Abstract
Background: One of the most important problems of ovarian transplantation is the significant reduction in the number of primordial follicles during the short period after transplantation due to post-transplantation ischemia. The aim of the work was to evaluate the effect of enoxaparin application on follicular survival after cryopreserved and fresh ovary transplantation in rats. Materials and Methods: The study used female Sprague Dawley rats (n=56). The animals were ovariectomized and the healing of fresh and cryopreserved ovarian tissue was evaluated. Estrogen blood level, percentage of ovarian live tissue, and angiogenesis were evaluated 16 days after transplantation of fresh ovary and 7, 14, and 28 days after transplantation of cryopreserved ovarian tissue. The animals in the experimental groups were treated after transplantation by enoxaparin subcutaneously in doses of 200 IU/kg per day. Results: A statistically significant higher (p < 0.05) percentage of live tissue was recorded in the treated goup (14.5±6.5 vs. 20.6±5.7% in control vs. treated groups) 7 days after transplantation of cryopreserved ovarian tissue, and a significantly more intensive (p<0.005) neoangiogenesis was recorded in the treated group (12.7±1.9 capillaries in 250 μm2) in comparison with the control group (7.4±2.1 capillaries in 250 μm2) 28 days after transplantation of cryopreserved ovarian tissue. Conclusions: Administration of enoxaparin after transplantation of cryopreserved ovarian tissue may temporarily improve tissue survival. The use of enoxaparin does not adversely affect neoangiogenesis around the transplanted ovary. The positive effect of low molecular weight heparin application on neoangiogenesis was demonstrated four weeks after transplantation.
Highlights
Advances in the treatment of malignant diseases has led to a significant increase of life expectancy in cancer patients, especially in young ones
Because women are born with an irreplaceable supply of germ cells in their ovaries, cytotoxic damage to ovarian stromal and germ cells leads to unavoidable effects on ovarian function, resulting in female infertility [1]
A subsequent work presented that ovarian encapsulation with hyaluronic acid-based hydrogel alone can prevent or minimalize ischemia-induced follicle loss, preserve the follicular pool, promote follicular survival, facilitate angiogenesis, and restore hormone levels [12]
Summary
Advances in the treatment of malignant diseases has led to a significant increase of life expectancy in cancer patients, especially in young ones. One direction of contemporary medicine is focused on improving the quality of life of patients who have undergone cancer treatment. Due to the increasing number of young women delaying childbearing to later life for various reasons, and to the growing number of women experiencing cancer before completing childbearing, preservation of fertility for patients undergoing chemotherapy has become a significant part of reproductive medicine [2]. There are several options currently available for preserving fertility in young cancer patients, such as cryopreservation of embryos and oocytes. Cryopreservation of ovarian tissue is the only option available for prepubescent girls and women in need of immediate chemotherapy [3]
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