In Vitro Activation of Follicles and Fresh Tissue Auto-transplantation in Primary ovarian insufficiency Patients.

In Vitro Activation of Follicles and Fresh Tissue Auto-transplantation in Primary ovarian insufficiency Patients.

J Clin Endocrinol Metab. 2016 Aug 29;:jc20161589

Authors: Zhai J, Yao G, Dong F, Bu Z, Cheng Y, Sato Y, Hu L, Zhang Y, Wang J, Dai S, Li J, Sun J, Hsueh AJ, Kawamura K, Sun Y

Abstract
CONTEXT: Recently, two Primary ovarian insufficiency (POI) patients delivered healthy babies after IVA (In Vitro Activation) treatment followed by auto-transplantation of frozen-thawed ovarian tissues.
OBJECTIVE: To report the first case of live birth after IVA treatment following fresh ovarian tissue grafting in POI patients, together with monitoring of follicle development and serum hormonal changes.
DESIGN: Prospective observational cohort study.
SETTING: We performed IVA treatment in 14 POI patients with mean age of 29 years, mean duration since last menses of 3.8 years, and average basal FSH level of 94.5 mIU/mL.
INTERVENTIONS: Prior to IVA treatment, all patients received routine hormonal treatments with no follicle development. We removed one ovary from POI patients and treated them with Akt stimulators. We improved upon early procedures by grafting back fresh tissues using a simplified protocol.
MAIN OUTCOME MEASURES: In six of the 14 patients (43%), a total of 15 follicle development waves were detected, and 4 patients had successful oocyte retrieval to yield 6 oocytes. For 2 patients showing no spontaneous follicle growth, HMG treatment induced follicle growth at 6-8 months after grafting. After IVF of oocyte retrieved, 4 early embryos were derived. Following embryo transfer, one patient became pregnant and delivered a healthy baby boy, with three other embryos under cryopreservation.
CONCLUSION: IVA technology can effectively activate residual follicles in some POI patients and allow them to conceive their own genetic offspring. IVA may also be useful for treating patients with ovarian dysfunction including aging women and cancer survivors.

PMID: 27571179 [PubMed - as supplied by publisher]

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