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Ovarian Cortex Transplantation
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Ovarian cortex transplantation Madeleine Pellerin MD , Olivier Garbin MD , Marius Teletin MD , Lise Lecointre MD , Cherif Akladios MD-PhD , Olivier Pirrello MD PII: DOI: Reference:
S1553-4650(19)31344-5 https://doi.org/10.1016/j.jmig.2019.12.007 JMIG 4028
To appear in:
The Journal of Minimally Invasive Gynecology
Received date: Revised date: Accepted date:
9 October 2019 24 November 2019 3 December 2019
Please cite this article as: Madeleine Pellerin MD , Olivier Garbin MD , Marius Teletin MD , Lise Lecointre MD , Cherif Akladios MD-PhD , Olivier Pirrello MD , Ovarian cortex transplantation, The Journal of Minimally Invasive Gynecology (2019), doi: https://doi.org/10.1016/j.jmig.2019.12.007
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier Inc. on behalf of AAGL.
Ovarian cortex transplantation Madeleine Pellerin1 MD, Olivier Garbin1 MD, Marius Teletin2 MD, Lise Lecointre3 MD, Cherif Akladios3 MD- PhD, Olivier Pirrello4 MD 1Gynecology Unit, CMCO, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 19 rue Louis Pasteur, 67 300 Schiltigheim, France 2Assisted reproductive technique laboratory, CMCO, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 19 rue Louis Pasteur, 67 300 Schiltigheim, France 3Gynecology Unit, hôpital de Hautepierre, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67200 Strasbourg, France 4Assisted reproductive technique unit, CMCO, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 19 rue Louis Pasteur, 67 300 Schiltigheim, France
Corresponding author: Madeleine Pellerin CMCO, 19 rue Louis Pasteur, 67 300 Schiltigheim, France [email protected]
The authors have nothing to disclose
Abstract Study objective To describe a laparoscopic technique for transplantation of cryopreserved ovarian cortex Design Educational Video Setting: University Hospital of Strasbourg, France Intervention: A 28 years-old nulliparous woman presented an anaplastic T lymphoma which was then treated with chemotherapy. Before the treatment, ovarian cortex was collected by laparoscopy in order to preserve fertility. Remission was achieved, but the patient suffered from premature ovarian failure. At 32 years-old, she wished to become pregnant. The patient was thus included in the research protocol DATOR (Ovarian tissue transplantation development in order to restore ovarian), and the
transplantation’s site were chosen accordingly. The cortex was stored in liquid nitrogen at -196°C after slow congelation. In order to restore ovarian function, and because of pregnancy desire, we transplanted cryopreserved ovarian cortex in the right ovary, and inside a pocket of the peritoneum of the left ovarian fossa. The first step was an adhesiolysis to treat small adhesions developed after the first surgery. On the right, the ovarian cortex was opened by an antimesial incision with cold scissors. The cryopreserved ovarian cortex was placed through the cortex of the right ovary, and fixed with stitches. On the left side, the peritoneum of the ovarian fossa was opened, and a sub peritoneal pocket was dissected. Cortex was inserted. It was then closed with absorbable sutures or with a hemostatic pad. Six months after her surgery, the patient had natural cycles. We monitored an ovulation of both sides. She had three in vitro fecundation (IVF), but with failures of embryo transfer. She conceived spontaneously a year after the surgery. She gave birth to a healthy child of 3300g. Conclusion: For patients who have suffered from premature ovarian failure due to chemotherapy, ovarian cortex transplantation can restore the ovulatory function, allows IVF, and permit, as in our case, a spontaneous pregnancy.
Video legend: This video shows an ovarian cortex autograft in a patient who suffered from premature ovarian failure. It describes the surgical technique we used to graft cryopreserved ovarian cortex. The patient later recovered natural cycles and had a spontaneous pregnancy.
This video article has been approved by local ethical committee.
Ovarian cortex transplantation Madeleine Pellerin MD , Olivier Garbin MD , Marius Teletin MD , Lise Lecointre MD , Cherif Akladios MD-PhD , Olivier Pirrello MD PII: DOI: Reference:
S1553-4650(19)31344-5 https://doi.org/10.1016/j.jmig.2019.12.007 JMIG 4028
To appear in:
The Journal of Minimally Invasive Gynecology
Received date: Revised date: Accepted date:
9 October 2019 24 November 2019 3 December 2019
Please cite this article as: Madeleine Pellerin MD , Olivier Garbin MD , Marius Teletin MD , Lise Lecointre MD , Cherif Akladios MD-PhD , Olivier Pirrello MD , Ovarian cortex transplantation, The Journal of Minimally Invasive Gynecology (2019), doi: https://doi.org/10.1016/j.jmig.2019.12.007
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier Inc. on behalf of AAGL.
Ovarian cortex transplantation Madeleine Pellerin1 MD, Olivier Garbin1 MD, Marius Teletin2 MD, Lise Lecointre3 MD, Cherif Akladios3 MD- PhD, Olivier Pirrello4 MD 1Gynecology Unit, CMCO, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 19 rue Louis Pasteur, 67 300 Schiltigheim, France 2Assisted reproductive technique laboratory, CMCO, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 19 rue Louis Pasteur, 67 300 Schiltigheim, France 3Gynecology Unit, hôpital de Hautepierre, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67200 Strasbourg, France 4Assisted reproductive technique unit, CMCO, Pôle de Gynécologie Obstétrique des Hôpitaux Universitaires de Strasbourg, 19 rue Louis Pasteur, 67 300 Schiltigheim, France
Corresponding author: Madeleine Pellerin CMCO, 19 rue Louis Pasteur, 67 300 Schiltigheim, France [email protected]
The authors have nothing to disclose
Abstract Study objective To describe a laparoscopic technique for transplantation of cryopreserved ovarian cortex Design Educational Video Setting: University Hospital of Strasbourg, France Intervention: A 28 years-old nulliparous woman presented an anaplastic T lymphoma which was then treated with chemotherapy. Before the treatment, ovarian cortex was collected by laparoscopy in order to preserve fertility. Remission was achieved, but the patient suffered from premature ovarian failure. At 32 years-old, she wished to become pregnant. The patient was thus included in the research protocol DATOR (Ovarian tissue transplantation development in order to restore ovarian), and the
transplantation’s site were chosen accordingly. The cortex was stored in liquid nitrogen at -196°C after slow congelation. In order to restore ovarian function, and because of pregnancy desire, we transplanted cryopreserved ovarian cortex in the right ovary, and inside a pocket of the peritoneum of the left ovarian fossa. The first step was an adhesiolysis to treat small adhesions developed after the first surgery. On the right, the ovarian cortex was opened by an antimesial incision with cold scissors. The cryopreserved ovarian cortex was placed through the cortex of the right ovary, and fixed with stitches. On the left side, the peritoneum of the ovarian fossa was opened, and a sub peritoneal pocket was dissected. Cortex was inserted. It was then closed with absorbable sutures or with a hemostatic pad. Six months after her surgery, the patient had natural cycles. We monitored an ovulation of both sides. She had three in vitro fecundation (IVF), but with failures of embryo transfer. She conceived spontaneously a year after the surgery. She gave birth to a healthy child of 3300g. Conclusion: For patients who have suffered from premature ovarian failure due to chemotherapy, ovarian cortex transplantation can restore the ovulatory function, allows IVF, and permit, as in our case, a spontaneous pregnancy.
Video legend: This video shows an ovarian cortex autograft in a patient who suffered from premature ovarian failure. It describes the surgical technique we used to graft cryopreserved ovarian cortex. The patient later recovered natural cycles and had a spontaneous pregnancy.
This video article has been approved by local ethical committee.