Abstract

BackgroundOvarian tissue cryopreservation is a technique for fertility preservation addressed to prepubertal girls or to patients for whom no ovarian stimulation is possible before initiation of gonadotoxic treatments. Autotransplantation of frozen-thawed ovarian tissue is the only available option for reuse but presents some limitations: ischemic tissue damages post-transplant and reintroduction of malignant cells in cases of cancer. It is therefore essential to qualify ovarian tissue before autograft on a functional and oncological point of view. Here, we aimed to isolate viable cells from human ovarian cortex in order to obtain an ovarian cell suspension analyzable by multicolor flow cytometry.MethodsOvarian tissue (fresh or frozen-thawed), from patients with polycystic ovarian syndrome (reference tissue) and from patients who underwent ovarian tissue cryopreservation, was used for dissociation with an automated device. Ovarian tissue-dissociated cells were analyzed by multicolor flow cytometry; the cell dissociation yield and viability were assessed. Two automated dissociation protocols (named laboratory and commercial protocols) were compared.ResultsThe effectiveness of the dissociation was not significantly different between reference ovarian tissue (1.58 × 106 ± 0.94 × 106 viable ovarian cells per 100 mg of ovarian cortex, n = 60) and tissue from ovarian tissue cryopreservation (1.70 × 106 ± 1.35 × 106 viable ovarian cells, n = 18). However, the viability was slightly different for fresh ovarian cortex compared to frozen-thawed ovarian cortex whether we used reference tissue (p = 0.022) or tissue from ovarian cryopreservation (p = 0.018). Comparing laboratory and commercial protocols, it appeared that cell yield was similar but cell viability was significantly improved when using the commercial protocol (81.3% ± 12.3% vs 23.9% ± 12.5%).ConclusionBoth dissociation protocols allow us to isolate more than one million viable cells per 100 mg of ovarian cortex, but the viability is higher when using the commercial dissociation kit. Ovarian cortex dissociation is a promising tool for human ovarian cell qualification and for ovarian residual disease detection by multicolor flow cytometry.

Highlights

  • Ovarian tissue cryopreservation is a technique for fertility preservation addressed to prepubertal girls or to patients for whom no ovarian stimulation is possible before initiation of gonadotoxic treatments

  • Assessment by multicolor flow cytometry of isolated viable cells obtained from ovarian cortex The ovarian cell suspension obtained after ovarian cortex dissociation was analyzed by MFC to quantify viable nucleated cells (SYTO 13+/7-Amino-Actinomycin D (7-AAD)−) and to determine the cell yield of the dissociation technique

  • No statistically significant difference was observed for cell yield between reference ovarian tissue (1.58 × 106 viable cells per 100 mg of tissue ± 1.22 × 106, n = 60) and tissue from ovarian tissue cryopreservation (OTC) (1.70 × 106 viable cells per 100 mg of tissue ± 1.65 × 106, n = 18) (p = 0.781, Fig. 3a)

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Summary

Introduction

Ovarian tissue cryopreservation is a technique for fertility preservation addressed to prepubertal girls or to patients for whom no ovarian stimulation is possible before initiation of gonadotoxic treatments. Women with cancer have several options to preserve their fertility: ovarian transposition (only in cases of pelvic irradiation), embryo or oocyte cryopreservation and ovarian tissue cryopreservation (OTC) [3, 4] (which can be combined with immature oocytes collection [5, 6]). Ovarian cortex cryopreservation is recognized in France as one fertility preservation option (law of Bioethics n°2004–800) and has several advantages as no ovarian stimulation is required and it can be proposed to prepubertal girls or patients in whom gonadotoxic treatment cannot be postponed [10]

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