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Hum. Reprod. Advance Access originally published online on August 19, 2005
Human Reproduction 2005 20(12):3539-3546; doi:10.1093/humrep/dei250
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Follow-up of ovarian function post-chemotherapy following ovarian cryopreservation and transplantation

K.L.T. Schmidt1,2,4, C. Yding Andersen2, A. Loft1, A.G. Byskov2, E. Ernst3 and A. Nyboe Andersen1

1 The Fertility Clinic, section 4071 and 2 The Laboratory of Reproductive Biology, section 5712, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen and 3 The Fertility Clinic, Skejby Sygehus, DK-8200 Aarhus N, Denmark

4 To whom correspondence should be addressed. E-mail: tryde{at}dadlnet.dk

BACKGROUND: The purpose of this study was to assess the ovarian function after treatment of a malignant disease in women who previously had cortical tissue from an entire ovary cryopreserved prior to chemotherapy, and to assess ovarian function after autotransplantation of cryopreserved ovarian tissue. All were treated with chemotherapeutic drugs with an estimated high risk of inducing ovarian failure. METHODS: Twenty-two women with breast cancer (n = 8), Hodgkin’s disease (n = 6), non-Hodgkin’s (n = 2), leukaemia (n = 5) or brain tumour (n = 1) underwent a clinical examination >18 months after cryopreservation. Three patients with premature ovarian failure had ovarian tissue autotransplanted orthotopically and heterotopically. Ovarian function was assessed by ultrasonography of the remaining ovary and hormone measurements. RESULTS: Nine of 22 women (41%) had sonographic and hormonal signs of ovarian failure with ovarian volumes <1.3 cm3, no antral follicles and high FSH levels (median 57.1 IU/l). Thirteen of the 22 women (59%) still menstruated and 10 had a seemingly normal ovarian function, with a median ovarian volume of 6.8 cm3, a median number of antral follicles of six, FSH <15 IU/l and normal estradiol levels. All three patients with autotransplanted ovarian tissue regained ovarian function as confirmed by return of menses, follicles on ultrasonography and normalized hormone levels. Two embryos were created from the crypreserved tissue after IVF. CONCLUSIONS: Treatment with bone-marrow transplantation and/or high doses of alkylating agents led to ovarian failure in all patients. Autotransplantation of ovarian tissue led to return of ovarian function.

Key words: autotransplantation/cancer survivors/cryopreservation/IVF/premature ovarian failure


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