Autotransplantation of Cryopreserved/Thawed Ovarian Tissue: Overview of Methods and Challenges

Abstract

In recent years, an increasing number of women diagnosed with malignant or non-malignant diseases have been subjected to cytotoxic chemoradiotherapy. Women who face the possibility of premature or imminent ovarian failure caused by cytotoxic therapy may retain their fertility potential via ovarian tissue cryopreservation. Despite its advantages, this fertility preservation method for women at risk of losing reproductive function is considered experimental due to 1) a possible decrease in the ovarian follicular pool as a result of cryopreservation and thawing procedures (although this has been minimised by improved methods), or by ischemic damage occurring during ovarian transplantation; and 2) the risk of minimal residual disease (which is the most important factor). Although the indications for ovarian cryopreservation now extend beyond cancer, cancer survivors remain as the patient population who most commonly need this procedure. For these patients, the risk of minimal residual disease, which can be defined as reintroducing pre-existing cancer cells, is an important challenge for the application of this method. Even though the risk of reimplanting pre-existing cancer cells through ovarian transplantation is minimal or non-existent for most types of cancer, this risk must be ascertained according to cancer type and disease stage.

Keywords

• Human,ovary,cryopreservation,transplantation,fertility preservation

References

1. 1- American Cancer Society. Special section: obesity. Cancer Facts and Figures 2001. 1st ed. Atlanta GA: National Media Office; 2001. p.20-7.
2. 2. Blatt J. Pregnancy outcomes in long-term survivors of childhood cancer. Med Pediatr Oncol 1999; 33:29-33.
3. 3. Bedaiwy MA, Shahin AY, Falcone T. Reproductive organ transplantation: advances and controversies. Fertil Steril 2008; 90:2031-55.
4. 4. Howell SJ, Sharlet SM. Fertility preservation and management of gonadal failure associated with lymphoma therapy. Curr Oncol Rep 2002; 4:443-52.
5. 5. Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in cancer patients. Fertil Steril 2005; 83:1622-8.
6. 6. Donnez J, Dolmans MM, Demylle D, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 364:1405-10.
7. 7. Meirow D, Levron J, Eldar-Geva T, et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl
8. J Med 2005; 353:318-21.

9. 8. Torre A, Vertu-Ciolino D, Mazoyer C, Selva J, Lornage J, Salle B. Safeguarding fertility with whole ovary cryopreservation and microvascular transplantation: Higher
10. follicular survival with vitrification than with slow freezing in a ewe model. Transplantation. 2016;100(9):1889-97.
11. 9. Oktay K, Aydin BA, Karlikaya G. A technique for laparoscopic transplantation of frozen banked ovarian tissue. Fertil Steril 2001; 75:1212-6.
12. 10. Oktay K, Aydın BA, Economos K, et al. Restoration of ovarian function after autologous transplantation of human ovarian tissue in the forearm (Abstract). Fertil
13. Steril 2000; 74:S90.
14. 11. Dittrich R, Lotz L, Keck G, et al. Live birth after ovarian tissue autotransplantation following overnight transportation before cryopreservation. Fertil Steril. 2012;
15. 97:387-90.
16. 12. Donnez J, Silber S, Andersen CY, et al. Children born after autotransplantation of cryopreserved ovarian tissue. A review of 13 live births. Ann Med. 2011; 43:437-5
17. 0.
18. 13. Revel A, Laufer N, Ben MA, et al. Micro-organ ovarian transplantation enables pregnancy: a case report. Hum Reprod. 2011; 26:1097-103.
19. 14. Silber SJ. Ovary cryopreservation and transplantation for fertility preservation. Mol Hum Reprod. 2012; 18:59-67.
20. 15. Andersen CY, Silber SJ, Bergholdt SH, et al. Long-term duration of function of ovarian tissue transplants: case reports. Reprod Biomed Online. 2012; 25:128-32.
21. 16. Donnez J, Dolmans MM, Demylle D, et al. Livebirth after orthotopic transplantation of cryopreserved ovarian tissue. Lancet. 2004; 364(9443):1405-10.
22. 17. Shaw JM, Bowles J, Koopman P, et al. Fresh and cryopreserved ovarian tissue from donors with lymphoma, transmit the cancer to graft recipients. Hum Reprod
23. 1996; 11:1668-73.
24. 18. Sonmezer M, Oktay K. Fertility preservation in female patients. Hum Reprod Update 2004; 10:251-66.
25. 19. Chu JY, Craddock TV, Danis RK, et al. Ovarian tumor as manifestation of relapse in acute lymphoblastic leukemia. Cancer 1981; 48:377-9.
26. 20. Yada-Hashimoto N, Yamamoto T, Kamiura S, et al. Metastatic ovarian tumors: a review of 64 cases. Gynecol Oncol 2003; 89:314-7.
27. 21. McCarville MB, HillDA, Miller BE, et al. Secondary ovarian neoplasms in children: imaging features with histopathologic correlation. Pediatr Radiol 2001; 31:358-
28. 64.22. Sonmezer M, Shamonki MI, Oktay K. Ovarian tissue cryopreservation: benefits and risks. Cell Tissue Res 2005; 322:125-32.
29. 23. Oktay K, Newton H, Mullan J, et al. Development of human primordial follicles to antral stages in SCID/hpg mice stimulated with follicle stimulating hormone. Hum
30. Reprod 1998; 13:1133-8.
31. 24. Oktay K, Newton H, Gosden RG. Transplantation of cryopreserved human ovarian tissue results in follicle growth initiation in SCID mice. Fertil Steril 2000; 73:599-
32. 603.
33. 25. Oktay KH, Yih M. Preliminary experience with orthotopic and heterotopic transplantation of ovarian cortical strips. Semin Reprod Med 2002; 20:63-74.
34. 26. Rosendahl M, Tolstrup Andersen M, et al. Evidence of residual disease in cryopreserved ovarian cortex from female patients with leukaemia. Fertil Steril. 2010;
35. 94:2186-90.
36. 27. Bastings L, Beerendonk CC, Westphal JR, et al. Autotransplantation of cryopreserved ovarian tissue in cancer survivors and the risk of reintroducing malignancy: a
37. systematic review. Hum Reprod Update. 2013; 19:483-506.
38. 28. Hou M, Andersson M, Eksborg S, et al. Xenotransplantation of testicular tissue into nude mice can be used for detecting leukemic cell contamination. Hum Reprod.
39. 2007; 22:1899-906.
40. 29. Jahnukainen K, Hou M, Petersen C, et al. Intratesticular transplantation of testicular cells from leukemic rats causes transmission of leukemia. Cancer Res. 2001;
41. 61:706-10.
42. 30. Lee D, Suh DS, Lee SC, Tigyi GJ, Kim JH. Role of autotaxin in cancer stem cells. Cancer Metastasis Rev. 2018. doi: 10.1007/s10555-018-9745-x. [Epub ahead of
43. print]