Cryopreservation of female germ cells and ovarian tissues for fertility preservation
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REVIEW ARTICLE
Cryopreservation of female germ cells and ovarian tissues for fertility preservation Shu Hashimoto • Nao Suzuki • Bunpei Ishizuka Yoshiharu Morimoto
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Received: 15 March 2011 / Accepted: 21 April 2011 / Published online: 15 May 2011 Ó Japan Society for Reproductive Medicine 2011
Abstract To preserve the fertility of patients who undergo chemotherapy and/or radiotherapy, procedures for cryopreservation of female germ cells have been investigated. Cyropreservation methods differ according to follicle stage because the mammalian ovary contains a large number of oocytes at different growth stages. Follicles at very early stages, for example the primordial and primary stages, are usually cryopreserved within ovarian cortical tissue because they need surrounding somatic cells for subsequent development. In contrast, fully-grown oocytes in Graafian follicles are cryopreserved without any other cells at the metaphase II stage. Recently, ultra-rapid cooling was incorporated into cryopreservation procedures for human ovaries. In this review, we describe oocyte freezing, the development of ultra-rapid cooling systems for ovarian tissues, freezing of human ovaries, and ovarian transplantation. Keywords Cancer Freezing Oocyte Ovary Vitrification
Introduction In 2008, approximately 692,000 women in the USA were diagnosed with some form of invasive cancer. Approximately 55,000 of these women (8%) were under the age of 40 [1]. S. Hashimoto (&) Y. Morimoto IVF Namba Clinic, 1-17-28 Minami-horie, Nishi-ku, Osaka 5500015, Japan e-mail: [email protected] N. Suzuki B. Ishizuka Department of Obstetrics and Gynecology, St Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 2168511, Japan
Young female cancer patients face various problems, including a decrease in their quality of life (QOL) because of early menopause or loss of fertility after remission [2]. Chemotherapy and radiotherapy have effects not only on cancer cells but also on normal cells and can cause loss of reproductive function in young women because of adverse effects such as ovarian failure. Gonadal dysfunction is a common consequence of cytotoxic chemotherapy or radiotherapy. In women who have undergone chemotherapy, ovarian failure leads to oligomenorrhea, amenorrhea, and anovulation. The frequency of ovarian failure depends on the age of the patient, the anticancer agents used, and the dose of each agent [3]. Chemotherapy-induced amenorrhea is defined as amenorrhea that persists for more than 3 months and occurs within 1 year of the start of chemotherapy [3]. In adult female cancer patients, improvement of post-treatment QOL and preservation of fertility can be achieved by measures such as protection of ovarian function against the effects of anticancer agents by administration of gonadotropin-releasing hormone (GnRH) analogs or oral contraceptives [4, 5], transposition of the ovaries outside the radiation field [6], or cryopreservation of unfertilized and fertilized ova. However, these measures are c
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