Selection of patients before and after anticancer treatment for ovarian cryopreservation

BACKGROUND Although ovarian cryopreservation in patients with cancer should ideally be performed before the initiation of therapy, cryopreservation from such patients often becomes an option only later. The justification for the procedure needs to be elucidated. METHODS Eighteen cancer patients befo...

Full description

Saved in:
Bibliographic Details
Published in:Human reproduction (Oxford) 2008-04, Vol.23 (4), p.869-877
Main Authors: Abir, Ronit, Ben-Haroush, Avi, Felz, Carmela, Okon, Elimelch, Raanani, Hila, Orvieto, Raoul, Nitke, Shmuel, Fisch, Benjamin
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antineoplastic Agents - adverse effects
apoptosis
Biological and medical sciences
chemotherapy
Child
Cryopreservation
Female
follicles
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Neoplasms - drug therapy
Ovarian Follicle - cytology
Ovarian Follicle - drug effects
Ovary - cytology
Ovary - drug effects
Patient Selection
transmission electron microscopy
viability
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND Although ovarian cryopreservation in patients with cancer should ideally be performed before the initiation of therapy, cryopreservation from such patients often becomes an option only later. The justification for the procedure needs to be elucidated. METHODS Eighteen cancer patients before chemotherapy and 23 others after chemotherapy participated in the study. Freshly dissected ovarian samples were prepared for light microscopy to demonstrate follicular numbers and apoptosis, transmission electron microscopy to enhance intracellular changes, and staining with fluorescent markers (calcein AM, rhodamin 123 and ethidium homodimer) to test for viability. RESULTS High numbers of preantral follicles were detected in ovaries of patients ≤20 years. No antral follicles were detected. All the follicles were viable and not apoptotic. Deterioration in follicular quality was observed after chemotherapy, manifested mainly as an increase in abnormal granulosa cell nuclei (P < 0.05–0.0001) and in oocyte vacuolization (P < 0.0001). CONCLUSIONS Our study stresses the importance of prechemotherapy ovarian cryopreservation. However, the large number of viable, non-apoptotic follicles in ovaries of younger patients (age ≤ 20 years) indicates that ovarian cryopreservation might be considered after treatment in this age group. Further studies of ovarian samples from women aged 20–30 years are needed to determine the exact age margin wherein postchemotherapy ovarian cryopreservation can be suggested.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/dem413