title: Orthotopic reimplantation of cryopreserved ovarian cortical strips after high-dose chemotherapy for Hodgkin's lymphoma.
abstract: BACKGROUND
  Infertility is a common late effect of chemotherapy and radiotherapy, and has a substantial effect on the quality of life for young survivors of cancer. For men, semen cryopreservation is a simple way of preserving reproductive potential but for women, storage of mature eggs rarely proves successful, and the alternative-immediate in vitro fertilisation with cryopreservation of embryos-is not always appropriate. Reimplantation of cryopreserved ovarian tissue has been shown to restore natural fertility in animals. We applied this technique in a woman who had received sterilising chemotherapy for lymphoma.
  
  
  METHODS
  A 36-year-old woman underwent a right oophorectomy with cryopreservation of ovarian cortical strips before receiving high-dose CBV chemotherapy for a third recurrence of Hodgkin's lymphoma. 19 months later, when serum sex steroid analysis confimed a postmenopausal state, two ovarian cortical strips were thawed and reimplanted-one onto the left ovary and another at the site of the right ovary.
  
  
  RESULTS
  7 months after reimplantation of ovarian cortical strips, the patient reported resolution of hot flashes and, for the first time, oestradiol was detected in the serum. This finding was associated with a decrease in the concentrations of follicle-stimulating hormone and luteinising hormone, and ultrasonography revealed a 10 mm thick endometrium, a poorly visualised left ovary, and a 2 cm diameter follicular structure to the right of the midline. The patient had one menstrual period, but by 9 months after the implantation, her sex steroid concentrations had returned to those seen with ovarian failure.
  
  
  CONCLUSIONS
  Orthotopic reimplantation of frozen/thawed ovarian cortical strips is a well tolerated technique for restoring ovarian function in women treated with sterilising chemotherapy for cancer.
authors.affiliation: Cancer Research Campaign Department of Medical Oncology, Christie Hospital, Wilmslow Road, M20 4BX, Manchester, UK
authors.forename: J A
authors.initials: JA
authors.lastname: Radford
authors.forename: B A
authors.initials: BA
authors.lastname: Lieberman
authors.forename: D R
authors.initials: DR
authors.lastname: Brison
authors.forename: A R
authors.initials: AR
authors.lastname: Smith
authors.forename: J D
authors.initials: JD
authors.lastname: Critchlow
authors.forename: S A
authors.initials: SA
authors.lastname: Russell
authors.forename: A J
authors.initials: AJ
authors.lastname: Watson
authors.forename: J A
authors.initials: JA
authors.lastname: Clayton
authors.forename: M
authors.initials: M
authors.lastname: Harris
authors.forename: R G
authors.initials: RG
authors.lastname: Gosden
authors.forename: S M
authors.initials: SM
authors.lastname: Shalet
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D015925:Cryopreservation; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced* / Q000601:surgery*; D009926:Organ Preservation; D010052:Ovariectomy; D010053:Ovary / Q000502:physiology / Q000637:transplantation; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide