Aktuelle Möglichkeiten der konventionellen langsamen Kryokonservierung sowie der Vitrifikation von humanem Ovarialgewebe

Zusammenfassung

Die konventionelle langsame Kryokonservierung oder die Vitrifikation von humanem Ovarialgewebe zum Erhalt der Fertilität oder späteren Vermeidung einer Hormonsubstitution besitzen angesichts des verbesserten Langzeitüberlebens nach malignen Erkrankungen eine zunehmende Bedeutung. Wir wissen heute, dass sowohl nach konventioneller Kryokonservierung als auch nach Vitrifikation mit großer Wahrscheinlichkeit vitales Gewebe erhalten bleibt. Unklar bleibt aber weiterhin die optimale Verwendung des Gewebes. Die Autotransplantation führte bisher lediglich zu einer passageren Follikelreifung bzw. Hormonsynthese.

Weitere klinische Studien an einer größeren Patientenzahl sind erforderlich, um die Langlebigkeit der Transplantate, die längerfristige Hormonsynthese und Follikelreifung, die Möglichkeit und den Verlauf von Schwangerschaften sowie die Sicherheit der Autotransplantation bei malignen Erkrankungen zu evaluieren. Unabhängig davon könnte sich auch bei humanem Ovarialgewebe die Vitrifikation zu einer zeit- und kostensparenden Alternative entwickeln. Derzeit sind die Untersuchungen zur konventionellen langsamen Kryokonservierung weiter fortgeschritten als die zur Vitrifikation.

Unter der Voraussetzung, dass die Patientinnen kritisch über die aktuellen Möglichkeiten und Probleme der Methoden aufgeklärt sind, ist zum jetzigen Zeitpunkt eine konventionelle langsame Kryokonservierung von humanem Ovarialgewebe gerechtfertigt.

Abstract

Improved survival after gynecologic and other malignancies is making techniques to preserve ovarian tissue for future hormone production and fertility increasingly important. Human ovarian tissue can be preserved with both slow cryopreservation and vitrification. However, to date autotransplantation of ovarian tissue has resulted in only temporary follicle maturation or hormone synthesis. Ongoing research is aiming to improve the longevity of transplants and to evaluate the possibility and outcome of pregnancy after autotransplantation in patients after cancer. While vitrification has the future potential to save time and money, studies on slow cryopreservation are further advanced at this point and with appropriate informed consent slow cryopreservation is justified for selected women.

Humanes Ovarialgewebe - Kryokonservierung - Vitrifikation

Human ovarian tissue - cryopreservation - vitrification

Literatur

• 1 Apperley J F, Reddy N. Mechanism and management of treatment related gonadal failure in recipients of high dose chemoradiotherapy.  Blood Rev. 1995;  9 93-116
• 2 Grovas A, Fremgen A, Rauck A, Ruymann F B, Hutchinson C L, Winchester D P, Menck H R. The National Cancer Data Base report on patterns of childhood cancers in the United States.  Cancer. 1997;  80 2321-2332
• 3 Boring C C, Squires T S, Tong T, Montgomery S. Cancer statistics, 1994.  CA Cancer J Clin. 1994;  44 7-26
• 4 Blatt J. Pregnancy outcome in long-term survivors of childhood cancer.  Med Pediatr Oncol. 1999;  33 29-33
• 5 Baker T G. Radiosensitivity of mammalian oocytes with particular reference to the human female.  Am J Obstet Gynecol. 1971;  110 746-761
• 6 Chapman R M, Sutcliffe S B, Malpas J S. Cytotoxic-induced ovarian failure in women with Hodgkin's disease. I. Hormone function.  J Am Med Assoc. 1979;  242 1877-1881
• 7 Meister L A, Meadows A T. Late effects of childhood cancer therapy.  Curr Probl Pediatr. 1993;  23 102-131
• 8 Posada M N, Kolp L, Garcia J E. Fertility options for female cancer patients: facts and fiction.  Fertil Steril. 2001;  75 647-653
• 9 Shalet S M. Effects of cancer therapy on gonadal function of patients.  Cancer Treat Rev. 1980;  7 141-152
• 10 Byrne J, Fears T R, Gail M H, Pee D, Connelly R R, Austin D F, Holmes G F, Holmes F F, Latourette H B, Meigs J W, Strong L C, Myers M H, Mulvihill J J. Early menopause in long-term survivors of cancer during adolescence.  Am J Obstet Gynecol. 1992;  166 788-793
• 11 Bath L E, Critchley H OD, Chambers S E, Anderson R A, Kelnar C JH, Wallace W HB. Ovarian and uterine characteristics after total body irradiation in childhood and adolescence: response to sex steroid replacement.  Brit J Obstet Gynaecol. 1999;  106 1265-1272
• 12 Meirow D. Ovarian injury and modern options to preserve fertility in female cancer patients treated with high dose radio-chemotherapy for hemato-oncological neoplasias and other cancers.  Leuk Lymphoma. 1999;  33 65-76
• 13 Gosden R G, Kim S S, Mathews S J. Frozen banking of follicles. Jansen R, Mortimer D Towards Reproductive Certainty. New York; Parthenon 1999
• 14 Lightman A, Werner-Kimel N, Solt I, Filmer S, Deutch M, Itskovitz-Eldor J. A program of ovarian tissue cryopreservation for women with malignant disease: lessons from 5 years' experience.  Fertil Steril. 2001;  76 (Suppl 1) 81
• 15 Aubard Y, Piver P, Pech J C, Galinat S, Teissier M P. Ovarian tissue cryopreservation and gynecologic oncology: a review.  Eur J Obstet Gynecol Reprod Biol. 2001;  97 5-14
• 16 Oktay K, Karlikaya G. Ovarian function after transplantation of frozen, banked autologous ovarian tissue.  N Engl J Med. 2000;  342 1919
• 17 Oktay K, Economos K, Kan M, Rucinski J, Veeck L, Rosenwaks Z. Endocrine function and oocyte retrieval after autologous transplantation of ovarian cortical strips to the forearm.  J Am Med Assoc. 2001;  286 1490-1493
• 18 Van Uem J F, Siebzehnrübl E R, Schuh B, Koch R, Trotnow S, Lang N. Birth after cryopreservation of unfertilized oocytes.  Lancet. 1987;  1 752-753
• 19 Porcu E, Fabbri R, Seracchioli R, Ciotti P M, Magrini O, Flamigni C. Birth of a healthy female after intracytoplasmic sperm injection of cryopreserved human oocytes.  Fertil Steril. 1997;  68 724-730
• 20 Nawroth F, Kissing K. Pregnancy after intracytoplasmatic sperm injection (ICSI) of cryopreserved human oocytes.  Acta Obstet Gynecol Scand. 1998;  77 462-463
• 21 Würfel W, Schleyer M, Krüsmann G, Fiedler K. Zur Fertilisation kryokonservierter humaner Oozyten (Kryo-Oo) durch intrazytoplasmatische Injektion von Spermatozoen (ICSI).  Geburtsh Frauenheilk. 2000;  60 450-455
• 22 Ludwig M, Al-Hasani S, Felberbaum R, Diedrich K. New aspects of cryopreservation of oocytes and embryos in assisted reproduction and future perspectives.  Hum Reprod. 1999;  14 (Suppl 1) 162-185
• 23 Schuth W, Keck C. Die ideale reproduktionsmedizinische Behandlung - aus der Sicht der Betroffenen.  Geburtsh Frauenheilk. 2001;  61 476-482
• 24 Meirow D, Fasouliotis S J, Nugent D, Schenker J G, Gosden R G, Rutherford A J. Laparoscopic technique for obtaining ovarian cortical biopsy specimens for fertility conservation in patients with cancer.  Fertil Steril. 1999;  71 948-951
• 25 Kim S S, Battaglia D, Soules M, Gosden R G. Quantitative assessment of tissue damage in ovarian cortical slices prior to transplantation.  Fertil Steril. 2001;  76 (Suppl 1) 81
• 26 Cortvrindt R, Smitz J. Fluorescent probes allow rapid and precise recording of follicle density and staging in human ovarian cortical biopsy samples.  Fertil Steril. 2001;  75 588-593
• 27 Gosden R G, Telfer E, Faddy M J, Brook D J. Ovarian cyclicity and follicular recruitment in unilaterally ovariectomized mice.  J Reprod Fertil. 1989;  87 257-264
• 28 Van den Broecke R, Van der Elst J, Liu J, Hovatta O, Dhont M. The female-to-male transsexual patient: a source of human ovarian cortical tissue for experimental use.  Hum Reprod. 2001;  16 145-147
• 29 Poirot C, Vacher-Lavenu M C, Helardot P, Guibert J, Brugieres L, Jouannet P. Human ovarian tissue cryopreservation: indications and feasibility.  Hum Reprod. 2002;  17 1447-1452
• 30 Kim S S, Battaglia D E, Soules M R. The future of human ovarian cryopreservation and transplantation: fertility and beyond.  Fertil Steril. 2001;  75 1049-1056
• 31 Rahimi G, Isachenko E, Sauer H, Wartenberg M, Isachenko V, Hescheler J, Mallmann P, Nawroth F. Measurement of apoptosis in long-term cultures of human ovarian tissue.  Reproduction. 2001;  122 657-663
• 32 Mazur P. Kinetics of water loss from cells at subzero temperatures and the likelihood of intracellular freezing.  J Gen Physiol. 1963;  47 347-369
• 33 Farrant J. Mechanisms of injury and protection in living cells and tissues at low temperatures. Smith AU Current Trends in Cryobiology. New York; Plenum 1970
• 34 Farrant J. Water transport and cell survival in cryobiological procedures.  Philos Trans R Soc London B. 1977;  278 291-306
• 35 Franks F. The properties of aqueous solutions at subzero temperatures. Franks F Water and Aqueous Solutions at Subzero Temperatures. New York; Plenum 1982
• 36 Mazur P. The role of intracellular freezing in the death of cells cooled at supraoptimal rates.  Cryobiology. 1977;  14 251-272
• 37 Muldrew K, McGann L E. The osmotic rupture hypothesis of intracellular freezing injury.  Biophys J. 1994;  66 532-541
• 38 Rapatz G, Nath J, Luyet B. Electron microscope study of erythrocytes in rapidly frozen mammalian blood.  Biodynamica. 1963;  9 83-94
• 39 Steponkus P L, Wiest S C. Freeze-thaw induced lesions in the plasma membrane. Lyons JM, Graham DG, Raison JK Low Temperature Stress in Crop Plants: The Role of the Membrane. New York; Academic Press 1979
• 40 Stowell R E, Young D E, Arnold E A, Trump B F. Structural, chemical and functional alterations in mammalian nucleus following different conditions of freezing, storage and thawing.  FASEB Fed Proc. 1965;  24 (Suppl 15) 115-141
• 41 Trump B F, Young D E, Arnold E A, Stowell R E. Effects of freezing and thawing on the structure, chemical constitution and function of cytoplasmic structures.  FASEB Fed Proc. 1965;  24 (Suppl 15) 144-167
• 42 Whittingham D G, Leibo S P, Mazur P. Survival of mouse embryos frozen to - 196° and - 269 °C.  Science. 1972;  178 411-414
• 43 Whittingham D G. Fertilization in vitro and development to term of unfertilized mouse oocytes previously stored at - 196 °C.  J Reprod Fertil. 1977;  49 89-94
• 44 Karlsson J OM, Eroglu A, Toth T L, Cravalho E G, Toner M. Fertilization and development of mouse oocytes cryopreserved using a theoretically optimized protocol.  Hum Reprod. 1996;  11 1296-1305
• 45 Mazur P, Leibo S P, Chu E HY. A two-factor hypothesis of freezing injury.  Exp Cell Res. 1972;  71 345-351
• 46 Mazur P, Rall W F, Leibo S P. Kinetics of water loss and the likelihood of intracellular freezing in mouse ova: Influence of the method of calculating the temperature dependence of water permeability.  Cell Biophys. 1984;  6 197-214
• 47 Pegg D E. The current status of tissue cryopreservation.  CryoLetters. 2001;  22 105-114
• 48 Mazur P. Equilibrium, quasi-equilibrium, and non-equilibrium freezing of mammalian embryos.  Cell Biophys. 1990;  17 53-92
• 49 Mazur P. Cryobiology: the freezing of biological systems.  Science. 1970;  168 939-949
• 50 Pegg D E, Jacobsen I A, Armitage W J, Taylor M J. Mechanisms of cryoinjury in organs. Pegg DE, Jacobsen IA Organ Preservation 2. Edinburgh; Churchill Livingstone 1979
• 51 Gosden R G, Baird D T, Wade J C, Webb R. Restoration of fertility to oophorectomized sheep by ovarian autografts stored at - 196 °C.  Hum Reprod. 1994;  9 597-603
• 52 Candy C, Wood M, Whittingham D. Follicular development in cryopreserved marmoset ovarian tissue after transplantation.  Hum Reprod. 1995;  10 2334-2338
• 53 Gunasena K T, Lakey J RT, Villines P M, Bush M, Raath C, Critser E S, McGann L E, Critser J K. Antral follicles develop in xenografted cryopreserved african elephant (Loxodonta africana) ovarian tissue.  Anim Reprod Sci. 1998;  53 265-275
• 54 Shaw J, Wood E, Trounson A. Transplantation and cryopreservation of ovarian tissue. Trounson AO, Gardner D Handbook of In Vitro Fertilization. London; CRC press 1999
• 55 Paynter S J, Cooper A, Fuller B J, Shaw R W. Cryopreservation of bovine ovarian tissue: structural normality of follicles after thawing and culture in vitro.  Cryobiology. 1999;  38 301-309
• 56 Newton H, Aubard Y, Rutherford A, Sharma V, Gosden R. Low temperature storage and grafting of human ovarian tissue.  Hum Reprod. 1996;  11 1487-1491
• 57 Newton H, Fisher J, Arnold J RP, Pegg D E, Faddy M J, Gosden R G. Permeation of human ovarian tissue with cryoprotective agents in preparation for cryopreservation.  Hum Reprod. 1998;  13 376-380
• 58 Gosden R, Newton H, Kim S S. The cryopreservation of human ovarian tissue. Kempers RD, Cohen J, Haney AF, Younger JB Fertility and Reproductive Medicine. Proceedings of the XVI. World Congress on Fertility and Sterility. Amsterdam; Elsevier Science 1998
• 59 Wang X, Chen H, Yin H, Kim S S, Lin Tan S, Gosden R G. Fertility after intact ovary transplantation.  Nature. 2002;  415 385
• 60 Weissmann A, Gotlieb L, Colgan T, Jurisicova A, Greenblatt E M, Casper E F. Preliminary experience with subcutaneous human ovarian cortex transplantation in the NOD-SCID mouse.  Biol Reprod. 1999;  60 1462-1467
• 61 Radford J A, Lieberman B A, Brison D R, Smith A R, Critchlow J D, Russell S A, Watson A J, Clayton J A, Harris M, Gosden R G, Shalet S M. Orthotopic reimplantation of cryopreserved ovarian cortical strips after high-dose chemotherapy for Hodgkin's lymphoma.  Lancet. 2001;  357 1172-1175
• 62 Oktay K, Aydin B A, Karlikaya G. A technique of laparoscopic transplantation of frozen-banked ovarian tissue.  Fertil Steril. 2001;  75 1212-1216
• 63 Nugent D, Newton H, Gallivan L, Gosden R G. Protective effect of vitamin E on ischaemia-reperfusion injury in ovarian grafts.  J Reprod Fertil. 1998;  114 341-346
• 64 Fahy G M, MacFarlane D R, Angell C A, Meryman H T. Vitrification as an approach to cryopreservation.  Cryobiology. 1984;  21 407-426
• 65 Arav A, Zeron Y. Vitrification of bovine oocytes using modified minimum drop size technique (MDS) is effected by the composition and concentration of the vitrification solution and by the cooling conditions.  Theriogenology. 1997;  47 341
• 66 Martino A, Songsasen N, Leibo S P. Development into blastocysts of bovine oocytes cryopreserved by ultra-rapid cooling.  Biol Reprod. 1996;  54 1059-1069
• 67 Vajta G, Booth P J, Holm P, Greve T, Callesen H. Successful vitrification of early stage bovine in vitro produced embryos with the open pulled straw (OPS) method.  CryoLetters. 1997;  18 191-195
• 68 Rall W F. Factors affecting survival of mouse embryos cryopreserved by vitrification.  Cryobiology. 1987;  24 387-402
• 69 Liebermann J, Nawroth F, Isachenko V, Isachenko E, Rahimi G, Tucker M J. Potential importance of vitrification in reproductive medicine.  Biol Reprod. 2002;  67 1671-1680
• 70 Lee K A, Lee S H, Yoon S J, Choi D H, Yoon T K, Cha K Y. Resumption of the human primordial follicle growth in xenografts after vitrification of the ovarian tissues.  Fertil Steril. 2000;  74 (Suppl 1) 214
• 71 Zhang J, Liu J, Xu K P, Liu B, DiMattina M. Extracorporal development and ultrarapid freezing of human fetal ova.  J Assist Reprod Genet. 1995;  12 361-368
• 72 Lee S H, Shin C S, Ko J J, Lee H C, Park C, Lee K A. In vitro culture of the human adult ovarian tissues after vitrification: comparison among detection methods of the culture effect.  Fertil Steril. 2000;  74 (Suppl 1) 161
• 73 Isachenko V, Isachenko E, Rahimi G, Krivokharchenko A, Alabart J L, Nawroth F. Cryopreservation of human ovarian tissue by direct plunging into liquid nitrogen: negative effects of disaccharides in vitrification solution.  CryoLetters. 2002;  23 333-344
• 74 Isachenko E, Isachenko V, Rahimi G, Nawroth F. Cryopreservation of human ovarian tissue by direct plunging into liquid nitrogen.  Eur J Obstet Gynecol Reprod Biol. 2003;  108 187-194
• 75 Shaw J M, Bowles J, Koopman P, Wood E C, Trounson A O. Fresh and cryopreserved ovarian tissue samples from donors with lymphoma transmit the cancer to graft recipients.  Hum Reprod. 1996;  11 1668-1673
• 76 Meirow D, Yehuda D B, Prus D, Poliack A, Schenker J G, Rachmilewitz E A, Lewin A. Ovarian tissue banking in patients with Hodgkin's disease: is it safe?.  Fertil Steril. 1998;  69 996-998
• 77 Kurokawa T, Kinoshita T, Ito T, Saito H, Hotta T. Detection of minimal residual disease B cell lymphoma by PCR mediated RNase protection assay.  Leukemia. 1996;  10 1222-1231
• 78 Gosden R G, Rutherford A, Norfolk D R. Transmission of malignant cells in ovarian grafts.  Hum Reprod. 1997;  12 403
• 79 Shaw J, Trounson A. Oncological implications in the replacement of ovarian tissue.  Hum Reprod. 1997;  12 403-405
• 80 Oktay K, Buyuk E. The potential of ovarian tissue transplant to preserve fertility.  Expert Opin Biol Ther. 2002;  2 361-370
• 81 Oktay K H, Yih M. Preliminary experience with orthotopic and heterotopic transplantation of ovarian cortical strips.  Semin Reprod Med. 2002;  20 63-74