Ovarian cortex transplantation.
Fiche publication
Date publication
décembre 2019
Journal
Journal of minimally invasive gynecology
Auteurs
Membres identifiés du Cancéropôle Est :
Dr TELETIN Marius
Tous les auteurs :
Pellerin M, Garbin O, Teletin M, Lecointre L, Akladios C, Pirrello O
Lien Pubmed
Résumé
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.
Référence
J Minim Invasive Gynecol. 2019 Dec 12;: