Cryopreservation of Ovarian Tissue in Pediatric Patients

Cancer treatments improve the survival rate of children and adolescents; however chemo- and radiotherapy result in gonadal damage leading to acute ovarian failure and sterility. Ovarian tissue cryopreservation allows long-term storage of primordial follicles and represents the only possibility of preserving the potential fertility in prepubertal girls. The aim of the present study is to describe our experience in ovarian tissue cryopreservation in 45 pediatric patients. The number of follicles per square millimeter of the overall section area and follicle quality were evaluated histologically. A strong negative correlation was found between age and follicular density in patients both prior to and after chemotherapy (P < 0.0001). Damage in follicular quality, that is, increased oocyte vacuolization and detachment of the oocyte from granulosa cells, was found after chemotherapy. Ovarian tissue cryopreservation, preferably performed before initiation of chemotherapy, should be offered to pediatric patients, including prepubertal girls, at risk of sterility.

[1]  B. Lawrenz,et al.  Fertility preservation in prepubertal girls prior to chemotherapy and radiotherapy--review of the literature. , 2012, Journal of pediatric and adolescent gynecology.

[2]  G. Pasquinelli,et al.  Follicle features in adolescent and young adult women with Hodgkin's disease prior to chemotherapy: a preliminary report. , 2011, Reproductive biomedicine online.

[3]  W. Wallace,et al.  Fertility preservation in girls and young women , 2011, Clinical endocrinology.

[4]  I. Oskam,et al.  Fertility-preserving measures for girls and young women with cancer. , 2011, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[5]  W. Wallace.  Oncofertility and preservation of reproductive capacity in children and young adults , 2011, Cancer.

[6]  J. Brämswig.  What is the future for fertility preservation in girls with cancer? , 2011, Klinische Padiatrie.

[7]  T. Fehm,et al.  Fertility Preservation in Girls and Adolescents Before Chemotherapy and Radiation – Review of the Literature , 2011, Klinische Padiatrie.

[8]  J. Ginsberg.  New advances in fertility preservation for pediatric cancer patients , 2011, Current opinion in pediatrics.

[9]  G. Pasquinelli,et al.  Optimization of protocols for human ovarian tissue cryopreservation with sucrose, 1,2-propanediol and human serum. , 2010, Reproductive biomedicine online.

[10]  J. Donnez,et al.  Fertility preservation in girls during childhood: is it feasible, efficient and safe and to whom should it be proposed? , 2010, Human reproduction update.

[11]  C. Battaglia,et al.  A new simple technique of laparoscopic temporary ovarian suspension in addition to ovarian cryopreservation for women prior to posterior pelvic radiation. , 2010, Gynecologic oncology.

[12]  K. Oktay,et al.  Fertility preservation medicine: A new field in the care of young cancer survivors , 2009, Pediatric blood & cancer.

[13]  S. Revel-Vilk,et al.  At what age can human oocytes be obtained? , 2009, Fertility and sterility.

[14]  B. Birgit,et al.  Fertility Preservation in Girls with Turner Syndrome: Prognostic Signs of the Presence of Ovarian Follicles , 2009 .

[15]  O. Hovatta,et al.  Fertility preservation in girls with turner syndrome: prognostic signs of the presence of ovarian follicles. , 2009, The Journal of clinical endocrinology and metabolism.

[16]  D. Baird,et al.  Ovarian cryopreservation for fertility preservation: indications and outcomes. , 2008, Reproduction.

[17]  M. Fallat,et al.  Preservation of Fertility in Pediatric and Adolescent Patients With Cancer , 2008, Pediatrics.

[18]  S. Sarnacki,et al.  Immature Cryopreserved Ovary Restores Puberty and Fertility in Mice without Alteration of Epigenetic Marks , 2008, PloS one.

[19]  B. Fisch,et al.  Selection of patients before and after anticancer treatment for ovarian cryopreservation. , 2008, Human reproduction.

[20]  C. Genestie,et al.  Feasibility of ovarian tissue cryopreservation for prepubertal females with cancer , 2007, Pediatric blood & cancer.

[21]  B. Fisch,et al.  Laparoscopic ovarian tissue preservation in young patients at risk for ovarian failure as a result of chemotherapy/irradiation for primary malignancy. , 2007, Journal of pediatric surgery.

[22]  V. Ravitsky,et al.  Should ovarian cryopreservation be offered to girls with cancer , 2007, Pediatric blood & cancer.

[23]  K. Oktay,et al.  Ovarian tissue cryopreservation: benefits and risks , 2005, Cell and Tissue Research.

[24]  Richard A. Anderson,et al.  Fertility preservation for young patients with cancer: who is at risk and what can be offered? , 2005, The Lancet. Oncology.

[25]  E. Gabusi,et al.  Ovarian tissue banking and fertility preservation in cancer patients: histological and immunohistochemical evaluation. , 2003, Gynecologic oncology.

[26]  K. Schmiegelow,et al.  Diminished ovarian reserve in female childhood cancer survivors with regular menstrual cycles and basal FSH <10 IU/l. , 2003, Human reproduction.

[27]  Kevin Barraclough,et al.  I and i , 2001, BMJ : British Medical Journal.

[28]  D. Meirow,et al.  The effects of radiotherapy and chemotherapy on female reproduction. , 2001, Human reproduction update.

[29]  A. Gougeon.  Regulation of ovarian follicular development in primates: facts and hypotheses. , 1996, Endocrine reviews.

[30]  R. Gosden,et al.  Transplantation of frozen-thawed mouse primordial follicles. , 1993, Human reproduction.