IVF outcome in patients with orthotopically transplanted ovarian tissue.
BACKGROUND
Chemo- or radiotherapy can induce premature ovarian failure (POF), and ovarian tissue cryopreservation and transplantation may be proposed to restore ovarian function. Our aim was to evaluate the quality of oocytes and embryos derived from frozen-thawed transplanted ovarian tissue.


METHODS
Women were 21-28 years old at tissue cryopreservation. Nine women suffering POF following chemotherapy with or without radiotherapy underwent orthotopic ovarian tissue transplantation. After 12 months of spontaneous cycles without pregnancy, oocyte retrieval was performed in four patients during mildly stimulated or spontaneous cycles. ICSI was performed in all cases, with embryo transfer on day 3. Light and electron microscopy was used to study oocytes and embryos.


RESULTS
Signs of ovarian function restoration (estradiol peak, decreased FSH, follicular development) began 16-26 weeks after reimplantation. Twenty-one oocyte retrieval attempts were made. At least one oocyte was collected in 15 cases, giving an empty follicle rate per retrieval of 29% (6/21). Sixteen oocytes were recovered, of which 6 were abnormal or immature (38%) and 10 (62%) were in metaphase II (MII). Three MII oocytes failed to fertilize, two showed abnormal fertilization and five normal MII oocytes successfully fertilized with subsequent normal embryo development (Grade 2), yielding an embryo transfer rate of 24% per retrieval. No pregnancy occurred.


CONCLUSIONS
IVF in women with orthotopically grafted frozen-thawed ovarian tissue involves a higher risk of empty follicles, abnormal or immature oocytes, and low embryo transfer rates.
Dolmans
Marie-Madeleine
MM
Department of Gynecology, Cliniques Universitaires St Luc, Université Catholique de Louvain, Avenue Hippocrate, 10 B-1200 Brussels, Belgium.
Donnez
Jacques
J
Camboni
Alessandra
A
Demylle
Dominique
D
Amorim
Christiani
C
Van Langendonckt
Anne
A
Pirard
Céline
C
D000328:Adult; D015925:Cryopreservation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000166:cytology; D005260:Female; D006801:Humans; D009865:Oocytes / Q000648:ultrastructure; D006080:Ovarian Follicle / Q000254:growth & development; D010053:Ovary / Q000637:transplantation*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced / Q000628:therapy*; D020554:Sperm Injections, Intracytoplasmic; D014182:Transplantation, Autologous