells in the ovarian tissue. By quantitative RT-PCR, 2 of 6 CML patients were positive for BCR-ABL in their ovarian tissue. Among the 12 ALL patients, 7 of the 10 with available molecular markers showed positive leukemic markers in their ovarian tissue (translocations or rearrangement genes). Four mice grafted with ovarian tissue from ALL patients developed intraperitoneal leukemic masses. In conclusion, this study demonstrates, by quantitative RT-PCR, ovarian contamination by malignant cells in acute as well as chronic leukemia, whereas histology fails to do so. Moreover, chemotherapy before ovarian cryopreservation does not exclude malignant contamination. Finally, reimplantation of cryopreserved ovarian tissue from ALL and CML patients puts them at risk of disease recurrence.
          Article 0 comments Cited 89 times – based on 0 reviews     Review now
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            Physician referral for fertility preservation in oncology patients: a national study of practice behaviors.

            P. Jacobsen, T Albrecht, JOHNATHAN LANCASTER … (2009)
            Cancer survival rates are improving, and the focus is moving toward quality survival. Fertility is a key aspect of quality of life for cancer patients of childbearing age. Although cancer treatment may impair fertility, some patients may benefit from referral to a specialist before treatment. However, the majority of studies examining patient recall of discussion and referral for fertility preservation (FP) show that less than half receive this information. This study examined the referral practices of oncologists in the United States. This study examined oncologists' referral practice patterns for FP among US physicians using the American Medical Association Physician Masterfile database. A 53-item survey was administered via mail and Internet to a stratified random sample of US physicians. Forty-seven percent of respondents routinely refer cancer patients of childbearing age to a reproductive endocrinologist. Referrals were more likely among female physicians (P = .004), those with favorable attitudes (P = .043), and those whose patients routinely ask about FP (odds ratio = 2.09; 95% CI, 1.31 to 3.33). Less than half of US physicians are following the guidelines from the American Society of Clinical Oncology, which suggest that all patients of childbearing age should be informed about FP.
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              Fertility preservation in women.

              Jacques Donnez, Marie-Madeleine Dolmans (2013)
              In women, ∼10% of cancers occur in those 90% of girls and young women with diseases that require such treatments. However, these treatments can result in premature ovarian failure, depending on the follicular reserve, the age of the patient and the type and dose of drugs used. This article discusses the different fertility preservation strategies: medical therapy before chemotherapy; ovarian transposition; embryo cryopreservation; oocyte vitrification; and ovarian tissue cryopreservation. The indications, results and risks of these options are discussed. Whether medical therapy should be used to protect the gonads during chemotherapy remains a source of debate. Fertility preservation needs to be completed before chemotherapy and/or irradiation is started and might take 2-3 weeks with established techniques such as embryo or oocyte cryopreservation. Further studies are needed in patients with cancer to confirm the excellent outcomes obtained in patients without cancer or in egg donation programmes. For prepubertal girls or cases where immediate therapy is required, cryopreservation of ovarian tissue is the only available option. Finally, possible future approaches are reviewed, including in vitro maturation of nonantral follicles, the artificial ovary, oogonial stem cells and drugs to prevent follicle loss.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Hum. Reprod.
                Title: Human reproduction (Oxford, England)
                ISSN (Electronic): 1460-2350
                ISSN (Print): 0268-1161
                Publication date (Electronic): Dec 2015
                Volume: 30
                Issue: 12
                Affiliations
                [1 ] Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark annetteklueverjensen@gmail.com.
                [2 ] Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark.
                [3 ] The Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark.
                [4 ] The Fertility Clinic, Odense University Hospital, 5000 Odense, Denmark.
                [5 ] The Fertility Clinic, Aarhus University Hospital, Skejby, 8200 Aarhus, Denmark.
                Article
                Publisher Item ID: dev230
                DOI: 10.1093/humrep/dev230
                PubMed ID: 26443605
                SO-VID: a58145ad-e0dd-4392-b519-b22188aaae25
                Copyright © © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
                History

                Keywords: fertility preservation,ovarian graft longevity,ovarian transplantation,reproductive outcome,transplantation safety
                Data availability:
                Keywords: fertility preservation, ovarian graft longevity, ovarian transplantation, reproductive outcome, transplantation safety

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