Abstract
Introduction Modern anti-cancer strategies have distinctly increased survival rates; nevertheless, often accompanied by sterility. Currently, the only option for preserving fertility in prepubertal females is to cryopreserve ovarian tissue and re-transplant frozen-thawed tissue to restore fertility after treatment. Our aim was to report the occurrence of repetitive antral follicle formation and oocyte maturation in a prepubescent ovarian tissue xenograft without exogenous hormone stimulation. Material and Methods Frozen-thawed ovarian tissue from a 6-year-old patient suffering from nephroblastoma was xenotransplanted in oophorectomized severe combined immunodeficiency (SCID) mice to evaluate follicle development. Ergebnisse Repetitive follicle development to the antral stage occurred in the same xenograft of prepubertal ovarian tissue without exogenous hormone administration; 37 days after retrieving a maturing oocyte (this first retrieval has been previously published), another, completely mature oocyte was harvested from the xenograft. Subsequent histological evaluation of the grafted tissue showed primordial follicles, nearly all stages of developing follicles, as well as large atretic ones. Many clusters with dormant primordial follicles were also present. Conclusion Xenotransplanted prepubertal ovarian tissue has the potential for repetitive oocyte retrieval cycles without administering exogenous hormones. The results indicate that the human ovarian tissue might be able to synchronize the hypothalamus-hypophysis-axes of the mouse to the physiological human cycle; this should be investigated in future studies.
Highlights
Modern anti-cancer strategies have distinctly increased survival rates; often accompanied by sterility
Ergebnisse Repetitive follicle development to the antral stage occurred in the same xenograft of prepubertal ovarian tissue without exogenous hormone administration; 37 days after retrieving a maturing oocyte, another, completely mature oocyte was harvested from the xenograft
Xenotransplanted prepubertal ovarian tissue has the potential for repetitive oocyte retrieval cycles without administering exogenous hormones
Summary
Modern anti-cancer strategies have distinctly increased survival rates; often accompanied by sterility. Various strategies have been developed for fertility preservation; the most advantageous option usually depends on the patients particular situation, including age as well as potential arising risk in case of postponing anti-cancer treatment. Thawing and re-transplantation of frozen tissue can be performed to restore fertility after anti-cancer treatment [1 – 5] This preservation method profits from two main advantages; ovarian cortex usually incorporates a huge amount of follicles [6, 7] and provides a high developmental potential, especially in prepubertal females [8, 9]. These results and worldwide more than 85 reported live births after re-transplantation of autologous frozen-thawed ovarian tissue to date [13] emphasize the potential of this technique; according to the criteria of the European Society of Human Reproduction and Embryology (ESHRE) special interests groups “Ethics and Law” as well as “Safety and Quality in Assisted Reproductive Technology” and the American Society for Reproductive Medicine (ASRM), this method should be graded as innovative [14, 15], on the way to routine clinical practice [16]
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