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. 2008 Apr;105(15):274-8.
doi: 10.3238/arztebl.2008.0274. Epub 2008 Apr 11.

First retransplantation of cryopreserved ovarian tissue following cancer therapy in Germany

Ralf Dittrich  1 , Andreas Mueller, Helge Binder, Patricia G Oppelt, Stefan P Renner, Tamme Goecke, Inge Hoffmann, W Matthias Beckmann
Affiliations

First retransplantation of cryopreserved ovarian tissue following cancer therapy in Germany

Ralf Dittrich et al. Dtsch Arztebl Int. 2008 Apr.

Abstract

Introduction: New anticancer treatments have increased survival rates for cancer patients but often at the cost of sterility. One way of preserving fertility in these patients is the use of cryopreservation of ovarian tissue with subsequent retransplantation following a period of recurrence-free survival. We report the follow-up of the first case of retransplantation of ovarian tissue in Germany.

Methods: Immediately following the diagnosis of anal cancer, ovarian tissue was removed laparoscopically, and cryopreserved. The patient was then treated with combined radiochemotherapy, which resulted in iatrogenic premature ovarian failure, and was associated with inhibin B serum levels lower than 10 ng/L. After the 2.5 year period of cancer remission, the cryopreserved ovarian tissue was retransplanted orthotopically.

Results: Five months later estradiol serum levels had risen from lower than 20 pg/mL to 436 pg/mL. Three ovarian follicles were detected ultrasonographically in the pelvic side wall. Finally the patient reported her first menstruation after the intervention. The endocrine activity of the transplanted cryopreserved tissue has demonstrated viability, and the ability to develop.

Discussion: Cycle monitoring and timed intercourse should now help to achieve conception. These first results from Germany for retransplantation of cryopreserved ovarian tissue clearly show its potential for preserving fertility.

Keywords: cancer; cryopreservation; fertility protection; ovarian tissue; transplantation.

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Figures

Figure 1
Figure 1
Histological section of a reference sample of the removed ovarian tissue with a clearly visible primordial follicle (200x magnification)
Figure 2
Figure 2
Thawed ovarian tissue prior to retransplantation
Figure 3
Figure 3
Introduction of the fragments of ovarian tissue into the peritoneal pocket
Figure 4
Figure 4
Sonographic image of the follicles in the transplanted tissue
Graph
Graph
Sequential serum levels of FSH, LH, and estradiol. The restoration of ovarian endocrine function was first detected from three months following transplantation; day 0 is the day prior to transplantation of the cryopreserved ovarian tissue
See this image and copyright information in PMC

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