7 research outputs found
Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University
Objective: To report the 20-year experience in ovarian tissue cryopreservation
(OTC) and ovarian tissue transplantation (OTT) of the Bologna clinical center
(Bologna, Italy).
Design: Retrospective cohort study.
Patients: 1026 pediatrics and women aged between 2 and 38 years who
underwent OTC and OTT between January 2002 to January 2022.
Results: Of the 1026 patients, 238 (22.8%) were pediatrics (≤ 17 years, Group 1)
and 788 (77.2%) were adult women (range 18-38 years, Group 2). In Group 1,
184 (77.3%) patients had malignant diseases and 54 (22.7%) had non-malignant
diseases. In Group 2, 746 (94.7%) patients had malignant diseases and 42 (5.3%)
had non-malignant diseases. No real complications were observed during
surgery. In all the samples analyzed most of the follicles were in the resting
stage, while only a few follicles were growing. In both fresh and thawed
samples, follicular density was higher in Group 1 than in Group 2 (p < 0.01).
Regardless of age, good preservation of follicles and stroma was observed in
fresh and thawed ovarian tissue by histological and immunohistochemical
analyses (estrogen and progesterone receptors; Ki67 and Bcl2 markers;
TUNEL). To date, out of 1026 total women, 812 (79.1%) had their tissue
stored. Sixty-eight (6.6%) patients died from their primary disease. Twentyfour
(2.3%) women performed 33 OTTs between December 2011 and January
2022. Restoration of menstruation was observed in 15 out of 17 menopausal
women. Six pregnancies were achieved, two hesitated in abortion and four in
the birth of healthy babies.
Conclusion: OTC is the only fertility preservation technique applicable in prepubertal/
pediatrics and in adult patients when stimulation for oocytes/embryos
cryopreservation is not possible. The reported data can help future patients and
physicians in their discussions and decisions about the need and possibilities of
preserving ovarian function
Transplantation of cryopreserved ovarian tissue in a patient affected by metastatic struma ovarii and endometriosis
In this case report, the outcomes of cryopreserved ovarian tissue transplantation performed in a patient affected by struma-ovarii associated with mature cystic teratoma, recurrent endometriotic cysts and diffuse peritoneal malignant struma-ovarii implants were described. Before cryopreservation, the patient underwent two left ovarian surgeries for enucleation cysts 8â\u80\u89years after righ salpingo-oophorectomy for struma-ovarii. Ovarian biopsy was collected in another hospital and transported to our laboratory for cryopreservation. The patient was submitted to radioiodine-therapy for metastases from malignant struma-ovarii. After treatment she experienced premature ovarian failure. Ten years after cryopreservation, a first orthotopic transplantation was performed in the left ovary and in a peritoneal pocket. Before transplantation, ovarian samples were analyzed to assess neoplastic contamination and tissue quality. Three years later, a second transplantation was heterotopically performed in abdominal subcutaneous sites. The analysis on thawed ovarian tissue did not reveal micrometastasis and they showed follicle and stroma damages. After transplantation few small follicles were observed at ultrasound examination and hormonal levels remained at menopausal values. To date no ovarian function recovery has been observed. The report highlights that ovarian tissue cryopreservation after multiple ovarian surgery may have some limitations. An accurate counseling should be offered to patients who wish to preserve fertility
Sonographic Assessment of Uterine Biometry for the Diagnosis of Diffuse Adenomyosis in a Tertiary Outpatient Clinic
Background: to compare several uterine biometric parameters at transvaginal ultrasound (TVUS) between adenomyosis and non-adenomyosis uteri and evaluate their role for the diagnosis of diffuse adenomyosis. Methods: prospective observational study conducted between the 1 February 2022 and the 30 April 2022. In this case, 56 patients with TVUS diagnosis of adenomyosis were included. A 1:1 ratio age and parity-matched group of non-adenomyosis patients was selected. We compared sonographic uterine biometric parameters (longitudinal (LD), anteroposterior (APD) and transverse (TD) diameters, volume, simple and complex diameter ratios) and investigated their diagnostic performance. Results: all sonographic parameters were significantly different between the study groups, except for TD/(LD+APD). Optimal cut-off values of APD and LD/APD showed the best sensitivity and specificity. APD diameter equal or superior to 39.5 mm (95% CI, 36.2-42.8) had sensitivity of 0.70 (95% CI, 0.57-0.80), specificity of 0.71 (95% CI, 0.59-0.82) and accuracy of 0.75 (95% CI, 0.66-0.84). LD/APD equal or inferior to 2.05 (95% CI, 1.96-2.13) showed sensitivity and specificity of 0.70 (95% CI, 0.57-0.80) each and accuracy of 0.72 (95% CI, 0.62-0.81). Conclusions: several biometric uterine parameters at TVUS in fertile-aged women were statistically different between adenomyosis and non-adenomyosis uteri, though their optimal cut-off values showed low accuracy in diagnosing adenomyosis
Transvaginal and transperineal ultrasound follow-up after laparoscopic correction of uterine retrodisplacement in women with posterior deep infiltrating endometriosis
Retrodisplacement of the uterus (retroflexion and/or retroversion) may be associated with pelvic pain symptoms and posterior deep infiltrating endometriosis (DIE). Previous studies in symptomatic women with retrodisplacement of the uterus showed the efficacy of hysteropexy in terms of pain symptoms improvement