演題抄録

International Symposium

開催概要
開催回
第53回・2015年・京都
 

Evaluation of ovarian tissue cryopreservation and transplantation based on Edinburgh Selection Criteria

演題番号 : IS1-2

[筆頭演者]
Wallace Hamish:1 

1:Department of Pediatric Oncology, University of Edinburgh, UK

 

Ovarian tissue cryopreservation with later reimplantation has been shown to preserve fertility in adult women, but this approach remains unproven in children and adolescents. We aimed to assess the use of the Edinburgh selection criteria for ovarian tissue cryopreservation in girls and young women with cance.
Cryopreservation of ovarian tissue has been selectively offered to girls and young women with cancer who met the Edinburgh selection criteria since 1996. 410 female patients younger than 18 years at diagnosis were treated for cancer (including leukaemia and brain tumours) at the Edinburgh Children's Cancer Centre over the study period. We determined the ovarian status of these patients and classified them as having POI or not
34 (8%) of the 410 patients met the Edinburgh selection criteria and were offered ovarian tissue cryopreservation before starting cancer treatment. 13 patients declined the procedure and the procedure was completed successfully in 20 patients. Median age at the time of follow-up for the 20 assessable patients was 16·9 years (IQR 15·5-21·8). Of the 14 assessable patients who had successfully undergone ovarian cryopreservation, six had developed POI at a median age of 13·4 years (IQR 12·5-14·6). Of the six assessable patients who had declined the procedure, one had developed POI. Assessment of ovarian function was possible for 141 of the 376 patients who were not offered cryopreservation; one of these patients had developed POI. The cumulative probability of developing POI after treatment was completed was significantly higher for patients who met the criteria for ovarian tissue cryopreservation than for those who did not (15-year probability 35% [95% CI 10-53] vs 1% [0-2]; p<0·0001; hazard ratio 56·8 [95% CI 6·2-521·6] at 10 years).
We have shown that the Edinburgh selection criteria accurately identify the girls and young women who will develop POI, and validate their use for selection of patients for ovarian tissue cryopreservation.

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