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Zha Y, Li Y, Lyu W. Research progress on the prevention and treatment of chemotherapy-induced ovarian damage. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024:1-9. [PMID: 38742393 DOI: 10.3724/zdxbyxb-2023-0495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Chemotherapy is a main treatment option for malignant tumors, but it may cause various adverse effects, including dysfunction of female endocrine and fertility. Chemotherapy-induced ovarian damage has been concerned, apart from ovarian preservation, the prevention and treatment of ovarian dysfunction are widely studied. In this article, the mechanisms of ovarian injury caused by chemotherapy, including the apoptosis of follicle and supporting cells, follicle "burn out", ovarian stromal and microvascular damage; and influencing factors, including age at diagnosis and initial low pre-treatment anti-Müllerian hormone levels, toxicity, dose and regimen of chemotherapy drugs are reviewed based on the latest research results and clinical practice. The article also discusses measures and frontier therapies for prevention and treatment of ovarian injury, including the application of gonadotropin releasing hormone agonists or antagonists, tyrosine kinase inhibitors, antioxidants, sphingosine-1-phosphate, ceramide-1-phosphate, mammalian target of rapamycin inhibitors, granulocyte-colony stimulating factor, stem cell therapy and artificial ovary, etc.
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Affiliation(s)
- Yuxin Zha
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
| | - Yang Li
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou 310006, China
| | - Weiguo Lyu
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou 310006, China.
- Zhejiang Provincial Key Laboratory of Women's Reproductive Health, Hangzhou 310006, China.
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Piekarska A, Pawelec K, Szmigielska-Kapłon A, Ussowicz M. The state of the art in the treatment of severe aplastic anemia: immunotherapy and hematopoietic cell transplantation in children and adults. Front Immunol 2024; 15:1378432. [PMID: 38646536 PMCID: PMC11026616 DOI: 10.3389/fimmu.2024.1378432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Acquired aplastic anemia (AA) is an immune-mediated bone marrow (BM) failure where marrow disruption is driven by a cytotoxic T-cell-mediated autoimmune attack against hematopoietic stem cells. The key diagnostic challenge in children, but also in adults, is to exclude the possible underlying congenital condition and myelodysplasia. The choice of treatment options, either allogeneic hematopoietic cell transplantation (alloHCT) or immunosuppressive therapy (IST), depends on the patient's age, comorbidities, and access to a suitable donor and effective therapeutic agents. Since 2022, horse antithymocyte globulin (hATG) has been available again in Europe and is recommended for IST as a more effective option than rabbit ATG. Therefore, an update on immunosuppressive strategies is warranted. Despite an improved response to the new immunosuppression protocols with hATG and eltrombopag, some patients are not cured or remain at risk of aplasia relapse or clonal evolution and require postponed alloHCT. The transplantation field has evolved, becoming safer and more accessible. Upfront alloHCT from unrelated donors is becoming a tempting option. With the use of posttransplant cyclophosphamide, haploidentical HCT offers promising outcomes also in AA. In this paper, we present the state of the art in the management of severe AA for pediatric and adult patients based on the available guidelines and recently published studies.
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Affiliation(s)
- Agnieszka Piekarska
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Pawelec
- Department of Oncology, Pediatric Hematology, Clinical Transplantology and Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | | | - Marek Ussowicz
- Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Wroclaw, Poland
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Missontsa MM, Bernaudin F, Fortin A, Dhédin N, Pondarré C, Yakouben K, Neven B, Castelle M, Cavazzana M, Lezeau H, Peycelon M, Paye-Jaouen A, Sroussi J, Diesch-Furlanetto T, Barraud-Lange V, Sarnacki S, Fahd M, Marchand I, Delcour C, Vexiau D, Arlet JB, Kamdem A, Arnaud C, Dalle JH, Poirot C. Ovarian tissue cryopreservation for fertility preservation before hematopoietic stem cell transplantation in patients with sickle cell disease: safety, ovarian function follow-up, and results of ovarian tissue transplantation. J Assist Reprod Genet 2024; 41:1027-1034. [PMID: 38358434 PMCID: PMC11052959 DOI: 10.1007/s10815-024-03054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
PURPOSE To describe the experience of performing ovarian tissue cryopreservation (OTC) before hematopoietic stem cell transplantation (HSCT), among girls/women with severe sickle cell disease (SCD)(SS or S/β0-thalassemia) who are, besides the usual surgical risk, at risk of SCD-related complications during the fertility preservation procedure for improving their counseling and management. METHODS This retrospective study included 75 patients (girls/women) with SCD who have had OTC before myeloablative conditioning regimen (MAC) for HSCT. Characteristics of patients and data on OTC, ovarian status follow-up, and results of ovarian tissue transplantation (OTT) were collected in medical records. RESULTS At OTC, the median (IQR 25-75; range) age of the patients was 9.6 (6.9-14.1; 3.6-28.3) years, 56/75 were prepubertal, and no SCD or surgery-related complications occurred. The median follow-up post-HSCT was > 9 years. At the last follow-up, among prepubertal patients at HSCT, 26/56 were ≥ 15 years old and presented with a premature ovarian insufficiency (POI), except 2, including the patient who had received an OTT to induce puberty. Eight were 13-15 years old and presented for POI. The remaining 22 patients were under 13. Among the 19 patients who were menarche at HSCT, 2 died 6 months post-HSCT and we do not have ovarian function follow-up for the other 2 patients. All the remaining patients (n = 15) had POI. Five patients had OTT. All had a return of ovarian function. One patient gave birth to a healthy baby. CONCLUSION OTC is a safe fertility preservation technique and could be offered before MAC independent of the patient's age.
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Affiliation(s)
- Mitawa Millin Missontsa
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, APHP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France
- Clinique Ngaliema Fertility Center, 42 Avenue Pumbu, Gombe, Kinshasa, Congo
| | - Françoise Bernaudin
- Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, 94000, Creteil, France
| | - Anne Fortin
- Department of Obstetrics Gynecology, APHP, Pitié-Salpêtrière-Charles Foix University Hospital, 75013, Paris, France
| | - Nathalie Dhédin
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, APHP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Corinne Pondarré
- Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, 94000, Creteil, France
- University Paris XII, Inserm U 955, 94000, Creteil, France
| | - Karima Yakouben
- Department of Pediatric Immunology and Hematology, APHP, University Paris Cité, Robert Debré Hospital, 75019, Paris, France
| | - Bénédicte Neven
- Department of Immuno-Hematology and Pediatric Rheumatology, APHP Center, University Paris Cité, Necker-Enfants Malades Hospital, 75015, Paris, France
- University Paris Cité, 75010, Paris, France
| | - Martin Castelle
- Department of Immuno-Hematology and Pediatric Rheumatology, APHP Center, University Paris Cité, Necker-Enfants Malades Hospital, 75015, Paris, France
| | - Marina Cavazzana
- University Paris Cité, 75010, Paris, France
- Department of Biotherapy, Necker-Enfants Malades Hospital, 75015, Paris, France
| | - Harry Lezeau
- Department of Visceral, Urological and Traumatological Surgery, Intercommunal Hospital of Créteil, 9400, Creteil, France
| | - Matthieu Peycelon
- Department of Pediatric Surgery and Urology, Centre de Référence Des Malformations Rares Des Voies Urinaires (MARVU), ERN eUROGEN Accredited Center, APHP North-Université Paris Cité, Robert-Debré University Hospital, Inserm UMR, 1141 NeuroDev, 75019, Paris, France
| | - Annabel Paye-Jaouen
- Department of Pediatric Surgery and Urology, Centre de Référence Des Malformations Rares Des Voies Urinaires (MARVU), ERN eUROGEN Accredited Center, APHP North-Université Paris Cité, Robert-Debré University Hospital, Inserm UMR, 1141 NeuroDev, 75019, Paris, France
| | - Jeremy Sroussi
- Department of Obstetrics Gynecology, APHP, University Paris Cité, Lariboisière Hospital, 75010, Paris, France
| | - Tamara Diesch-Furlanetto
- Division of Pediatric Oncology/Hematology, University Children's Hospital of Basel, UKBB, Basel, Switzerland
| | - Virginie Barraud-Lange
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, APHP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France
- Department of Reproductive Biology, APHP Center, University Paris Cité, Cochin Hospital, 75014, Paris, France
| | - Sabine Sarnacki
- University Paris Cité, 75010, Paris, France
- Department of Visceral and Urological Pediatric Surgery, APHP Center, University Paris Cité, Necker Hospital, 75015, Paris, France
| | - Mony Fahd
- Department of Pediatric Immunology and Hematology, APHP, University Paris Cité, Robert Debré Hospital, 75019, Paris, France
| | - Isis Marchand
- Department of Endocrinology, Intercommunal Hospital of Créteil, 94000, Creteil, France
| | - Clémence Delcour
- Department of Obstetrics Gynecology, APHP, University Paris Cité, Robert Debré Hospital, 75019, Paris, France
| | - Dominique Vexiau
- Department of Gynecology, APHP, University Paris Cité, Saint-Louis Hospital, 75010, Paris, France
| | - Jean-Benoît Arlet
- Department of Internal Medicine and French Sickle Cell Disease Referral Center, APHP, University Paris Cité, Georges-Pompidou European Hospital, 75015, Paris, France
| | - Annie Kamdem
- Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, 94000, Creteil, France
| | - Cécile Arnaud
- Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, 94000, Creteil, France
| | - Jean-Hugues Dalle
- Department of Pediatric Immunology and Hematology, APHP, University Paris Cité, Robert Debré Hospital, 75019, Paris, France
- University Paris Cité, 75010, Paris, France
| | - Catherine Poirot
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, APHP, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France.
- Médecine Sorbonne University, 75005, Paris, France.
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Lacroix I. Adverse drug reactions on male fertility. Therapie 2024; 79:199-203. [PMID: 37973492 DOI: 10.1016/j.therap.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/21/2023] [Indexed: 11/19/2023]
Abstract
For several years, fertility disorders have been on the increase worldwide. These disorders affect both sexes, but are more pronounced in men; and in half of cases the etiology is unknown. The role of drugs in male infertility has been little studied to date. Most of the available data comes from experimental animal studies, with all their limitations. With the exception of a few drugs, such as certain anticancer agents, human data are rare. This article describes the mainly drugs known to have deleterious effects on male fertility, the mechanisms leading to these effects and methods used to assess the risk of drug-induced male infertility. It underlines the need for further work in experimental research, clinical trials and post-marketing surveillance to improve our knowledge of drugs that induce male infertility. Although these adverse effects are not life-threatening, they can have a significant impact on patients' lives.
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Affiliation(s)
- Isabelle Lacroix
- "Drugs, Pregnancy and Breast-Feeding" Unit, Department of Medical and Clinical Pharmacology, Regional Centre for Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre (CRPV), Toulouse University Hospital, Faculty of Medicine, INSERM 1295 CERPOP, 31000 Toulouse, France.
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5
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Duffin K, Neuhaus N, Andersen CY, Barraud-Lange V, Braye A, Eguizabal C, Feraille A, Ginsberg JP, Gook D, Goossens E, Jahnukainen K, Jayasinghe Y, Keros V, Kliesch S, Lane S, Mulder CL, Orwig KE, van Pelt AMM, Poirot C, Rimmer MP, Rives N, Sadri-Ardekani H, Safrai M, Schlatt S, Stukenborg JB, van de Wetering MD, Wyns C, Mitchell RT. A 20-year overview of fertility preservation in boys: new insights gained through a comprehensive international survey. Hum Reprod Open 2024; 2024:hoae010. [PMID: 38449521 PMCID: PMC10914450 DOI: 10.1093/hropen/hoae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
STUDY QUESTION Twenty years after the inception of the first fertility preservation programme for pre-pubertal boys, what are the current international practices with regard to cryopreservation of immature testicular tissue? SUMMARY ANSWER Worldwide, testicular tissue has been cryopreserved from over 3000 boys under the age of 18 years for a variety of malignant and non-malignant indications; there is variability in practices related to eligibility, clinical assessment, storage, and funding. WHAT IS KNOWN ALREADY For male patients receiving gonadotoxic treatment prior to puberty, testicular tissue cryopreservation may provide a method of fertility preservation. While this technique remains experimental, an increasing number of centres worldwide are cryopreserving immature testicular tissue and are approaching clinical application of methods to use this stored tissue to restore fertility. As such, standards for quality assurance and clinical care in preserving immature testicular tissue should be established. STUDY DESIGN SIZE DURATION A detailed survey was sent to 17 centres within the recently established ORCHID-NET consortium, which offer testicular tissue cryopreservation to patients under the age of 18 years. The study encompassed 60 questions and remained open from 1 July to 1 November 2022. PARTICIPANTS/MATERIALS SETTING METHODS Of the 17 invited centres, 16 completed the survey, with representation from Europe, Australia, and the USA. Collectively, these centres have cryopreserved testicular tissue from patients under the age of 18 years. Data are presented using descriptive analysis. MAIN RESULTS AND THE ROLE OF CHANCE Since the establishment of the first formal fertility preservation programme for pre-pubertal males in 2002, these 16 centres have cryopreserved tissue from 3118 patients under the age of 18 years, with both malignant (60.4%) and non-malignant (39.6%) diagnoses. All centres perform unilateral biopsies, while 6/16 sometimes perform bilateral biopsies. When cryopreserving tissue, 9/16 centres preserve fragments sized ≤5 mm3 with the remainder preserving fragments sized 6-20 mm3. Dimethylsulphoxide is commonly used as a cryoprotectant, with medium supplements varying across centres. There are variations in funding source, storage duration, and follow-up practice. Research, with consent, is conducted on stored tissue in 13/16 centres. LIMITATIONS REASONS FOR CAUTION While this is a multi-national study, it will not encompass every centre worldwide that is cryopreserving testicular tissue from males under 18 years of age. As such, it is likely that the actual number of patients is even higher than we report. Whilst the study is likely to reflect global practice overall, it will not provide a complete picture of practices in every centre. WIDER IMPLICATIONS OF THE FINDINGS Given the research advances, it is reasonable to suggest that cryopreserved immature testicular tissue will in the future be used clinically to restore fertility. The growing number of patients undergoing this procedure necessitates collaboration between centres to better harmonize clinical and research protocols evaluating tissue function and clinical outcomes in these patients. STUDY FUNDING/COMPETING INTERESTS K.D. is supported by a CRUK grant (C157/A25193). R.T.M. is supported by an UK Research and Innovation (UKRI) Future Leaders Fellowship (MR/S017151/1). The MRC Centre for Reproductive Health at the University of Edinburgh is supported by MRC (MR/N022556/1). C.L.M. is funded by Kika86 and ZonMW TAS 116003002. A.M.M.v.P. is supported by ZonMW TAS 116003002. E.G. was supported by the Research Program of the Research Foundation-Flanders (G.0109.18N), Kom op tegen Kanker, the Strategic Research Program (VUB_SRP89), and the Scientific Fund Willy Gepts. J.-B.S. is supported by the Swedish Childhood Cancer Foundation (TJ2020-0026). The work of NORDFERTIL is supported by the Swedish Childhood Cancer Foundation (PR2019-0123; PR2022-0115), the Swedish Research Council (2018-03094; 2021-02107), and the Birgitta and Carl-Axel Rydbeck's Research Grant for Paediatric Research (2020-00348; 2021-00073; 2022-00317; 2023-00353). C.E is supported by the Health Department of the Basque Government (Grants 2019111068 and 2022111067) and Inocente Inocente Foundation (FII22/001). M.P.R. is funded by a Medical Research Council Centre for Reproductive Health Grant No: MR/N022556/1. A.F. and N.R. received support from a French national research grant PHRC No. 2008/071/HP obtained by the French Institute of Cancer and the French Healthcare Organization. K.E.O. is funded by the University of Pittsburgh Medical Center and the US National Institutes of Health HD100197. V.B-L is supported by the French National Institute of Cancer (Grant Seq21-026). Y.J. is supported by the Royal Children's Hospital Foundation and a Medical Research Future Fund MRFAR000308. E.G., N.N., S.S., C.L.M., A.M.M.v.P., C.E., R.T.M., K.D., M.P.R. are members of COST Action CA20119 (ANDRONET) supported by COST (European Cooperation in Science and Technology). The Danish Child Cancer Foundation is also thanked for financial support (C.Y.A.). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Kathleen Duffin
- Department of Biomedical Sciences, University of Edinburgh, Edinburgh, UK
| | - Nina Neuhaus
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, University Hospital of Copenhagen & Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Virginie Barraud-Lange
- Department of Reproductive Biology CECOS, AP-HP Centre—University of Paris Cité, Cochin Hospital, Paris, France
- AYA Unit, Fertility Preservation Consultation, Haematology Department, AP-HP Nord, University of Paris Cité, Saint-Louis Hospital, Paris, France
| | - Aude Braye
- Department of Genetics, Reproduction and Development (GRAD), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Cristina Eguizabal
- Cell Therapy, Stem Cells and Tissues Group, Basque Center for Blood Transfusion and Human Tissues, Bizkaia, Spain
- Biocruces Bizkaia Health Research Institute, Bizkaia, Spain
| | - Aurélie Feraille
- NorDIC, Team “Adrenal and Gonadal Pathophysiology”, Biology of Reproduction-CECOS Laboratory, Rouen University Hospital, Université de Rouen Normandie, Rouen, France
| | - Jill P Ginsberg
- Division of Oncology, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Debra Gook
- Reproductive Services/Melbourne IVF, The Royal Women’s Hospital, Parkville, VIC, Australia
- Department of Obstetrics and Gynaecology, Royal Women’s Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Ellen Goossens
- Department of Genetics, Reproduction and Development (GRAD), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kirsi Jahnukainen
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, NORDFERTIL Research Lab Stockholm, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
- Division of Haematology-Oncology and Stem Cell Transplantation, New Children’s Hospital, Pediatric Research Center, Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Yasmin Jayasinghe
- Department of Obstetrics and Gynaecology, Royal Women’s Hospital, University of Melbourne, Parkville, VIC, Australia
- Oncofertility Program, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Victoria Keros
- Division of Gynecology and Reproduction, Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Division of Urology, Department of Clinical Science, Intervention and Technology—CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Sabine Kliesch
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - Sheila Lane
- Department of Paediatric Oncology and Haematology, Children’s Hospital Oxford, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Callista L Mulder
- Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Kyle E Orwig
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ans M M van Pelt
- Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Catherine Poirot
- Fertility Preservation Consultation, Haematology Department, AYA Unit, Saint Louis Hospital, AP-HP Médecine Sorbonne Université, Paris, France
- Department of Reproductive Biology, Cochin Hospital, Paris, France
| | - Michael P Rimmer
- MRC Centre for Reproductive Health, Institute of Regeneration and Repair, University of Edinburgh, Edinburgh, UK
| | - Nathalie Rives
- NorDIC, Team “Adrenal and Gonadal Pathophysiology”, Biology of Reproduction-CECOS Laboratory, Rouen University Hospital, Université de Rouen Normandie, Rouen, France
| | - Hooman Sadri-Ardekani
- Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Myriam Safrai
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Sackler Faculty of Medicine, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Tel Aviv University, Tel Aviv, Israel
| | - Stefan Schlatt
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - Jan-Bernd Stukenborg
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, NORDFERTIL Research Lab Stockholm, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
| | | | - Christine Wyns
- Department of Gynecology and Andrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, Institute of Regeneration and Repair, University of Edinburgh, Edinburgh, UK
- Royal Hospital for Children and Young People, Edinburgh, UK
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Decanter C, Elefant E, Poirot C, Courbiere B. What reproductive follow-up for adolescent and young women after cancer? A review. Reprod Biomed Online 2024; 49:103891. [PMID: 38761433 DOI: 10.1016/j.rbmo.2024.103891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/02/2024] [Accepted: 02/09/2024] [Indexed: 05/20/2024]
Abstract
Fertility capacity has been shown to be one of the main concerns of young cancer survivors. Gonadotoxic treatments may lead to both premature ovarian failure and/or infertility. This review aimed to define which, and when, reproductive indicators should be followed-up to help doctors to counsel patients regarding their fertility and ovarian function, and to determine if a second stage of fertility preservation after the end of cancer treatment is clinically relevant. Longitudinal assessment of anti-Müllerian hormone (AMH) concentrations during cancer treatment indicates the degree of follicular depletion, and allows discrimination between low and high gonadotoxic treatments. Sustained low AMH concentrations after treatment, especially in the case of alkylating protocols, may reduce the duration of the conception window significantly, and expose the patient to the risk of premature ovarian failure. It remains unknown whether this may impact further fertility capacity because of the lack of systematic follow-up of adolescent and young adult (AYA) women after chemo-radiotherapy. It appears that dedicated reproductive follow-up of AYA women under cancer treatment is needed to refine fertility preservation strategies, and to determine if low AMH concentrations after treatment impact the chance of pregnancy in this specific survivor population.
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Affiliation(s)
- C Decanter
- CHU Lille, ART and Fertility Preservation Department, Lille, France; ONCOLille Cancer Institute, Lille, France.
| | - E Elefant
- Reference Centre for Teratogenic Agents, Hospital Armand Trousseau, Paris, France; Faculty of Medicine, Sorbonne University, Paris, France
| | - C Poirot
- Department of Haematology, Adolescents and Young Adults, Fertility Preservation, Assistance Publique des Hôpitaux de Paris, Saint Louis Hospital, Paris, France; Medecine Sorbonne University, Paris, France
| | - B Courbiere
- Department of Gynaecology-Obstetric and Reproductive Medicine-Fertility Preservation, AP-HM, Hôpital La Conception, Marseille, France; Aix-Marseille Université, Avignon Université, Avignon, France
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7
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Taniskidou AM, Voultsos P, Tarlatzis V, Timotheadou E. Perceptions and experiences of fertility preservation in female patients with cancer in Greece. BMC Womens Health 2024; 24:108. [PMID: 38336757 PMCID: PMC10858603 DOI: 10.1186/s12905-024-02955-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/06/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND As advances in oncology have led to remarkable and steady improvements in the survival rates of patients with cancer and anticancer treatment can cause premature ovarian failure in women, fertility preservation (FP) has become a global public health concern and an integral part of the care for women diagnosed with cancer during reproductive age. However, for various reasons, FP remains underutilized for patients with cancer. There are substantial gaps in our knowledge about women's experiences and perceptions of the issue. This study aims to contribute to bridging that gap. METHODS This prospective qualitative study was conducted from March 2018 to February 2023. A combination of purposive and snowball sampling was used. Data were collected by semistructured interviews with nineteen reproductive-age women who had been recently diagnosed with cancer. Data were classified and analysed with a thematic analysis approach. RESULTS A variety of distinct themes and subthemes emerged from the analysis of the interview data. The cancer diagnosis emerged as a factor that considerably affects the women's attitudes towards biological parenthood: It can further increase their (strong) previous desire or decrease their previous (weak) desire. Women with a recent cancer diagnosis had not received adequate and multidisciplinary counselling, including clear and sufficient information. However, participants felt satisfied with the information they received because they either received the information they requested or remained in denial about the need to be informed (i.e., because they felt overwhelmed after the cancer diagnosis). Embryo cryopreservation emerged as a less desirable FP option for women with cancer. Participants showed respect for human embryos, not always for religious reasons. Surrogacy emerged as the last resort for most participants. Religious, social or financial factors did play a secondary (if any) role in women's decision-making about FP. Finally, male partners' opinions played a secondary role in most participants' decision-making about FP. If embryo cryopreservation was the selected option, partners would have a say because they were contributing their genetic material. CONCLUSIONS The findings that emerged from the data analysis were partly consistent with prior studies. However, we identified some interesting nuances that are of clinical importance. The results of this study may serve as a starting point for future research.
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Affiliation(s)
- Anna-Maria Taniskidou
- Laboratory of Forensic Medicine & Toxicology (Division: Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR, 54124, Greece
| | - Polychronis Voultsos
- Laboratory of Forensic Medicine & Toxicology (Division: Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR, 54124, Greece.
| | - Vasileios Tarlatzis
- 1st Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR, 54124, Greece
| | - Eleni Timotheadou
- Department of Medical Oncology, School of Medicine, Faculty of Health Sciences, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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8
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Sarian G, Chalas C, Le Teuff G, Fayech C, Dumas A, Demoor-Goldschmidt C, Fresneau B. Post-treatment sperm cryopreservation practices in childhood and young adult cancer survivors. Reprod Biomed Online 2024; 48:103573. [PMID: 38113762 DOI: 10.1016/j.rbmo.2023.103573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/17/2023] [Accepted: 09/25/2023] [Indexed: 12/21/2023]
Abstract
RESEARCH QUESTION What are current practices of post-treatment fertility preservation in male childhood cancer survivors (CCS) who have not benefitted from pre-therapeutic fertility preservation in France and other European countries? DESIGN A survey was conducted of all fertility preservation centres in France (n = 30) and European fertility specialists (n = 9) in five European countries. Eight clinical cases and 40 questions were included to assess the effect of age at diagnosis, type of treatment (alkylating-agents, orchidectomy, testicular radiotherapy) and sperm parameters on the probability of a post-treatment fertility preservation proposal. Demographic characteristics of the responding practitioner were also collected. RESULTS Post-treatment sperm cryopreservation was proposed by 100% of fertility specialists in cases of severe oligoasthenoteratozoospermia, 77-88% in cases of moderate oligoasthenoteratozoospermia and in 65-77% in cases of sperm motility and vitality impairment. In cases of normal sperm parameters, 27-54% of fertility specialists would propose post-treatment sperm cryopreservation. These results did not differ significantly according to the type of treatment received or to responder-related factors. Practices of European specialists were also guided by sperm parameter results; 44-67% of specialists responding that they would propose sperm cryopreservation in cases of moderate to severe sperm parameter alterations. CONCLUSION Post-treatment semen analysis could be widely proposed to CCS who have not benefitted from pre-therapeutic fertility preservation. Post-treatment fertility preservation could be proposed in cases of persistent moderate to severe sperm parameter alterations. Guidelines would be important to homogenize practices and to encourage oncologists to refer CCS for fertility assessments.
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Affiliation(s)
| | - Céline Chalas
- Hospital Cochin, University of Paris-Cite, Department of Reproductive Biology-CECOS, Paris, France; Fédération française des CECOS, Toulouse, France
| | - Gwénaël Le Teuff
- Gustave Roussy, Paris-Saclay University, Department of Biostatistics and Epidemiology, Villejuif, F-94805, France
| | - Chiraz Fayech
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France
| | - Agnès Dumas
- University of Paris-Cite, ECEVE UMR 1123, F-75010 Paris, France; Inserm, Center for Research in Epidemiology and Public Health, U 1018, Epidemiology of Radiation, Villejuif, France
| | - Charlotte Demoor-Goldschmidt
- Inserm, Center for Research in Epidemiology and Public Health, U 1018, Epidemiology of Radiation, Villejuif, France; University Hospital of Angers, Department of Pediatric Oncology and Hematology, Angers, France; Centre François Baclesse, Department of Radiotherapy and Protontherapy, Caen, France; Centre François Baclesse, Department of Supportive Care, Caen, France
| | - Brice Fresneau
- Gustave Roussy, Paris-Saclay University, Department of Children and Adolescents Oncology, Villejuif, F-94805, France; Inserm, Center for Research in Epidemiology and Public Health, U 1018, Epidemiology of Radiation, Villejuif, France.
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9
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Barraud-Lange V, Boissel N, Gille AS, Jean C, Sitbon L, Schubert B, Yakouben K, Fahd M, Peycelon M, Paye-Jaouen A, Chalas C, Vanhaesebrouck A, Doz F, Surun A, Lemelle L, Sarnacki S, Neven B, Philippe-Chomette P, Dufour C, Rigaud C, Leverger G, Tabone MD, Irtan S, Pondarée C, Lezeau H, Lenaour G, Sibony M, Comperat E, Brocheriou I, Wolf JP, Dalle JH, Poirot C. A 10-year experience in testicular tissue cryopreservation for boys under 18 years of age: What can be learned from 350 cases? Andrology 2024; 12:385-395. [PMID: 37418281 DOI: 10.1111/andr.13493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND A growing number of centers worldwide are preserving testicular tissue (TT) of young boys at risk of fertility loss to preserve their fertility. Data in this regard are scarce and experience sharing is essential to the optimization of the process. OBJECTIVES This report of our 10-year activity of pediatric fertility preservation (FP) has the objective to (1) improve knowledge regarding the feasibility, acceptability, safety, and potential usefulness of the procedure; (2) analyze the impact of chemotherapy on spermatogonia in the cryopreserved TT. MATERIALS AND METHODS For this retrospective study of data prospectively recorded, we included all boys under 18 years of age referred to the FP consultation of our academic network between October 2009 and December 2019. Characteristics of patients and cryopreservation of testicular tissue (CTT) were extracted from the clinical database. Univariate and multivariate analyses were used to assess factors associated with the risk of absence of spermatogonia in the TT. RESULTS Three hundred and sixty-nine patients (7.2 years; 0.5-17.0) were referred to the FP consultation for malignant (70%) or non-malignant (30%) disease, of whom 88% were candidates for CTT, after a previous chemotherapy exposure (78%). The rate of recorded immediate adverse events was 3.5%, with painful episodes dominating. Spermatogonia were detected in the majority of TTs: 91.1% of those exposed to chemotherapy and 92.3% of those not exposed (p = 0.962). In multivariate analysis, the risk of absence of spermatogonia was almost three-fold higher in boys > 10 years of age ([OR] 2.74, 95% CI 1.09-7.26, p = 0.035) and four-fold higher in boys exposed to alkylating agents prior to CTT ([OR] 4.09, 95% CI 1.32-17.94, p = 0.028). DISCUSSION/CONCLUSION This large series of pediatric FP shows that this procedure is well accepted, feasible, and safe in the short term, strengthening its place in the clinical care pathway of young patients requiring a highly gonadotoxic treatment. Our results demonstrate that CTT post-chemotherapy does not impair the chance to preserve spermatogonia in the TT except when the treatment includes alkylating agents. More data on post-CTT follow-up are still required to ensure the long-term safety and usefulness of the procedure.
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Affiliation(s)
- Virginie Barraud-Lange
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Nicolas Boissel
- Université Paris Cité, Paris, France
- Department of Hematology, Adolescents and Young Adults Unit, AP-HP. North-Université Paris Cité. Saint-Louis Hospital, Paris, France
| | - Anne-Sophie Gille
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Camille Jean
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Leslie Sitbon
- Biomega-Bioclinic, Department Intercommunal Hospital of Créteil, Assisted Reproductive Biology, Créteil, France
| | - Benoit Schubert
- Eurofins Biomnis Laboratory, Institut Rhonalpin IVF Center, Clinique du Val d'Ouest, Ecully, France
| | - Karima Yakouben
- Department of Pediatric Immunology and Hematology, APHP. North-Université Paris Cité. Robert Debré Hospital, Paris, France
| | - Mony Fahd
- Department of Pediatric Immunology and Hematology, APHP. North-Université Paris Cité. Robert Debré Hospital, Paris, France
| | - Matthieu Peycelon
- Université Paris Cité, Paris, France
- Department of Pediatric Surgery and Urology, Centre de Référence des Malformations Rares des Voies Urinaires (MARVU), Inserm UMR 1141 NeuroDev, APHP. North-Université Paris Cité. Robert-Debré Hospital, Paris, France
| | - Annabel Paye-Jaouen
- Department of Pediatric Surgery and Urology, Centre de Référence des Malformations Rares des Voies Urinaires (MARVU), Inserm UMR 1141 NeuroDev, APHP. North-Université Paris Cité. Robert-Debré Hospital, Paris, France
| | - Céline Chalas
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Alexis Vanhaesebrouck
- Interdisciplinary Research Institute on Social issues (IRIS), UMR 8156-997, Sorbonne Paris North University, Aubervilliers, France
- Department of Legal and Social Medicine, AP-HP, Jean-Verdier Hospital, Bondy, France
- Department of Social Epidemiology, Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - François Doz
- Université Paris Cité, Paris, France
- Curie Institute, SIREDO Center (Care, Innovation, Research in Pediatric, Adolescent and Young Adult Oncology, Paris, France
| | - Aurore Surun
- Curie Institute, SIREDO Center (Care, Innovation, Research in Pediatric, Adolescent and Young Adult Oncology, Paris, France
| | - Lauriane Lemelle
- Curie Institute, SIREDO Center (Care, Innovation, Research in Pediatric, Adolescent and Young Adult Oncology, Paris, France
| | - Sabine Sarnacki
- Université Paris Cité, Paris, France
- Department of Visceral and Urological Pediatric Surgery, AP-HP. Center-Université Paris Cité. Necker Hospital, Paris, France
| | - Bénédicte Neven
- Université Paris Cité, Paris, France
- Department of Immuno-Hematology and Pediatric Rheumatology, APHP. Center-Université Paris Cité. Necker-Enfant Malades Hospital, Paris, France
| | | | - Christelle Dufour
- Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France
| | - Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Institute, Villejuif, France
| | - Guy Leverger
- Sorbonne University, Paris, France
- Department of Pediatric Onco-Hematology, AP-HP. Sorbonne University. Armand Trousseau Hospital, Paris, France
| | - Marie-Dominique Tabone
- Department of Pediatric Onco-Hematology, AP-HP. Sorbonne University. Armand Trousseau Hospital, Paris, France
| | - Sabine Irtan
- Sorbonne University, Paris, France
- Department of Pediatric Surgery, AP-HP. Sorbonne University. Armand Trousseau Hospital, Paris, France
| | - Corinne Pondarée
- Pediatric Department Sickle Cell Referral Center, Intercommunal Hospital of Créteil, Créteil, France
- University Paris XII, INSERM U 955, Créteil, France
| | - Harry Lezeau
- Department of Visceral, Urological and Traumatological Surgery, Intercommunal Hospital of Créteil, Créteil, France
| | | | - Mathilde Sibony
- Université Paris Cité, Paris, France
- Department of Pathology, AP-HP. Center-Université Paris Cité. Cochin Hospital, Paris, France
| | - Eva Comperat
- Sorbonne University, Paris, France
- Department of Pathology, AP-HP. Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Isabelle Brocheriou
- Sorbonne University, Paris, France
- Department of Pathology, AP-HP. Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Jean Philippe Wolf
- Université Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
| | - Jean-Hugue Dalle
- Université Paris Cité, Paris, France
- Department of Pediatric Immunology and Hematology, APHP. North-Université Paris Cité. Robert Debré Hospital, Paris, France
| | - Catherine Poirot
- Department of Reproductive Biology CECOS, AP-HP. Center-Université Paris Cite. Cochin Hospital, Paris, France
- Department of Hematology, Adolescents and Young Adults Unit, AP-HP. North-Université Paris Cité. Saint-Louis Hospital, Paris, France
- Sorbonne University, Paris, France
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10
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Malo C, Oliván S, Ochoa I, Shikanov A. In Vitro Growth of Human Follicles: Current and Future Perspectives. Int J Mol Sci 2024; 25:1510. [PMID: 38338788 PMCID: PMC10855051 DOI: 10.3390/ijms25031510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Ovarian tissue cryopreservation is gaining importance as a successful method to restore fertility to girls and young women at high risk of sterility. However, there are concerns regarding the safety of transplantation after ovarian tissue cryopreservation due to the high risk of reintroducing cancer cells and causing disease recurrence. In these cases, the development of culture systems that support oocyte development from the primordial follicle stage is required. Notable achievements have been reached in human follicle in vitro growth in the past decade. Currently, systems for the in vitro culture of ovarian tissue are based on two-dimensional substrates that do not support the survival of follicles or recapitulate the mechanical heterogenicity in the mammalian ovary. Recognition of the importance of special arrangements between cells has spurred research in three-dimensional culture systems, and the provision of a precise culture system that maximizes the diffusion of nutrients and gases through the follicles has raised interest in advanced biomimetic models. The current review critically examines various culture systems employed for the in vitro development of follicles, with a particular focus on solutions utilizing Organ-on-a-Chip (OOC) technology. The emphasis on OOC technology underscores its role as a promising avenue in ensuring the successful cultivation and maintenance of follicular structures during the culture period.
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Affiliation(s)
- Clara Malo
- Tissue Microenvironment (TME) Lab, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain; (S.O.); (I.O.)
- Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Sara Oliván
- Tissue Microenvironment (TME) Lab, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain; (S.O.); (I.O.)
- Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Ignacio Ochoa
- Tissue Microenvironment (TME) Lab, Aragón Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain; (S.O.); (I.O.)
- Institute for Health Research Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 50018 Zaragoza, Spain
| | - Ariella Shikanov
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA;
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
- Cellular and Molecular Biology Program, University of Michigan, Ann Arbor, MI 48109, USA
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11
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Ruan X. Chinese Expert Consensus on ovarian function and fertility preservation of cervical cancer in pregnancy (2023). Front Endocrinol (Lausanne) 2023; 14:1280631. [PMID: 38152134 PMCID: PMC10751331 DOI: 10.3389/fendo.2023.1280631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/08/2023] [Indexed: 12/29/2023] Open
Abstract
Cervical cancer in pregnancy (CCIP) refers to cervical cancer diagnosed during pregnancy, the most common gynecological malignant tumor. Because of the special physiological changes of CCIP, although preserving ovarian function and fertility is very important, the methods are very limited. There is no guideline or consensus on the preservation methods of ovarian function and fertility in this special period. Therefore, the Committee of Fertility Protection and Preservation of China Association for the Promotion of Health Science and Technology, combined with the Chinese Society of Gynecological Endocrinology affiliated to the International Society of Gynecological Endocrinology, Society Endocrinology Branch of Beijing Institute of Obstetrics & Gynecology, combined with Society on Fertility Preservation affiliated with the Chinese Preventive Medicine Association, organized relevant experts from different disciplines to formulate this consensus, in order to guide ovarian function and fertility preservation of CCIP patients.
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Affiliation(s)
- Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women’s Health, University of Tuebingen, University Women’s Hospital and Research Centre for Women’s Health, Tuebingen, Germany
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12
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Prades S, Jos SL, Saïas-Magnan J, Bujan L, Eustache F, Blagosklonov O, Lechevallier E, Brugnon F, Loup-Cabaniols V, Bosquet D, Prades M, Ducrocq B, Chalas C, Giscard-d'Estaing S, Mayeur A, Koscinsky I, Schmitt F, Papaxanthos-Roche A, Teletin M, Thibault E, Beauvillard D, Mirallie S, Delepine B, Benhaim A, May-Panloup P, Veau S, Frapsauce C, Fauque P, Costello R, Rives N, Metzler-Guillemain C, Perrin J. Efficient pathway for men fertility preservation in testicular cancer or lymphoma: a cross-sectional study of national 2018 data. Basic Clin Androl 2023; 33:35. [PMID: 38082221 PMCID: PMC10714657 DOI: 10.1186/s12610-023-00209-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In 15-49 years-old men, the main cancers are testicular cancer (TC) and lymphomas (L): freezing of ejaculated sperm is primarily used for male fertility preservation (FP) before cancer treatment. Our objective was to analyze the French FP rate in 15-49 years-old men diagnosed with TC or L in 2018. We designed a national descriptive cross-sectional study of sperm banking rate in men with a diagnosis of TC, Hodgkin L (HL) or non-Hodgkin L (NHL). From the French National Cancer Institute (INCa) 2018 data, we extracted the estimated incidence of TC and L in metropolitan France. From the 2018 activity report of CECOS network (Centers for Study and Banking of Eggs and Sperm), we extracted the number of men with TC or L who banked ejaculated sperm. We estimated the proportion of 15-49 years-old men diagnosed with TC or L who banked sperm. RESULTS Among 15-49 years-old men, INCa estimated 38,048 new cancer diagnoses in metropolitan France in 2018: 2,630 TC and 3,913 L (943 HL and 2,970 NHL). The CECOS network provided data from 26/27 metropolitan centers (96% response rate): 1,079 sperm banking for men with TC, 375 for HL and 211 for NHL. We estimated that the 2018 sperm banking rate in France was 41% for TC, 40% for HL, and 7% for NHL. CONCLUSIONS To our knowledge, our paper is the first cross-sectional study with multicenter and national data analyzing FP rate in cancer men: it suggests an efficient pathway for men to FP before cancer treatment, compared to previously published studies. Although sperm banking rate in 15-49 years-old men could definitely be improved, further studies should evaluate the information given to patients before gonadotoxic treatments, the factors associated with the absence of sperm banking and whether this lack of referral induces a loss of chance for these men.
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Affiliation(s)
- Ségolène Prades
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
| | - Sarah-Lyne Jos
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
| | - Jacqueline Saïas-Magnan
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
| | - Louis Bujan
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM, Universités Montpellier Et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, 1202, Toulouse, France
| | - Florence Eustache
- CECOS, Site Jean Verdier, Hôpitaux Universitaires Paris Seine-Saint-Denis, Bondy, France
- Genomics, Epigenetics and Physiopathology of Reproduction, Institut Cochin, Inserm U1016, Paris, France
| | - Oxana Blagosklonov
- Service de Biologie Et Medecine de La Reproduction, Cryobiologie-CECOS, CHRU Jean Minjoz, Besançon, France
| | - Eric Lechevallier
- Service d'Urologie et Transplantation Rénale, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Florence Brugnon
- 1240 IMOST, INSERM, Clermont Ferrand, France
- Service AMP CECOS, CHU Clermont Ferrand, Clermont Ferrand, France
| | - Vanessa Loup-Cabaniols
- CECOS Languedoc Roussillon, MONTPELLIER Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Dorian Bosquet
- Service de Médecine Et Biologie de la Reproduction - CECOS-CHU Amiens Picardie - Site Sud, Amiens, France
| | - Marie Prades
- Service de Biologie de La Reproduction-CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, 75020, PARIS, France
| | - Bérengère Ducrocq
- Institut de Biologie de la Reproduction - CECOS Hôpital Calmette, CHU de Lille, Lille, France
| | - Céline Chalas
- Laboratoire de Biologie de la Reproduction-CECOS, Assistance Publique-Hôpitaux de Paris.Centre Université Paris-Cité, GHU Cochin, Paris, France
| | - Sandrine Giscard-d'Estaing
- Biologie de La Reproduction, U1208, Hospices Civil de Lyon, HFME, Inserm, Bron, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard, Oullins, France
| | - Anne Mayeur
- Reproductive Biology Department, CECOS, Paris-Saclay University, Antoine-Béclère Hospital, APHP, Clamart, France
| | - Isabelle Koscinsky
- NGERE (Nutrition Génétique Et Exposition Aux Risques Environnementaux) INSERM 1256 Université de Lorraine, 10 Avenue de La Forêt de Haye, 54505, Vandoeuvre Les Nancy, France
- Laboratoire de Biologie de La Reproduction, Hôpital Saint Joseph 26 Boulevard de Louvain, 13008, Marseille, France
| | - Françoise Schmitt
- CECOS ALSACE Mulhouse Groupe Hospitalier, de La Région de Mulhouse Et Sud Alsace, Mulhouse, France
| | | | - Marius Teletin
- Institut de Génétique Et de Biologie Moléculaire Et Cellulaire (IGBMC), Université́ de Strasbourg, France-LBDR-CECOS, Hôpitaux Universitaires de Strasbourg (HUS), , Strasbourg, France
| | - Emmanuelle Thibault
- Laboratoire de Biologie de la Reproduction - CECOS Hôpital L'Archet 2 - CHU de Nice, Nice, France
| | | | - Sophie Mirallie
- Service de Médecine Et Biologie de La Reproduction, CHU Nantes, France
| | - Béatrice Delepine
- Service de Biologie de La Reproduction Reims - Pôle de Biologie Médicale Et Pathologie, Reims, France
| | - Annie Benhaim
- Service de Biologie de La Reproduction Coordinatrice Clinico-Biologique du Centre d'AMP du CHU de Caen Pôle de Biologie-CHU, Caen, France
| | - Pascale May-Panloup
- Biologie de La Reproduction, Centre Hospitalier Universitaire & Univ Angers, INSERM, CNRS, MITOVASC, Equipe MitoLab, SFR ICAT, 49000, Angers, France
| | - Ségolène Veau
- Service de Biologie de La Reproduction-CECOS, CHU Rennes - Hôpital Sud, Rennes, France
| | - Cynthia Frapsauce
- Service de Médecine Et de Biologie de La Reproduction-CECOS, CHRU Bretonneau, Tours, France
| | - Patricia Fauque
- Burgundy University, INSERM 1231, Dijon, France
- Dijon University Hospital, Biology of Reproduction-CECOS Laboratory, Dijon, France
| | - Régis Costello
- Service d'Hématologie Et Thérapie Cellulaire, Hôpital La Conception, Assistance Publique Des Hôpitaux de Marseille, 147 Boulevard Baille, 13005, Marseille, France
| | - Nathalie Rives
- NorDiC UMR 1239, team "Adrenal and Gonadal Pathophysiology", Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm, Rouen University Hospital, Rouen, France
| | - Catherine Metzler-Guillemain
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France
- Aix Marseille Univ, INSERM, MMG, UMR_S1251, Marseille, France
| | - Jeanne Perrin
- CECOS/Laboratory of Reproductive Biology, La Conception University Hospital, 13385, Marseille, France.
- Aix Marseille Univ, Avignon Université, CNRS, IRD, IMBE, Marseille, France.
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Ortiz E, Peña CJ, Hidalgo JJ, Monllor-Tormos A, Zolfaroli I, Vila MJ, Sánchez-Serrano M, Pellicer A, Cano A. Long-term effect of chemotherapy after ovarian decortication on the ovarian function in women surviving cancer. J Assist Reprod Genet 2023; 40:2827-2834. [PMID: 37755614 PMCID: PMC10656377 DOI: 10.1007/s10815-023-02949-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/16/2023] [Indexed: 09/28/2023] Open
Abstract
PURPOSE Ovarian decortication may affect ovarian function. We investigated the status of ovarian reserve after ovarian decortication plus chemotherapy at a stage of presumed stabilized recovery in women surviving cancer. METHODS We searched our database for cancer survivors subjected to ovarian decortication and chemotherapy at least 3 years previously. Ovarian function was explored for levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2), and menstrual pattern. RESULTS Forty women (mean age 29.6 (SD, 6.1) years) were assessed at a mean of 4.7 (1.5) years after surgery. The predecortication levels of AMH and FSH changed at post-treatment from 2.2 (1.4) to 0.5 (1.3) ng/mL for AMH (p < 0.001) and from 4.7 (2.1) to 16.7 (21. 6) IU/L for FSH (p < 0.001). Amenorrhea consistent with primary ovarian insufficiency (POI) was diagnosed in 11 women, and normal ovarian reserve (AMH ≥ 1.0 ng/mL) was found in 4 of the 21 women who recovered regular cycles. Logistic regression confirmed AMH as an independent predictor of diminished ovarian reserve (OR = 0.24, 95% CI: 0.04-0.63, p = 0.025) and POI (OR = 0.11, 95% CI: 0.01-0.52, p = 0.027), and age was predictive of POI (OR = 1.36, 95% CI: 1.08-1.96, p = 0.035) and of irregular menstrual cycle (OR = 1.20, 95% CI: 1.03-1.46, p = 0.034). CONCLUSION Ovarian decortication plus chemotherapy had a deleterious effect when assessed at a stage of stabilized ovarian recovery, but whether ovarian decortication had a specific impact cannot be revealed from our data.
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Affiliation(s)
- Ester Ortiz
- Service of Obstetrics and Gynecology, University Hospital Dr Peset, Av Gaspar Aguilar 90, 46017, Valencia, Spain
| | - Carlos J Peña
- Bioinformatics and Biostatistics Unit, INCLIVA, Calle Menéndez Pelayo 4, 46010, Valencia, Spain
| | - Juan-José Hidalgo
- Department of Gynecologic Oncology, La Fe University and Polytechnic Hospital, Av Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Aitana Monllor-Tormos
- Service of Obstetrics and Gynecology, INCLIVA, Av Blasco Ibáñez 19, 46010, Valencia, Spain
| | - Irene Zolfaroli
- Department of Gynecologic Oncology, La Fe University and Polytechnic Hospital, Av Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - María-José Vila
- Service of Obstetrics and Gynecology, University Hospital Dr Peset, Av Gaspar Aguilar 90, 46017, Valencia, Spain
| | - María Sánchez-Serrano
- Service of Obstetrics and Gynecology, INCLIVA, Av Blasco Ibáñez 19, 46010, Valencia, Spain
| | - Antonio Pellicer
- IVI RMA Rome Rome Italy; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, INCLIVA, Av Blasco Ibáñez 15, 46010, Valencia, Spain.
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14
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Wnuk K, Świtalski J, Miazga W, Tatara T, Religioni U, Olszewski P, Augustynowicz A. The Usage of Cryopreserved Reproductive Material in Cancer Patients Undergoing Fertility Preservation Procedures. Cancers (Basel) 2023; 15:5348. [PMID: 38001608 PMCID: PMC10670543 DOI: 10.3390/cancers15225348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Many cancer treatment methods can affect fertility by damaging the reproductive organs and glands that control fertility. Changes can be temporary or permanent. In order to preserve the fertility of cancer patients and protect the genital organs against gonadotoxicity, methods of fertility preservation are increasingly used. Considering that some patients ultimately decide not to use cryopreserved reproductive material, this review analysed the percentage of post-cancer patients using cryopreserved reproductive material, collected before treatment as part of fertility preservation. METHODS A systematic search of studies was carried out in accordance with the Cochrane Collaboration guidelines, based on a previously prepared research protocol. The search was conducted in Medline (via PubMed), Embase (via OVID), and the Cochrane Library. In addition, a manual search was performed for recommendations/clinical practice guidelines regarding fertility preservation in cancer patients. RESULTS Twenty-six studies met the inclusion criteria. The studies included in the review discussed the results of cryopreservation of oocytes, embryos, ovarian tissue, and semen. In 10 studies, the usage rate of cryopreserved semen ranged from 2.6% to 21.5%. In the case of cryopreserved female reproductive material, the return/usage rate ranged from 3.1% to 8.7% for oocytes, approx. 9% to 22.4% for embryos, and 6.9% to 30.3% for ovarian tissue. In studies analysing patients' decisions about unused reproductive material, continuation of material storage was most often indicated. Recovering fertility or death of the patient were the main reasons for rejecting cryopreserved semen in the case of men. CONCLUSION Fertility preservation before gonadotoxic treatment is widely recommended and increasingly used in cancer patients. The usage rate is an important indicator for monitoring the efficacy of these methods. In all of the methods described in the literature, this indicator did not exceed 31%. It is necessary to create legal and organizational solutions regulating material collection and storage and to create clear paths for its usage in the future, including by other recipients.
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Affiliation(s)
- Katarzyna Wnuk
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032 Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01826 Warsaw, Poland
| | - Jakub Świtalski
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01445 Warsaw, Poland;
| | - Wojciech Miazga
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032 Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01826 Warsaw, Poland
| | - Tomasz Tatara
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00032 Warsaw, Poland
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02091 Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01826 Warsaw, Poland
| | | | - Anna Augustynowicz
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01445 Warsaw, Poland;
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15
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Feraille A, Liard A, Rives N, Bubenheim M, Barbotin AL, Giscard d'Estaing S, Mirallié S, Ancelle A, Roux C, Brugnon F, Daudin M, Schneider P, Dumont L, Rondanino C. Impact of low- or moderate-risk gonadotoxic chemotherapy prior to testicular tissue freezing on spermatogonia quantity in human (pre)pubertal testicular tissue. Hum Reprod 2023; 38:2105-2118. [PMID: 37674325 DOI: 10.1093/humrep/dead161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/20/2023] [Indexed: 09/08/2023] Open
Abstract
STUDY QUESTION What is the impact of low- or moderate-risk gonadotoxic chemotherapy received prior to testicular tissue freezing (TTF), and of the cancer itself, on spermatogonia quantity in testicular tissue from (pre)pubertal boys? SUMMARY ANSWER Vincristine, when associated with alkylating agents, has an additional adverse effect on spermatogonia quantity, while carboplatin has no individual contribution to spermatogonia quantity, in testicular tissue of (pre)pubertal boys, when compared to patients who have received non-alkylating chemotherapy. WHAT IS KNOWN ALREADY The improved survival rates after cancer treatment necessitate the inclusion of fertility preservation procedures as part of the comprehensive care for patients, taking into consideration their age. Sperm cryopreservation is an established procedure in post-pubertal males while the TTF proposed for (pre)pubertal boys remains experimental. Several studies exploring testicular tissue of (pre)pubertal boys after TTF have examined the tubular fertility index (TFI, percentage of seminiferous tubule cross-sections containing spermatogonia) and the number of spermatogonia per seminiferous tubule cross-section (S/T). All studies have demonstrated that TFI and S/T always decrease after the introduction of chemotherapeutic agents, especially those which carry high gonadotoxic risks such as alkylating agents. STUDY DESIGN, SIZE, DURATION Testicular tissue samples from 79 (pre)pubertal boys diagnosed with cancer (from 6 months to 16 years of age) were cryopreserved between May 2009 and June 2014. Their medical diagnoses and previous chemotherapy exposures were recorded. We examined histological sections of (pre)pubertal testicular tissue to elucidate whether the chemotherapy or the primary diagnosis affects mainly TFI and S/T. PARTICIPANTS/MATERIALS, SETTING, METHODS (Pre)pubertal boys with cancer diagnosis who had been offered TTF prior to conditioning treatment for hematopoietic stem cell transplantation were included in the study. All the patients had previously received chemotherapy with low- or moderate-risk for future fertility. We have selected patients for whom the information on the chemotherapy received was complete. The quantity of spermatogonia and quality of testicular tissue were assessed by both morphological and immunohistochemical analyses. MAIN RESULTS AND THE ROLE OF CHANCE A significant reduction in the number of spermatogonia was observed in boys treated with alkylating agents. The mean S/T values in boys exposed to alkylating agents were significantly lower compared to boys exposed to non-alkylating agents (P = 0.018). In contrast, no difference was observed for patients treated with carboplatin as the sole administered alkylating agent compared to the group of patients exposed to non-alkylating agents. We observed an increase of S/T with age in the group of patients who did not receive any alkylating agent and a decrease of S/T with age when patients received alkylating agents included in the cyclophosphamide equivalent dose (CED) formula (r = 0.6166, P = 0.0434; r = -0.3759, P = 0.0036, respectively). The TFI and S/T decreased further in the group of patients who received vincristine in combination with alkylating agents (decrease of 22.4%, P = 0.0049 and P < 0.0001, respectively), but in this group the CED was also increased significantly (P < 0.0001). Multivariate analysis, after CED adjustment, showed the persistence of a decrease in TFI correlated with vincristine administration (P = 0.02). LIMITATIONS, REASONS FOR CAUTION This is a descriptive study of testicular tissues obtained from (pre)pubertal boys who were at risk of infertility. The study population is quite heterogeneous, with a small number of patients in each sub-group. Our results are based on comparisons between patients receiving alkylating agents compared to patients receiving non-alkylating agents rather than chemotherapy-naive patients. The French national guidelines for fertility preservation in cancer patients recommend TTF before highly gonadotoxic treatment. Therefore, all the patients had received low- or moderate-risk gonadotoxic chemotherapy before TTF. Access to testicular tissue samples from chemotherapy-naive patients with comparable histological types of cancer was not possible. The functionality of spermatogonia and somatic cells could not be tested by transplantation or in vitro maturation due to limited sample sizes. WIDER IMPLICATIONS OF THE FINDINGS This study summarizes the spermatogonial quantity of (pre)pubertal boys prior to TTF. We confirmed a negative correlation between the cumulative exposure to alkylating agents and spermatogonial quantity. In addition, the synergistic use of vincristine in combination with alkylating agents showed a cumulative deleterious effect on the TFI. For patients for whom fertility preservation is indicated, TTF should be proposed for chemotherapy with a predicted CED above 4000 mg/m2. However, the data obtained from vincristine and carboplatin use should be confirmed in a subsequent study including more patients. STUDY FUNDING/COMPETING INTEREST(S) This study had financial support from a French national research grant PHRC No. 2008/071/HP obtained by the French Institute of Cancer and the French Healthcare Organization. The sponsors played no role in the study. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Aurélie Feraille
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
| | - Agnès Liard
- Department of Child Surgery, Univ Rouen Normandie, Rouen University Hospital, Rouen, France
| | - Nathalie Rives
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
| | | | - Anne-Laure Barbotin
- Institut de Biologie de la Reproduction-Spermiologie-CECOS de Lille, CHU de Lille, Lille, France
| | | | - Sophie Mirallié
- Laboratoire de Biologie de la Reproduction-CECOS de Nantes, CHU de Nantes, Nantes, France
| | - Amélie Ancelle
- Laboratoire de Biologie de la Reproduction-CECOS de Caen, CHU de Caen, Caen, France
| | - Christophe Roux
- Laboratoire de Biologie de la Reproduction-CECOS de Besançon, CHU de Besançon, Besançon, France
| | - Florence Brugnon
- Laboratoire de Biologie de la Reproduction-CECOS d'Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Myriam Daudin
- CECOS Midi-Pyrénées, University Hospital of Toulouse, Hôpital Paule de Viguier, Toulouse, France
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology, Univ Rouen Normandie, Rouen University Hospital, Rouen, France
| | - Ludovic Dumont
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
| | - Christine Rondanino
- Biology of Reproduction-CECOS Laboratory, Univ Rouen Normandie, Inserm U1239, NorDIC, Team "Adrenal and Gonadal Pathophysiology", Rouen University Hospital, Rouen, France
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16
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Miquel L, Liotta J, Hours A, Bottin P, Castel P, Perrin J, Guillemain C, Courbiere B. Feasibility and efficiency of delayed ovarian stimulation and metaphase II oocyte banking for fertility preservation and childbearing desire after fertility-impairing treatment. Sci Rep 2023; 13:15661. [PMID: 37730827 PMCID: PMC10511488 DOI: 10.1038/s41598-023-42583-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
The aim of our study was to evaluate the feasibility and efficiency of delayed ovarian stimulation and metaphase II oocyte banking for fertility preservation after fertility-impairing treatment regardless of the initial disease. We conducted a cohort study based on population of women < 40 years of age with diminished ovarian reserve caused by fertility-impairing treatment (n = 129). Three groups of women were compared according to the type of initial disease: hematological malignancies, solid tumors, and benign diseases. The primary endpoint was the number of metaphase II oocytes collected per woman. We studied the cumulative live-birth rate per cycle with fertilized metaphase II oocyte, for women who wanted to conceive. We studied 245 delayed controlled ovarian stimulation cycles in 129 women: 201 for fertility preservation and 44 for in vitro fertilization and fresh embryo transfers. The number of metaphase II oocytes collected per woman after banking was similar in the three groups, with a mean of 10.7 ± 4.6, 12.3 ± 9.1, and 10.1 ± 7.6 metaphase II oocytes (p = 0.46), respectively. In the subgroup of women who wanted to conceive, the cumulative live birth rate per woman was 38%, with 8 live births for these 21 women. After fertility-impairing treatment, practitioners should discuss a fertility preservation procedure for banking metaphase II oocytes.
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Affiliation(s)
- Laura Miquel
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pôle femmes parents enfants, AP-HM, La Conception University Hospital, Marseille, France.
| | - Julie Liotta
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pôle femmes parents enfants, AP-HM, La Conception University Hospital, Marseille, France
| | - Alice Hours
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pôle femmes parents enfants, AP-HM, La Conception University Hospital, Marseille, France
| | - Pauline Bottin
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pôle femmes parents enfants, AP-HM, La Conception University Hospital, Marseille, France
| | - Pierre Castel
- Department of Obstetrics, Gynecology and Reproductive Medicine, Pôle femmes parents enfants, AP-HM, La Conception University Hospital, Marseille, France
| | - Jeanne Perrin
- Aix Marseille Univ, CNRS, IRD, Avignon Université, IMBE, 13397, Marseille, France
| | | | - Blandine Courbiere
- Aix Marseille Univ, CNRS, IRD, Avignon Université, IMBE, 13397, Marseille, France
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17
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Pawłowski P, Ziętara KJ, Michalczyk J, Fryze M, Buchacz A, Zaucha-Prażmo A, Zawitkowska J, Torres A, Samardakiewicz M. Fertility Preservation in Children and Adolescents during Oncological Treatment-A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers. Cancers (Basel) 2023; 15:4393. [PMID: 37686669 PMCID: PMC10487203 DOI: 10.3390/cancers15174393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Oncofertility is any therapeutic intervention to safeguard the fertility of cancer patients. Anti-cancer therapies (chemotherapy, radiation therapy, etc.) entail the risk of reproductive disorders through cytotoxic effects on gamete-building cells, especially those not yet fully developed. This literature review analyzes the available data on securing fertility in pediatric and adolescent populations to identify the methods used and describe aspects related to financing, ethics, and the perspective of patients and their parents. Topics related to oncofertility in this age group are relatively niche, with few peer-reviewed articles available and published studies mostly on adults. Compared to pubertal individuals, a limited number of fertility preservation methods are used for prepubertal patients. Funding for the procedures described varies from country to country, but only a few governments choose to reimburse them. Oncofertility of pediatric and adolescent patients raises many controversies related to the decision, parents' beliefs, having a partner, ethics, as well as the knowledge and experience of healthcare professionals. As the fertility of young cancer patients is at risk, healthcare professionals should make every effort to provide them with an opportunity to fulfill their future reproductive plans and to have a family and offspring. Systemic solutions should form the basis for the development of oncofertility in pediatric and adolescent populations.
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Affiliation(s)
- Piotr Pawłowski
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Karolina Joanna Ziętara
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Justyna Michalczyk
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (J.M.)
| | - Magdalena Fryze
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.F.); (M.S.)
| | - Anna Buchacz
- Youth Cancer Europe, 400372 Cluj-Napoca, Romania;
| | - Agnieszka Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; (A.Z.-P.); (J.Z.)
| | - Joanna Zawitkowska
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; (A.Z.-P.); (J.Z.)
| | - Anna Torres
- Department of Pediatric and Adolescent Gynecology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Marzena Samardakiewicz
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.F.); (M.S.)
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18
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Delgouffe E, Braye A, Vloeberghs V, Mateizel I, Ernst C, Ferster A, Devalck C, Tournaye H, Gies I, Goossens E. Spermatogenesis after gonadotoxic childhood treatment: follow-up of 12 patients. Hum Reprod Open 2023; 2023:hoad029. [PMID: 37547664 PMCID: PMC10403430 DOI: 10.1093/hropen/hoad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/13/2023] [Indexed: 08/08/2023] Open
Abstract
STUDY QUESTION What is the long-term impact of presumed gonadotoxic treatment during childhood on the patient's testicular function at adulthood? SUMMARY ANSWER Although most patients showed low testicular volumes and some degree of reproductive hormone disruption 12.3 (2.3-21.0) years after gonadotoxic childhood therapy, active spermatogenesis was demonstrated in the semen sample of 8 out of the 12 patients. WHAT IS KNOWN ALREADY In recent decades, experimental testicular tissue banking programmes have been set up to safeguard the future fertility of young boys requiring chemo- and/or radiotherapy with significant gonadotoxicity. Although the risk of azoospermia following such therapies is estimated to be high, only limited long-term data are available on the reproductive potential at adulthood. STUDY DESIGN SIZE DURATION This single-centre prospective cohort study was conducted between September 2020 and February 2023 and involved 12 adult patients. PARTICIPANTS/MATERIALS SETTING METHODS This study was carried out in a tertiary care centre and included 12 young adults (18.1-28.3 years old) who had been offered testicular tissue banking prior to gonadotoxic treatment during childhood. All patients had a consultation and physical examination with a fertility specialist, a scrotal ultrasound to measure the testicular volumes and evaluate the testicular parenchyma, a blood test for assessment of reproductive hormones, and a semen analysis. MAIN RESULTS AND THE ROLE OF CHANCE Testicular tissue was banked prior to the gonadotoxic treatment for 10 out of the 12 included patients. Testicular volumes were low for 9 patients, and 10 patients showed some degree of reproductive hormone disruption. Remarkably, ongoing spermatogenesis was demonstrated in 8 patients at a median 12.3 (range 2.3-21.0) years post-treatment. LIMITATIONS REASONS FOR CAUTION This study had a limited sample size, making additional research with a larger study population necessary to verify these preliminary findings. WIDER IMPLICATIONS OF THE FINDINGS These findings highlight the need for multicentric research with a larger study population to establish universal inclusion criteria for immature testicular tissue banking. STUDY FUNDING/COMPETING INTERESTS This study was conducted with financial support from the Research Programme of the Research Foundation-Flanders (G010918N), Kom Op Tegen Kanker, and Scientific Fund Willy Gepts (WFWG19-03). The authors declare no competing interests. TRIAL REGISTRATION NUMBER NCT04202094; https://clinicaltrials.gov/ct2/show/NCT04202094?id=NCT04202094&draw=2&rank=1 This study was registered on 6 December 2019, and the first patient was enrolled on 8 September 2020.
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Affiliation(s)
- E Delgouffe
- Correspondence address. Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium. Tel: +32-(0)2-477-46-44; E-mail: https://orcid.org/0000-0001-5611-2173
| | - A Braye
- Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - V Vloeberghs
- Brussels IVF, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - I Mateizel
- Brussels IVF, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - C Ernst
- Division of Paediatric Radiology, Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - A Ferster
- Department of Hemato-Oncology, Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - C Devalck
- Department of Hemato-Oncology, Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - H Tournaye
- Brussels IVF, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Department of Obstetrics, Gynaecology, Perinatology and Reproduction, Institute of Professional Education, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - I Gies
- Division of Paediatric Endocrinology, Department of Paediatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - E Goossens
- Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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19
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Zhang S, Liu Q, Chang M, Pan Y, Yahaya BH, Liu Y, Lin J. Chemotherapy impairs ovarian function through excessive ROS-induced ferroptosis. Cell Death Dis 2023; 14:340. [PMID: 37225709 DOI: 10.1038/s41419-023-05859-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/05/2023] [Accepted: 05/12/2023] [Indexed: 05/26/2023]
Abstract
Chemotherapy was conventionally applied to kill cancer cells, but regrettably, they also induce damage to normal cells with high-proliferative capacity resulting in cardiotoxicity, nephrotoxicity, peripheral nerve toxicity, and ovarian toxicity. Of these, chemotherapy-induced ovarian damages mainly include but are not limited to decreased ovarian reserve, infertility, and ovarian atrophy. Therefore, exploring the underlying mechanism of chemotherapeutic drug-induced ovarian damage will pave the way to develop fertility-protective adjuvants for female patients during conventional cancer treatment. Herein, we firstly confirmed the abnormal gonadal hormone levels in patients who received chemotherapy and further found that conventional chemotherapeutic drugs (cyclophosphamide, CTX; paclitaxel, Tax; doxorubicin, Dox and cisplatin, Cis) treatment significantly decreased both the ovarian volume of mice and the number of primordial and antral follicles and accompanied with the ovarian fibrosis and reduced ovarian reserve in animal models. Subsequently, Tax, Dox, and Cis treatment can induce the apoptosis of ovarian granulosa cells (GCs), likely resulting from excessive reactive oxygen species (ROS) production-induced oxidative damage and impaired cellular anti-oxidative capacity. Thirdly, the following experiments demonstrated that Cis treatment could induce mitochondrial dysfunction through overproducing superoxide in GCs and trigger lipid peroxidation leading to ferroptosis, first reported in chemotherapy-induced ovarian damage. In addition, N-acetylcysteine (NAC) treatment could alleviate the Cis-induced toxicity in GCs by downregulating cellular ROS levels and enhancing the anti-oxidative capacity (promoting the expression of glutathione peroxidase, GPX4; nuclear factor erythroid 2-related factor 2, Nrf2 and heme oxygenase-1, HO-1). Our study confirmed the chemotherapy-induced chaotic hormonal state and ovarian damage in preclinical and clinical examination and indicated that chemotherapeutic drugs initiated ferroptosis in ovarian cells through excessive ROS-induced lipid peroxidation and mitochondrial dysfunction, leading to ovarian cell death. Consequently, developing fertility protectants from the chemotherapy-induced oxidative stress and ferroptosis perspective will ameliorate ovarian damage and further improve the life quality of cancer patients.
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Affiliation(s)
- Shenghui Zhang
- Stem Cell and Biotherapy Technology Research Center, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, China
- Department of Biomedical Sciences, Advanced Medical and Dental Institute (IPPT), Universiti Sains Malaysia, Penang, Malaysia
| | - Qin Liu
- Stem Cell and Biotherapy Technology Research Center, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, China
| | - Mengyuan Chang
- Stem Cell and Biotherapy Technology Research Center, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, China
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Ying Pan
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Badrul Hisham Yahaya
- Department of Biomedical Sciences, Advanced Medical and Dental Institute (IPPT), Universiti Sains Malaysia, Penang, Malaysia.
| | - Yanli Liu
- Stem Cell and Biotherapy Technology Research Center, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, China.
| | - Juntang Lin
- Stem Cell and Biotherapy Technology Research Center, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, China.
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20
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Houpert R, Almont T, Mésenge C, Kleinebreil L, Forlini L, Magnone B, Leroux V, Vestris M, Montabord C, Carmenate J, Galán Y, Rubio MC, Enriquez R, Burte C, Gatimel N, Bujan L, Kara N, Edwige O, Huyghe É, Joachim C, Véronique-Baudin J. International cooperation and the challenge of internet accessibility in Caribbean territories: example of a collaborative platform between the University Hospital of Martinique and Ramón González Coro Hospital in Cuba, through the French PRPH-3 program. BMC MEDICAL EDUCATION 2023; 23:352. [PMID: 37208670 DOI: 10.1186/s12909-023-04321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Martinique shares with the other Caribbean countries specific public health issues, particularly in the diagnostic and therapeutic management of cancer patients. Mutualization of human and material resources by promoting cooperation is the most appropriate response to the challenges of the health systems of the Caribbean territories. Through the French PRPH-3 program, we propose to set up a collaborative digital platform adapted to the specificities of the Caribbean to strengthen professional links and skills in oncofertility and oncosexology and reduce inequalities in access to reproductive and sexual health care for cancer patients. METHODS Within the context of this program, we have developed of an open-source platform based on a Learning Content Management System (LCMS), with an operating system developed by UNFM for low speed internet. LO libraries have been created and interaction between trainers and learners were done in asynchronous mode. This training management platform is based on: a TCC learning system (Training, Coaching, Communities); a web-hosting with pedagogical engineering appropriate to low bandwidth; a reporting system and a responsibility for processing. RESULTS We have carried out a flexible, multilingual and accessible digital learning strategy functionality called e-MCPPO according to low-speed internet ecosystem. In close connection with the e-learning strategy we conceived (i) a multidisciplinary team; (ii) an appropriate training program for expert health professionals and (iii) a responsive design. DISCUSSION AND CONCLUSION This low-speed web-based infrastructure allows communities of experts to cooperate in creating, validating, publishing and managing academic learning content. The self-learning modules provide the digital layer for each learner to extend their skills. Learners, as well as trainers, would gradually take ownership of this platform and encourage its promotion. Innovation in this context is both technological (low-speed Internet broadcasting, free interactive software) and organizational (moderating educational resources). This collaborative digital platform is unique in its form and content. This challenge could contribute to the digital transformation of the Caribbean ecosystem for capacity building in this specifics topics.
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Affiliation(s)
- Rémi Houpert
- Research and Development in Oncology Unit UF3596, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique.
- Oncosexology Unit, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique.
| | - Thierry Almont
- Research and Development in Oncology Unit UF3596, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
- Oncosexology Unit, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
| | - Christian Mésenge
- World Francophone Digital University, UNFM / HNSM 14 rue du Val d'Osne, Saint-Maurice, 94450, France
| | - Line Kleinebreil
- World Francophone Digital University, UNFM / HNSM 14 rue du Val d'Osne, Saint-Maurice, 94450, France
| | - Laurence Forlini
- World Francophone Digital University, UNFM / HNSM 14 rue du Val d'Osne, Saint-Maurice, 94450, France
| | - Bruno Magnone
- World Francophone Digital University, UNFM / HNSM 14 rue du Val d'Osne, Saint-Maurice, 94450, France
| | - Vincent Leroux
- World Francophone Digital University, UNFM / HNSM 14 rue du Val d'Osne, Saint-Maurice, 94450, France
| | - Mylène Vestris
- Cancerology Department, General Cancer Registry of Martinique UF1441, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
| | - Christelle Montabord
- Research and Development in Oncology Unit UF3596, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
- Cancerology Department, General Cancer Registry of Martinique UF1441, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
| | | | - Yaima Galán
- National Cancer Registry of Cuba, National Institute of Oncology and Radiobiology, La Havane, Cuba
| | | | | | - Carol Burte
- French Society of Sexual Medicine (SFMS), Lille, France
| | - Nicolas Gatimel
- Embryonic Development, Fertility and Environment Laboratory (DEFE) UMR 1203, Toulouse 3 Paul Sabatier University, Toulouse, France
| | - Louis Bujan
- Embryonic Development, Fertility and Environment Laboratory (DEFE) UMR 1203, Toulouse 3 Paul Sabatier University, Toulouse, France
| | - Norelyakin Kara
- Urology Unit, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
| | - Olivier Edwige
- EDEO Technologies, 11 rue des Arts et métiers, Fort-de-France, 97200, Martinique
| | - Éric Huyghe
- Embryonic Development, Fertility and Environment Laboratory (DEFE) UMR 1203, Toulouse 3 Paul Sabatier University, Toulouse, France
- French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Reproductive Medicine Department, Paule de Viguier University Hospital, 330 avenue de Grande-Bretagne, Toulouse cedex 9, 70034, 31059, TSA, France
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, Bègles, 33130, France
| | - Clarisse Joachim
- Cancerology Department, General Cancer Registry of Martinique UF1441, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
- Oncosexology Unit, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
| | - Jacqueline Véronique-Baudin
- Research and Development in Oncology Unit UF3596, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
- Oncosexology Unit, Cancerology Department, Martinique University Hospital (CHU Martinique), Fort-de-France, Martinique
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Sun H, Guo Y, Yu R, Wang J, Liu Y, Chen H, Pang W, Yang G, Chu G, Gao L. Ru360 protects against vitrification-induced oocyte meiotic defects by restoring mitochondrial function. Theriogenology 2023; 204:40-49. [PMID: 37058855 DOI: 10.1016/j.theriogenology.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
Oocyte vitrification has been widely application in female fertility preservation. Recent studies found that vitrification of immature (germinal vesicle stage, GV) oocytes increased the risk of aneuploidy during meiotic maturation; however, the underlying mechanisms and the strategies to prevent this defect remain unexplored. In this study, we found that vitrification of GV oocytes decreased the first polarbody extrusion rate (90.51 ± 1.04% vs. 63.89 ± 1.39%, p < 0.05) and increased the aneuploid rate (2.50% vs. 20.00%, p < 0.05), accompanied with a series of defects during meiotic maturation, including aberrant spindle morphology, chromosome misalignment, incorrect Kinetochore-Microtubule attachments (KT-MTs) and weakened spindle assembly checkpoint protein complex (SAC) function. We also found that vitrification disrupted mitochondrial function by increasing mitochondrial Ca2+ levels. Importantly, inhibition of mitochondrial Ca2+ entry by 1 μM Ru360 significantly restored mitochondrial function and rescued the meiotic defects, indicating that the increase of mitochondrial Ca2+, at least, was a cause of meiotic defects in vitrified oocytes. These results shed light on the molecular mechanisms of oocyte vitrification-induced adverse effects of meiotic maturation and provided a potential strategy to improve oocyte cryopreservation protocols further.
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Affiliation(s)
- Haowei Sun
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Yaoyao Guo
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Ruochun Yu
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Jialun Wang
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Youxue Liu
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Hui Chen
- Animal Husbandry Industry Test and Demonstration Center of Shaanxi Province, Jingyang, 713708, Shaanxi, China.
| | - Weijun Pang
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Gongshe Yang
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Guiyan Chu
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
| | - Lei Gao
- Key Laboratory of Animal Genetics, Breeding and Reproduction of Shaanxi Province, College of Animal Science and Technology, Northwest A&F University, Yangling, 712100, Shaanxi, China.
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Autologous Human Mesenchymal Stem Cell-Based Therapy in Infertility: New Strategies and Future Perspectives. BIOLOGY 2023; 12:biology12010108. [PMID: 36671799 PMCID: PMC9855776 DOI: 10.3390/biology12010108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/12/2023]
Abstract
Infertility could be associated with a few factors including problems with physical and mental health, hormonal imbalances, lifestyles, and genetic factors. Given that there is a concern about the rise of infertility globally, increased focus has been given to its treatment for the last several decades. Traditional assisted reproductive technology (ART) has been the prime option for many years in solving various cases of infertility; however, it contains significant risks and does not solve the fundamental problem of infertility such as genetic disorders. Attention toward the utilization of MSCs has been widely regarded as a promising option in the development of stem-cell-based infertility treatments. This narrative review briefly presents the challenges in the current ART treatment of infertility and the various potential applications of autologous MSCs in the treatment of these reproductive diseases.
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Kuipers A. Gaps in Care for the Adolescent and Young Adult Cancer Survivor in the United States. Genet Test Mol Biomarkers 2022; 26:551-552. [PMID: 36577122 DOI: 10.1089/gtmb.2022.29065.persp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Angelea Kuipers
- Genetic Alliance, Damascus, Maryland, USA.,Bay Path University, Longmeadow, Massachusetts, USA
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