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#437 A method for safe ovarian tissue transplantation after neoplasia
  1. Christina Goudeli1,
  2. Demetrios Vassilakos2,
  3. Theofani Gavressea3,
  4. Vasileios Athanasiou4,
  5. Maria Sakellariou4 and
  6. Emmanouil Terzakis1
  1. 1Institouto Gynaikologias, Athens, Greece
  2. 2Mikroskopisi lab, Athens, Greece
  3. 3Iaso General Clinic, Athens, Greece
  4. 4IVF Athens Clinic, Athens, Greece


Introduction/Background In this case we suggest an alternative method to the time-consuming and invasive method of the xenograft implantation (ovarian tissue) to nude-mice. We herein report a nulliparous 36 years- old woman ovariectomized due to borderline ovarian tumors in right (52X30mm) and left (83X53mm) ovary (Ca125=79,6).

Methodology She underwent bilateral salpingo-oophorectomy, omentectomy, sentinel lymph node dissection and appendicectomy. According to the pre-surgical consent we retrieved a piece of ovarian cortex from a macroscopically healthy portion of the left ovary. In the IVF lab the biologist cut it in 18 microsamples 2by2mm and kept them in 4 vials following slow-freezing protocol. After eight months one vial with 9 slices was thawed rapidly, 3 were directly embedded in paraffin for immunohistochemical analysis, 3 were placed in 2D culture and 3 were placed in 3D culture conditions.

Results No malignant cell was observed and microscopically the slice concerned part of ovarian cortex with stroma including one oocyte. One year after uneventful follow-up we thawed 2 vials giving 1 of 8 slices for frozen section (negative).We took abdominal wash cytology (negative) and created a left lateral peritoneal pocket inducing a graft of Surgicel with the ovary-slices with no sutures. Three months later we noticed the first endocrine restoration (pre-op E2<5 and then E2=54) and five months post-op her menstrual period came. The patient is disease-free 3 years now.

Conclusion In vitro cyto-culture is a new approach to control the ovarian tissue re-implanted in cancer survivors. Until now there are no clinicopathological findings to contraindicate stimulation and proceed to IVF.

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