Restoration of ovarian function after cryopreserved ovarian tissue transplantation in women exposed to complex treatment for gynecological cancer: feasibility of this option in pediatric cancer patients
Alla S. Lisyanskya1,2, Natalia I. Tapilskaya1,3, Margarita B. Belogurova3,4, Yulia V. Dinikina3, Ekaterina V. Tsibatova4, Georgy M. Manikhas1
1City Clinical Oncology Dispensary; 2AVA-Peter Clinic; 3St. Petersburg State Pediatric Medical Academy, Department of Oncology, Radiodiagnostics and Radiotherapy Section; 4City Clinical Hospital №31, Department of Pediatric Oncology and Hematology Saint Petersburg, Russia
Alla S. Lisyanskya, City Clinical Oncology Dispensary, pr. Veteranov 56, 198255 St. Petersburg, Russia
Phone: +7 (812) 3768917, E-mail: firstname.lastname@example.org
To appreciate the possibilities for preserving ovarian function and improving quality of life in women of a reproductive age exposed to complex treatment for gynecological cancer.
Due to increasing pediatric cancer survival rates attention has turned to the long-term sequelae of treatment. Possibilities to preserve fertility in these pts are widely discussed.
Materials and methods
Sixteen pts with gynecological cancer participated in our research. Before undergoing gonadotoxic treatment, a laparoscopic collection of ovarian cortical tissue – which was then cryopreserved – was carried out in all pts. After the completion of a patient-specific treatment, hormonal blood tests confirmed premature ovarian failure. After heterotopic transplantation was performed, ovarian function was continuously monitored by hormonal blood tests; follicular development was assessed by ultrasonography.
Normal hormonal status was recovered in 15 pts due to transplantation procedure, while in 10 pts regular cyclic follicular development was observed. In 1 patient received a mature ovule after a follicle puncture. According to the psychological tests taken in all pts exposed to ovarian tissue transplantation, an increase in their life quality was registered.
Autotransplantation of ovarian tissue in reproductive-aged women with oncogynecological disease can preserve fertility and “stop” the menopause. Cryopreserved ovarian tissue – transplanted into a heterotopic site – may lead to the production of mature ovules that admit the possibility to conceive a child. These methods are reasonable in oncopediatric pts who have a realistic chance of long-term survival and whose scheduled treatment carries a high risk of gonadal damage.
oncogynecology, children, chemotherapy, fertility, cryopreservation