Current achievements and future research directions in ovarian tissue culture, in vitro follicle development and transplantation: Implications for fertility preservation

II Smitz, M. M. Dolmans, J. Donnez, J. E. Fortune, O. Hovatta, K. Jewgenow, H. M. Picton, C. Plancha, L. D. Shea, R. L. Stouffer, E. E. Telfer, T. K. Woodruff, M. B. Zelinski

Research output: Contribution to journalReview articlepeer-review

225 Scopus citations

Abstract

Background: Female cancer patients are offered 'banking' of gametes before starting fertility-threatening cancer therapy. Transplants of fresh and frozen ovarian tissue between healthy fertile and infertile women have demonstrated the utility of the tissue banked for restoration of endocrine and fertility function. Additional methods, like follicle culture and isolated follicle transplantation, are in development. methods: Specialist reproductive medicine scientists and clinicians with complementary expertise in ovarian tissue culture and transplantation presented relevant published literature in their field of expertise and also unpublished promising data for discussion. As the major aims were to identify the current gaps prohibiting advancement, to share technical experience and to orient new research, contributors were allowed to provide their opinioned expert views on future research. results: Normal healthy children have been born in cancer survivors after orthotopic transplantation of their cryopreserved ovarian tissue. Longevity of the graft might be optimized by using new vitrification techniques and by promoting rapid revascularization of the graft. For the in vitro culture of follicles, a successive battery of culture methods including the use of defined media, growth factors and three-dimensional extracellular matrix support might overcome growth arrest of the follicles. Molecular methods and immunoassay can evaluate stage of maturation and guide adequate differentiation. Large animals, including non-human primates, are essential working models. conclusions: Experiments on ovarian tissue from non-human primate models and from consenting fertile and infertile patients benefit from a multidisciplinary approach. The new discipline of oncofertility requires professionalization, multidisciplinarity and mobilization of funding for basic and translational research.

Original languageEnglish (US)
Article numberdmp056
Pages (from-to)395-414
Number of pages20
JournalHuman Reproduction Update
Volume16
Issue number4
DOIs
StatePublished - Feb 1 2010
Externally publishedYes

Keywords

  • Fertility preservation
  • Follicle
  • Oocyte
  • Tissue culture
  • Transplantation

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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