title: Orthotopic autotransplantation of cryopreserved ovarian tissue to a woman cured of cancer - follicular growth, steroid production and oocyte retrieval.
abstract: Cryopreservation of human ovarian tissue is now an option for cancer patients facing treatment with gonadotoxic regimes, as a means of preserving their fertility. So far, there have been only a few reports on autotransplantation of frozen-thawed tissue with regard to restoration of ovarian function. The present report describes a 32-year-old woman diagnosed with Hodgkin's lymphoma, who had cryopreserved ovarian tissue transplanted orthotopically after secondary ovarian failure due to chemotherapy. Only 8 weeks after transplantation, ultrasonography of the remaining ovary revealed two follicles with diameters of 10 and 15 mm. Concomitantly, circulating concentrations of oestradiol increased, while concentrations of gonadotrophins decreased. In the following months, the patient menstruated three times. Subsequent pituitary down-regulation with a gonadotrophin-releasing hormone (GnRH) agonist and ovarian stimulation resulted in development of one pre-ovulatory follicle from which a metaphase II oocyte was retrieved; however, this oocyte was unable to sustain further development after intracytoplasmic sperm injection (ICSI). Intrafollicular concentrations of oestradiol and progesterone suggested a normal luteinizing response of the follicle to human chorionic gonadotrophin stimulation. A 7-month follow-up revealed continued vivid follicular activity and normal oestradiol concentrations. In conclusion, cryopreserved human ovarian tissue restored ovarian function for several cycles and sustained development of mature oocytes in a woman cured of cancer.
authors.affiliation: The Fertility Clinic, Section 4071; Laboratory of Reproductive Biology, section 5712, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. rh12735@rh.dk
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Tryde Schmidt
authors.forename: Claus
authors.initials: C
authors.lastname: Yding Andersen
authors.forename: Jørgen
authors.initials: J
authors.lastname: Starup
authors.forename: Anne
authors.initials: A
authors.lastname: Loft
authors.forename: Anne Grete
authors.initials: AG
authors.lastname: Byskov
authors.forename: Anders
authors.initials: A
authors.lastname: Nyboe Andersen
mesh_terms: D000328:Adult; D000818:Animals; D015925:Cryopreservation; D015536:Down-Regulation; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000494:pharmacology; D006689:Hodgkin Disease / Q000628:therapy*; D006728:Hormones / Q000096:biosynthesis* / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D051379:Mice; D009865:Oocytes; D006080:Ovarian Follicle / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology*; D010053:Ovary / Q000637:transplantation*; D012074:Remission Induction; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous; D014463:Ultrasonography
chemical_list: D006728:Hormones; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone