title: Cryopreservation of ovarian tissue in pediatric patients undergoing sterilizing chemotherapy.
abstract: Significantly improved survival rates in children and adolescents with cancer have put fertility preservation high on the pediatric oncology agenda. Here we report a retrospective single-center study of 13 years experience of ovarian tissue cryopreservation (OTC) before sterilizing treatment in order to define the safety/benefits of OTC and study clinical/hormonal outcomes in girls. From 2000 to 2013, OTC was performed in 36 girls: eight had non-malignant disease and 28 had malignant disease. Laparoscopy was used to collect a third of each ovary that was frozen by a slow cooling protocol. Indications for OTC were 13 auto-, 19 allo-stem-cell-transplantation and 4 sterilizing chemotherapy. Ovarian tissue harvested by intraumbilical laparoscopy led to no major postoperative complications and did not delay chemotherapy. Histological analysis of ovarian tissue showed an average of 9 primordial follicles/mm(2) [0-83] and no malignant cells were identified. Median post-harvest follow-up was 36 months [1-112]: 26 girls were alive in complete remission and 10 had died. Hormonal results were evaluable for 27 patients (median age 17 yrs [5-26]): 16 patients were in premature ovarian insufficiency. OTC sampling one third of each ovary appears to be an appropriate approach to preserve fertility in children without consequences on subsequent therapeutic program.
authors.affiliation: a Centre Régional De Cancérologie Et Thérapie Cellulaire Pédiatrique, Hôpital Estaing , Clermont-Ferrand , France ;|b INSERM-CIC 1405, Unite CRECHE , Clermont-Ferrand , France ;|c Faculté De Médecine, Clermont Université, Université Clermont1 , Clermont-Ferrand , France ;
authors.forename: Fanny
authors.initials: F
authors.lastname: Chambon
authors.affiliation: d CHU Clermont-Ferrand, Assistance Médicale À La Procréation, CECOS, CHU Clermont-Ferrand , Clermont-Ferrand , 63001 , France ;|e Laboratoire Génétique Reproduction Et Développement, Université D'auvergne , INSERM U1103 , Clermont-Ferrand , France ;
authors.forename: Florence
authors.initials: F
authors.lastname: Brugnon
authors.affiliation: a Centre Régional De Cancérologie Et Thérapie Cellulaire Pédiatrique, Hôpital Estaing , Clermont-Ferrand , France ;|c Faculté De Médecine, Clermont Université, Université Clermont1 , Clermont-Ferrand , France ;
authors.forename: Victoria
authors.initials: V
authors.lastname: Grèze
authors.affiliation: c Faculté De Médecine, Clermont Université, Université Clermont1 , Clermont-Ferrand , France ;|d CHU Clermont-Ferrand, Assistance Médicale À La Procréation, CECOS, CHU Clermont-Ferrand , Clermont-Ferrand , 63001 , France ;|e Laboratoire Génétique Reproduction Et Développement, Université D'auvergne , INSERM U1103 , Clermont-Ferrand , France ;
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Grémeau
authors.affiliation: f CHU De Clermont-Ferrand, Unité De Biostatistiques, Délégation À La Recherche Clinique Et L'innovation , Clermont-Ferrand , France ;
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: c Faculté De Médecine, Clermont Université, Université Clermont1 , Clermont-Ferrand , France ;|g Service D'anatomopathologie, Hôpital Estaing , Clermont-Ferrand , France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Déchelotte
authors.affiliation: a Centre Régional De Cancérologie Et Thérapie Cellulaire Pédiatrique, Hôpital Estaing , Clermont-Ferrand , France ;|b INSERM-CIC 1405, Unite CRECHE , Clermont-Ferrand , France ;|c Faculté De Médecine, Clermont Université, Université Clermont1 , Clermont-Ferrand , France ;
authors.forename: Justyna
authors.initials: J
authors.lastname: Kanold
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002648:Child; D015925:Cryopreservation; D005240:Feasibility Studies; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects; D016522:Oncology Service, Hospital; D059351:Organ Sparing Treatments / Q000009:adverse effects; D010052:Ovariectomy / Q000009:adverse effects; D010053:Ovary / Q000187:drug effects / Q000528:radiation effects / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011832:Radiation Injuries; D012074:Remission Induction; D012189:Retrospective Studies; D012306:Risk; D019172:Transplantation Conditioning / Q000009:adverse effects*
keywords: Childhood cancer; fertility; ovarian tissue cryopreservation