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
Correspondence
Alla S. Lisyanskya, City Clinical Oncology Dispensary, pr. Veteranov 56, 198255 St. Petersburg, Russia
Phone: +7 (812) 3768917, E-mail: deton.hospital31@inbox.ru
Summary
Objective
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.
Results
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.
Conclusions
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.
Keywords
oncogynecology, children, chemotherapy, fertility, cryopreservation
