title: In Vitro Activation of Follicles and Fresh Tissue Auto-transplantation in Primary Ovarian Insufficiency Patients.
abstract: Recently, two patients with primary ovarian insufficiency (POI) delivered healthy babies after in vitro activation (IVA) treatment followed by auto-transplantation of frozen-thawed ovarian tissues.
  
  
  
  This study sought to report the first case of live birth after IVA treatment following fresh ovarian tissue grafting in patients with POI, together with monitoring of follicle development and serum hormonal changes.
  
  
  
  This was a prospective observational cohort study.
  
  
  
  We performed IVA treatment in 14 patients with POI with mean age of 29 years, mean duration since last menses of 3.8 years, and average basal FSH level of 94.5 mIU/mL.
  
  
  
  Prior to IVA treatment, all patients received routine hormonal treatments with no follicle development. We removed one ovary from patients with POI and treated them with Akt stimulators. We improved upon early procedures by grafting back fresh tissues using a simplified protocol.
  
  
  
  In six of the 14 patients (43%), a total of 15 follicle development waves were detected, and four patients had successful oocyte retrieval to yield six oocytes. For two patients showing no spontaneous follicle growth, human menopausal gonadotropin treatment induced follicle growth at 6-8 months after grafting. After vitro fertilization of oocyte retrieved, four early embryos were derived. Following embryo transfer, one patient became pregnant and delivered a healthy baby boy, with three other embryos under cryopreservation.
  
  
  
  IVA technology can effectively activate residual follicles in some patients with POI and allow them to conceive their own genetic offspring. IVA may also be useful for treating patients with ovarian dysfunction including aging women and cancer survivors.
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Jun
authors: J
authors: Zhai
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Guidong
authors: G
authors: Yao
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Fangli
authors: F
authors: Dong
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Zhiqin
authors: Z
authors: Bu
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Yuan
authors: Y
authors: Cheng
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Yorino
authors: Y
authors: Sato
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Linli
authors: L
authors: Hu
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Yingying
authors: Y
authors: Zhang
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Jingyuan
authors: J
authors: Wang
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Shanjun
authors: S
authors: Dai
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Jing
authors: J
authors: Li
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Jing
authors: J
authors: Sun
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Aaron J
authors: AJ
authors: Hsueh
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Kazuhiro
authors: K
authors: Kawamura
authors: Reproductive Medical Centre (J.Z., G.Y., F.D., Z.B., L.H., Y.Z., J.W., S.D., J.S., Y.Su), First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Obstetrics and Gynecology (Y.C., A.J.H.), Stanford University School of Medicine, Stanford, California 94305; and Department of Obstetrics and Gynecology (Y.Sa., K.K.), St. Marianna University School of Medicine, Kawasaki, 216-8511 Kanagawa, Japan.
authors: Yingpu
authors: Y
authors: Sun
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods*; D016377:Organ Transplantation; D006080:Ovarian Follicle / Q000187:drug effects*; D010053:Ovary / Q000637:transplantation*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016649:Primary Ovarian Insufficiency / Q000601:surgery*; D011446:Prospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D005640:Follicle Stimulating Hormone