Ovarian function after removal of an entire ovary for cryopreservation of pieces of cortex prior to gonadotoxic treatment: a follow-up study.
BACKGROUND
Ovarian function was studied in Danish patients who had ovarian tissue cryopreserved, and the patients' experiences with the procedure were investigated.


METHODS
There were 92 women who had an entire ovary removed for cryopreservation 18-75 months earlier. Reasons included: breast cancer (n = 31; 34%), Hodgkin's lymphoma (n = 23; 25%), bone marrow transplantation (BMT) (n = 19; 21%) and others (n = 19; 21%). Patients completed a questionnaire, and transvaginal ultrasonic antral follicle count and serum analysis for follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH) were performed in 73 women.


RESULTS
In total, 11% of the BMT patients had normal ovarian function. Hodgkin's patients who only received ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) (n = 12) and 60% of the breast cancer patients showed little evidence of ovarian damage. Regular menstruation was shown to be a good indicator of ovarian function. The cryopreservation procedure rarely complicated cancer treatment (5%) and 84% felt comforted because they had potentially secured their fertility.


CONCLUSIONS
Cryopreservation of ovarian tissue should be considered in young female patients with Hodgkin's lymphoma receiving more aggressive treatment than ABVD and in patients scheduled for BMT. The recommendation for breast cancer patient should be individualized. The cryopreservation process did not delay cancer treatment.
Rosendahl
Mikkel
M
Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Denmark. mikkel.rosendahl@rh.regionh.dk
Andersen
Claus Yding
CY
Ernst
Erik
E
Westergaard
Lars G
LG
Rasmussen
Per Emil
PE
Loft
Anne
A
Andersen
Anders Nyboe
AN
D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D015925:Cryopreservation / Q000379:methods*; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D005500:Follow-Up Studies; D006062:Gonadotropins / Q000378:metabolism*; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000379:methods; D014747:Vinblastine / Q000627:therapeutic use
D006062:Gonadotropins; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone