Fertility restoration in azoospermic cancer survivors from testicular VSELs that survive oncotherapy upon transplanting MSCs

ABSTRACT Fertility restoration in cancer patients is gaining a very important role in the field of reproductive medicine, due to the rising incidence of cancer as well as its early detection and improved survival rate. The two options for achieving this aim are ovarian tissue cryopreservation (OTC) and assisted reproductive treatment (ART) through oocyte or embryo cryopreservation after IVF. However, both these have some advantages and disadvantages over each other. OTC is still in experimental phase but is growing faster as an important part of fertility restoration. ART is time tested method which can be relied upon to a great extent, but there are some situations where ART cannot meet the expectations. This review is an overview of the pros and cons of both these options and the status of these methods in the present scenario of fertility preservation. How to cite this article Priya K, Divyashree PS. Restoring Fertility in Cancer Survivors: Ovarian Tissue Cryopreservation or Assisted Reproduction Technique. Int J Infertil Fetal Med 2017;8(1):24-31.

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Use of Simvastatin, Fibrin Clots, and Their Combination to Improve Human Ovarian Tissue Grafting for Fertility Restoration After Anti-Cancer Therapy

Frontiers in Oncology ◽

10.3389/fonc.2020.598026 ◽

2021 ◽

Vol 10 ◽

Author(s):

Roei Magen ◽

Yoel Shufaro ◽

Yair Daykan ◽

Galia Oron ◽

Elena Tararashkina ◽

...

Keyword(s):

Cancer Survivors ◽

Fertility Restoration ◽

Ovarian Tissue ◽

Significant Loss ◽

Human Ovarian Tissue ◽

Platelet Endothelial Cell Adhesion ◽

Group A ◽

Group B ◽

Von Willebrand ◽

Fibrin Clots

Anticancer treatments, particularly chemotherapy, induce ovarian damage and loss of ovarian follicles. There are limited options for fertility restoration, one of which is pre-chemotherapy cryopreservation of ovarian tissue. Transplantation of frozen-thawed human ovarian tissue from cancer survivors has resulted in live-births. There is extensive follicular loss immediately after grafting, probably due to too slow graft revascularization. To avoid this problem, it is important to develop methods to improve ovarian tissue neovascularization. The study’s purpose was to investigate if treatment of murine hosts with simvastatin or/and embedding human ovarian tissue within fibrin clots can improve human ovarian tissue grafting (simvastatin and fibrin clots promote vascularization). There was a significantly higher number of follicles in group A (ungrafted control) than in group B (untreated tissue). Group C (simvastatin-treated hosts) had the highest levels of follicle atresia. Group C had significantly more proliferating follicles (Ki67-stained) than groups B and E (simvastatin-treated hosts and tissue embedded within fibrin clots), group D (tissue embedded within fibrin clots) had significantly more proliferating follicles (Ki67-stained) than group B. On immunofluorescence study, only groups D and E showed vascular structures that expressed both human and murine markers (mouse-specific platelet endothelial cell adhesion molecule, PECAM, and human-specific von Willebrand factor, vWF). Peripheral human vWF expression was significantly higher in group E than group B. Diffuse human vWF expression was significantly higher in groups A and E than groups B and C. When grafts were not embedded in fibrin, there was a significant loss of human vWF expression compared to groups A and E. This protocol may be tested to improve ovarian implantation in cancer survivors.

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