title: Ovarian tissue cryopreservation in girls undergoing haematopoietic stem cell transplant: experience of a single centre.
abstract: Fertility after childhood haemopoietic stem cell transplant (HSCT) is a major concern. Conditioning regimens before HSCT present a high risk (>80%) of ovarian failure. Since 2000, we have proposed cryopreservation of ovarian tissue to female patients undergoing HSCT at our centre, to preserve future fertility. After clinical and haematological evaluation, the patients underwent ovarian tissue collection by laparoscopy. The tissue was analysed by histologic examination to detect any tumour contamination and then frozen following the slow freezing procedure and cryopreserved in liquid nitrogen. From August 2000 to September 2013, 47 patients planned to receive HSCT, underwent ovarian tissue cryopreservation. The median age at diagnosis was 11.1 years and at the time of procedure it was 13 years, respectively. Twenty-four patients were not pubertal at the time of storage, whereas 23 patients had already experienced menarche. The median time between laparoscopy and HSCT was 25 days. Twenty-six out of 28 evaluable patients (93%) developed hypergonadotropic hypogonadism at a median time of 23.3 months after HSCT. One patient required autologous orthotopic transplantation that resulted in one live birth. Results show a very high rate of iatrogenic hypergonadotropic hypogonadism, highlighting the need for fertility preservation in these patients.
authors.affiliation: Paediatric Onco-Haematology, City of Science and Health of Turin, Regina Margherita Children's Hospital, Torino, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Biasin
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, City of Science and Health of Turin, S. Anna Hospital, University of Torino, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Salvagno
authors.affiliation: Paediatric Onco-Haematology, City of Science and Health of Turin, Regina Margherita Children's Hospital, Torino, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Berger
authors.affiliation: Paediatric Onco-Haematology, City of Science and Health of Turin, Regina Margherita Children's Hospital, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nesi
authors.affiliation: Paediatric Onco-Haematology, City of Science and Health of Turin, Regina Margherita Children's Hospital, Torino, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Quarello
authors.affiliation: Paediatric Onco-Haematology, City of Science and Health of Turin, Regina Margherita Children's Hospital, Torino, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vassallo
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, City of Science and Health of Turin, S. Anna Hospital, University of Torino, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Evangelista
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, City of Science and Health of Turin, S. Anna Hospital, University of Torino, Torino, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Marchino
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, City of Science and Health of Turin, S. Anna Hospital, University of Torino, Torino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Revelli
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, City of Science and Health of Turin, S. Anna Hospital, University of Torino, Torino, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Benedetto
authors.affiliation: Paediatric Onco-Haematology, City of Science and Health of Turin, Regina Margherita Children's Hospital, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fagioli
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D064592:Autografts; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D005260:Female; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D050498:Live Birth; D010053:Ovary / Q000637:transplantation*