Assoc. for Women in Science

Winter 2015

AWIS Magazine covers topics important to women in science, technology, engineering, mathematics, and medicine fields. Topics include career advancement, work-life balance, the state of science and technology, women’s wellness, and AWIS’ political and

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wellness reproductive biology The Danish Ovarian Cryopreservation Program By Annette Klüver Jensen, MD Laboratory of Reproductive Biology, Rigshospitalet C ryopreservation, thawing and then autotransplantation of ovarian tissue is a fairly new option within the field of fertility treatment and reproductive biology, but is on the verge of becoming an integrated treatment for young women with cancer who are at risk of losing their fertility. The full function- al lifespan of grafts is still being evaluated because many of the transplanted women have continued to maintain ovarian activity. In Denmark at the Laboratory of Reproductive Biology, Rigshospitalet in Copenhagen, which is a laboratory under the Fertility Clinic, where the Cryopreservation Program began as one of the first programs worldwide in 2000. Since then, nearly 900 women and girls have had tissue cryopreserved and the women started to have autotransplantations of their ovarian tissue in 2003. Over the last five years we have autotransplanted an average nine patients per year. After 10 years with this program, we felt we had a large enough cohort to do a follow-up on this patient group. The aim of this retrospective cohort study was to evaluate the duration, safety, ovarian endocrine function and fertility out- come of the transplanted tissue to forty-one Danish women. They had in total 53 transplantations. Why Not Just do IVF and Oocyte Vitrification? The patients who are offered cryopreservation have a high risk of developing premature ovarian insufficiency (POI). These are women with autoimmune diseases, sex anomalies (e.g. Turner Syndrome Mosaicism), bilateral benign ovarian cysts (who has undergone several operations on their ovaries) and various cancer diagnoses. The main group of patients we have performed cryopreservation on are cancer patients. Many of the women do not have time to go through one or two rounds of IVF (in vitro fertil- ization) before they start chemotherapy treatment. In Denmark, we do an oophorectomy and freeze the entire cortex from one whole ovary. In average that gives us 20 pieces (5x5 mm) of ovarian tissue. Then we have the young girls (most of them in our cohort are prepubertal), which cannot undergo IVF treatment. An important factor when coun- seling these young patients is that we do not know what we will do in the future with their tissue, which consists of thousands of immature follicles. We have to keep in mind that this pro- cedure has only been on the market for one and half decades and we still do not have a whole overview of the full aspects of this procedure, besides this is a field with a lot of research. Who knows if in 15-20 years we will be able to do in vitro maturation (IVM) on the preantral follicles in the cryopreserved ovarian cortex? Then these girls, when they are in their fertile age, would have hundreds of follicles. Normally in a good IVF association for women in science | winter 2015 44

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