Children faced with a fertility threatening diagnosis or treatment plan will be offered ovarian tissue cryopreservation, particularly if pre menarchal and without other options to preserve fertility. Although considered experimental, there are over 120 live births worldwide using this technique

Ovarian tissue cryopreservation

Zaraq Khan, M.B.B.S.

The Institutional Review Board (IRB) protocol is being designed to offer ovarian tissue cryopreservation to female pediatric patients (birth-17 years of age) with fertility threatening medical diagnoses or facing surgery, chemotherapy or radiation therapy that may cause loss of reproductive potential. Because this procedure is currently considered experimental, the establishment of an IRB protocol under which this opportunity can be offered is needed.

Ovarian tissue cryopreservation is currently considered experimental but offers the only opportunity for fertility preservation in pre-menarchal girls faced with a fertility threatening diagnosis or treatment plan.

Ovarian Tissue Cryopreservation in Children

Ovarian Tissue Freezing For Fertility Preservation In Girls Facing A Fertility Threatening Medical Diagnosis Or Treatment Regimen

Mayo Clinic

Ovarian tissue will be vitrified and warmed by Ova kit type M protocol.

there are 3 types of experiments in each group, including Follicle survival evaluation by Neutral red staining, Histological evaluation by Hematoxylin and Eosin staining, 2.4. Evaluation GDF-9 and Caspase-3 gene expression by real-time PCR.

evaluation of the effectiveness of vitrification technique on ovarian tissue quality

Lan N Nguyen, MSC

Dang Q Vinh, MD, MCE

Lan Nguyen, MSC

Vinh Dang, MD,MCE

Tuong M Ho, MD, MCE

Ovarian tissue cryopreservation (OTC) is a new approach on fertility preservation for young female patients with cancer. It is now used by many IVF centers in the world. However, this is the first study which OTC by vitrification is carried on and assessed the effectiveness of the technique.

Ovaries from all less than 45 year-old breast cancer patients who undergo oophorectomy by laparoscopy after treated with chemotherapy will be enrolled to the study. Pieces of cortex of each patient will divide into two groups. Group 1 is fresh fragments (control group) and group 2 is vitrified group. Ovarian tissues in group 2 will be vitrified or warmed with medium and devices of Ova-kit type M (Kitazato, Japan).

Cortex fragments of each group will have:

* Follicle survival evaluation by Neutral red staining
* Histological evaluation by Hematoxylin and Eosin staining
* Evaluation relative Growth Differentiation Factor 9 (GDF-9) and Caspase-3 gene expression by real-time Polymerase chain reaction (PCR).

Comparison of data collected from 2 groups will be carried on to evaluate the effectiveness of the technique before applying this technique for cancer patients in Vietnam.

Assessing the Technique of Ovarian Tissue Cryopreservation by Vitrification in Vietnam

Vitrified Ovarian Tissue in Cancer Patients: Assessing the Technique in Vietnam

Percentage of survivable follicles per counted follicles in one fragment

Healthy follicles of primordial, primary, secondary follicles will be counted in one slide

Follicles in ovarian tissue will be collected, complementary deoxyribonucleic acid (cDNA) synthesis after messenger ribonucleic acid (mRNA) purification, relative quantification PCR for detecting gene expression

Mỹ Đức Hospital

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Gland and Hormone Related Diseases

Premature Birth

Primary Ovarian Insufficiency

Menopause, Premature

Pregnancy Complications

Urogenital Diseases

Female Urogenital Diseases

Female Urogenital Diseases and Pregnancy Complications

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Genital Diseases

Gonadal Disorders

Endocrine System Diseases

Menopause

Use of chemotherapy without removal of the disease ovary.

surgery to remove ovaries or high dose chemotherapy

Rodriq E. Stubbs, NP

Rodriq Stubbs, NP

Mitasha C. Joseph, RN, MPA

Glenn Schattman, MD

The study hopes to contribute to the development of technologies of ovarian tissue freezing-thawing and in vitro maturation of immature eggs such that a person at risk for premature ovarian failure might be able to conceive a genetically related child.

Procedure: The patient will undergo preoperative sonographic assessment of both ovaries to determine if either ovary is diseased or compromised. Patient will undergo preoperative blood sampling to measure AMH, FSH, LH and estradiol as indicators of current ovarian function (less than 8 teaspoons) if time allows and assessment of ovarian reserve is appropriate; menopausal levels of FSH (≥ 30 miu/ml) will be a contraindication to participation in this study. The patient may have infectious disease testing as part of the evaluation for fertility preservation treatment. Patient will undergo preoperative assessment and clearance for surgery by an anesthesiologist.

Intraoperative management will include laparotomy or laparoscopy, depending on the individual patient's history, exam and oncology plans. Removal of one or both ovaries will depend on preoperative ovarian assessment and recommendation of the oncologist. If ovarian survival for the anticipated treatment has never been documented then both ovaries will be removed. Both ovaries may also be removed if diseased or if the condition requires prophylactic oophorectomy to prevent risk of malignant transformation, e.g. 46 XX/46 XY chimera and BRCA mutation carriers. If ovarian function has rarely been documented for the anticipated treatment then one ovary will be removed and one may be left in situ or repositioned to avoid the field of radiation. The decision to leave the ovary in situ or to reposition will be made pre-operatively by the physician performing the surgery in consultation with the patient and the radiation oncologist. If there is no normal ovarian tissue, as determined by pathology, we will take biopsies of ovarian tissue not to exceed 50% of the ovarian volume from the contra-lateral side for freezing. Additionally, the remaining ovary may be repositioned and sutured to the posterior wall of the uterus or above the pelvic brim with a radio-opaque clip placed to identify this ovary for shielding during irradiation.

Ovarian tissue will be removed and treated as follows: (a) the cortex will be stripped from the remaining ovarian tissue as this outer layer contains most of the immature eggs or primordial follicles. The cortex will be sectioned into 8mm x 1mm strips, each to be frozen in vials containing 1-3 strips. One strip will be sent to pathology for paraffin embedding to be available for future assessment of occult lymphoma cells markers; (b) the central or medullary portion will be frozen separately for potential scientific analysis since this section would not be of any clinical utility. The amount of tissue frozen may vary depending in part by whether one or two ovaries are removed. At some point in the future, thawing of ovarian tissue, with either in vitro maturation or autologous transplantation into the pelvis or other area of the body could be performed. The patient would receive routine postoperative care. The patient's oncologist will be consulted regarding proper timing of the surgery and the need for any special intraoperative or postoperative management

However, since the survival of the primordial follicles in transplanted ovarian tissue is quite low (\<10%), methods for in vivo maturation of these eggs and improved methods of transplantation need to be developed. One or two vials of tissue (\<10% of all tissue frozen) will be thawed to develop the techniques of maturing oocytes. This may include transplantation of the tissue into an animal model for in vivo maturation.

Six months to 1 year following surgery and/or treatment for the medical condition, eg chemotherapy, hormone testing will be performed for evaluation of ovarian reserve. This may include AMH and FSH hormone levels as well as pelvic ultrasounds and dominant antra follicle count.

If the subject does not wish to utilize the ovarian tissue for her own clinical use, the options include discarding the cryopreserved ovarian tissue or donating the cryopreserved tissue for approved research studies.

Cryopreservation of Ovarian Tissue

Cryopreservation of Ovarian Tissue for Potential In Vitro Maturation or Autologous Transplantation

Ovarian tissue cryopreservation Survival of tissue undergoing cryopreservation, thawing and maturation of immature eggs.

Weill Medical College of Cornell University

Infertility

Laparoscopy with percutaneous grasp (2.9 mm).

Conventional laparoscopy with conventional laparoscopic trocars (10 or 5 mm).

Ovarian tissue explant for cryopreservation of ovarian tissue

Ovaian tissue explant

Benito Chiofalo

To compare surgical outcomes of oncologic patients that underwent conventional laparoscopy and percutaneous laparoscopy for cryopreservation of ovarian tissue.

This is a retrospective analysis to evaluate the efficacy and safety of percutaneous laparoscopy for the ovarian tissue explant in oncologic women. Surgical outcomes of patients that underwent percutaneous laparoscopy were compared with those of women that underwent conventional laparoscopy. Data from 2017 to 2021 were collected in a single Oncologic Center in Italy. The principal outcomes considered are post-operative pain, recovery time and aesthetic outcomes.

Percutaneous Laparoscopy for Ovarian Tissue Cryopreservation.

Percutaneous Laparoscopy for Ovarian Tissue Cryopreservation: a Single-center Experience.

Post-operative pain is evaluated with VAS score ranging from 1 to 10 (higher score, maximum pain)

General satisfaction regarding aesthetic outcomes is collected with a satisfaction survey. The score ranged from 1 to 5, with 1 indicating "very dissatisfied" and 5 "very satisfied".

Time from surgical intervention to discharge in days

Entity of blood loss during surgery in ml

The presence of absence of intra and post-operative complications (yes or not and type)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Ovarian Tissue Cryopreservation in Children	NCT02646384	Cancer	Ovarian tissue ...	- 17 Years	Mayo Clinic
Assessing the Technique of Ovarian Tissue Cryopreservation by Vitrification in Vietnam	NCT04666376	Ovarian Tissue ... Vitrification	evaluation of t...	- 45 Years	Mỹ Đức Hospital
Cryopreservation of Ovarian Tissue	NCT01558544	Cancer Risk of Prematu... Fertility Prese...	surgery to remo...	- 45 Years	Weill Medical College of Cornell University
Cryopreservation of Ovarian Tissue	NCT01558544	Cancer Risk of Prematu... Fertility Prese...	surgery to remo...	- 45 Years	Weill Medical College of Cornell University
Percutaneous Laparoscopy for Ovarian Tissue Cryopreservation.	NCT05134090	Oncology Fertility Issue... Surgery	Ovaian tissue e...	18 Years - 42 Years	Regina Elena Cancer Institute

Spots Global Cancer Trial Database for ovarian tissue cryopreservation